Lecture 6: Diseases of Cardiovascular System Flashcards
Structure of CV system
composed of
1) pulmonary circulation
2) systemic circulation
Pericardium
fibrous covering of heart
endocardium
innermost layer of heart, most susceptible for microbial infection
*blood supposed to be sterile with no microbiota
lymphatic system function
absorbs, transports, filsters lymph and initiates immune response
lymphatic system points(2)
- 4L fluid a day leaks from capillaries into tissue and is reabsorbed by lymph system
- filtrate can contain pathogens which are screened by immune cells
- immune cells in nodes, tonsils, spleen, adenoids
- removal of lymph nodes causes backup and accumulation of fluid in tissues - fluid eventually drains back into blood
Speticemia
bacterial infection of bloodstream, systemic infection
-more bacteria in blood stream than can be *effectively removed by WBS
lymphangitis
infection of lymphatic system
-lymphangitis vessel infection can cause an inflammation seen as a red streak on skin
Sepsis/septic shock
can trigger state of pysiological collapse, sudden drop in blood pressure and physiological collapse due to multiple organ failure
Bacteremia
bacteria in bloodstream
Septicemia clinical signs (4)
proceeded by? risk factor? sx (3) Septic shock Most common cause (pathogen)?
- Often secondary infection preceded by respiratory or urinary tract infections
- sx on infected tissue can introduce microbes into bloostream
- change in mental status, SBP < 100 (spontaneous bacterial peritonitis), RR >22 (respiratory rate)
- Septic shock: medication to maintain SBP > 65, high lactic acid
**most commonly causes by gram + species
Chain of events leading to sepsis and septic shock
- localized infection
- Septicemia
- endo/exo toxin accumulation
- blood clotting, tissue damage, hemorrhage-> death
- complement activation, lung damage, rapid breathing ->death
- macrophage and circulating leukocytes instate inflammatory cascade -> fever, increased heart rate, vasodilation.
- septic shock -> death
infective endocarditis
3 types
- affects endocardium and heart valves
A. acute
B. subacute
C. prosthetic valve disease
acute endocarditis
5 common pathogens
4 common symptoms
can cause what?
5 common pathogens
- Staph aureus
- streptococcus pneumonia
- neisseria gonorhheae
- streptococcus progenies
- enterococcus faecalis
4 common sx
- high fever
- fast heart rate
- fatigue
- signs of infections at other sites
can cause heart failures
Subacute endocarditis
definiton
2 pathogen
underlying heart vale disease
streptococcus, haemophilus
Prosthetic endocarditis
- acute or subacute onsent
2. sugery
Peuperal fever
2 pathogens
can develop into..?
childbed fever caused by
- streptococcus pyogenies
- streptococcus agalactiae
can develop in puerperal sepsis
-infective condition in mother following childbirth, can be fatal
*strep affected CV system
Neonatal spesis
caused by 2 pathogens
caused by
- streptococcus agalactiae
- E. coli
*strep affected CV infections
Rhuematic Fever
streptococcus pyogenes
-inflammatory response to throat infection and primarily affects joint and heart
Schistosomiasis
cause damage to (3) organs
causes by several species of blood flukes (phylum schistosoma)
eggs can cause damage in liver, intestines, bladder
*worms causing schistosomiasis not found in U.S.
Trematode S. mansoni life cycle
- miracida in snails convert to cercariae, leave snail and attach to human skin
- infect the blood and mature, caring fever and chills
- major effects are due to eggs in the liver or blaster. Substantial tissue damage
- egg infection in bladder causes urine pain and bloody urine
Schistoma in US
causes minor infection, swimmer’s itch
-mild since immune system eliminated before they get into blood.
Lymphatic Filariasis
pathogen
transmisstion
MOA
causes by wuchereria bancrofti- filarial nematode
-transmitted by mosquitos
-larvae infect lymphatic system and damage vessels and glands
-after years of infestation, arms legs, and scrotum swell and distort
AKA: elephantiasis, lymphedema
Black death (3 facts, incl. organism)
black plaque
- 14th c. europe
- millions dies
- caused by yersinia pests, organism found on rats and their fleas
Yersinia Pestis
- characteristics/staining
- transmission
causes black plaque
- facultative, gram negative rod.
- stains heavily at pole of cell (bi polar staining)
- transmitted between hosts by oriental rat flea
- picked up from rodents by flea
- biofilm formed in flea gut
- flea starved and tried to bite human, transmitting infection
3 forms of plague
- bubonic
- Septicemic
- Pnuemonic
Bubonic plague
- pathogenesis
- complications
- transmission
- bacteria localize in lymph nodes, hemorrhaging can occur
- causes painful and substantial swelling (buboes)
- dark splotches on skin from bleeding “black death”
- 60 % mortality if untreated - transmitted through bite if infected flea or exposure to infected material through a break in the skin
Septicemic plague
- pathogeneis
- sx (3)
- complication
- bacilli spread to bloodstream
- high fever, diarrhea, abdominal pain
- can lead to meningitis and nearly 100% fatal if untreated
Pneumonic plague
transmitted from person to person
buboes not present
Tularemia
cause
transmission (2)
sx
tx
“rabbit fever”
caused by francisella tularensis
-common in rabbits, rodents and animals
t: via arthropod bite (ticks) or inhalation
sx from bite: swollen glands, flu-like symptoms, skin ulceration
sx from inhalation: respiratory disease, swollen nodes, coughing, pain under breastbone, not communicable among humans
tx: streptomycin or oral cirpoflaxacin or DCN
Lyme Disease overview
cause
characteristics pathogen
4 sx
-major emerging infectious disease in US
- caused by borrelia burdgorferi
- gram-negative spirochete
- usually transmitted by ticks
- sx: fever, HA, fatigue, erythema migrans rash
3 stages lyme disese
- early, localized stage
- early disseminated stage
- late stage
early stage lyme disease
sx
tx
- involves slow expanding red rash: erythema migrans at bite site
- bulls-eye rash - rash acompanied by flu like symptoms
tx: 10 days DCN
early disseminated stage of lyme disease
sx
tx
- weeks to months later
1. bacteria disseminate to skin, heart, nervous system
tx: 10 days DCN
late stage lyme disease
sx
tx
- months to years later
1. chronic arthritis, swelling in larger joins
tx: 28 days DCN
Endemic relapsing fever
2 pathogens causing
caused by borrelia hermisii and borrelia turcatae
-transmitted by ticks and rodents
louseborne (epidemic) relapsing fever
cause
sx
tx (2 kinds)
caused by borrelia recurrentis carried by body lice
- chills, fever, HA peak with high numbers of microorganisms in bloos
- tx w/o CNS involvement: DCN
- tx w/ cns involvement: penicillin or ceftrioxone
Rickettsial infections
transmission
diseases assoc. (2)
- transmitted by arthropods (ticks, lice, fleas)
- usually hard ticks/dog ticks
- painless bite
- 8-10 hrs for tick to transmit infection to host - Diseases Associated
A. rocky mountain spotted fever (RMSF)
B. spotted fever rickettsiosis (SFR)
Rickettsisae
- small, gram (-) obligate intracellular parasites
Rickettsial infections
sx
tx
- classic sx: fever, HA, skin rash reflecting damage to small blood vessles
- malaise, myalgias, arthralgia, - the rash progresses to a macropapular rash in 90% patents
- begins in palm and soles of feet and spreads to trunk
tx: DCN
Ehrlichial infection
- sx
- complications
- tx
sx: similar to lyme disease, come and go more quickly
c: cause leukopenia (decreased WBC) which leads to susceptibility fo other infections
lives in leukocytes (monocytes)
tx: DCN
Human monocytes ehrlichiosis (HME)
cause by what pathogen
transmission
clinical presentation (4)
tx
caused by Ehrlichia Cheaffeensis
-transmitted by lone star tick
clinical presentation: acute febrile illness, myalgia, arthralgias, sometimes 1/3 cases result in maculopapuler rash
-sometimes confused with rocky mountain spotted fever
Drug of choice: DCN
Human Granulytic Anaplasmosios (HGA)
cause infects what cells transmitted sx dx tx
c: anaplasma phagocytophilum
g(-) bacterium
i: leukocytes- neutrophils
t: backlogged tick (same one that transmits lyme disease)
sx: similar to HME, rash is rare
dx: antibody tests distinguish from RMSF and ehrlichiosis
tx: DCN
Brucellosis
caused by what pathogens
characteristic of pathogen
serous systemic disease
p: brucella species
rx: affects people who work with large, ruminant animals
C; gram negative rod, b. abortus
Brucellosis
transmission
incubation
MOA
tx
t: infection can occur through eyes, abrasion, or consumption of contaminated dairy
i: 2-10 week incubation
bacteria transported to spleen, and lymph glands upon infection, causing flu-like symptoms
-chronic infection in one organ or systemically
tx: DCN 6 weeks, gentamicin 7-10 days
Infectious mononucleosis
pathogen
affects what organs
transmisstion
sx: special populations?
- systemic viral disease
c: epstein-barr virus
- member herpesviridae
a; affects b lymphocyte in lymph nodes and spleen
t: spread yay contact with saliva, kissing disease
- children don’t show symptoms
- adolescents or young adults who are infected may develop more severe symptoms that include fever, sore throat and enlarged nodes
EBV complications (6)
- heart problems (myocarditis)
- facial paralysis (guillan-barre)
- rupture of spleen
- Janice (hepatitis)
- Burkitt lymphona, tumor of the jaw prevalent in africa
- malaria parasite might help stimulate tumor development - t-cell malignancies, b-cell carcinoma, hodgkin disease, M.S.
aftermath EBV
dx:
vax,tv?
indefinite carrier once infected
dx: elevated lymphocyte levels
- presence of downy cells (damaged b cells)
- ab detected via mono spot test
- novax or tx
Burtkitt lymphoma
tumor of jaw, prevalent in africa
-malaria parasite might help stimulate
Cytomegalovirus overview (4 pts.)
- can produce serious birth defects
- largest member herpesviridae
- produces infectious mononucleosis-like sx
- can pass to fetus to cause mental impairment
CMV
member of TORCH microbes that cross placenta to cause severe congenital defects
TORCH
microbes that cross placenta to cause severe birth defects
TORCH pathogens
- Toxoplasma
- Rubells
- Cytomeglavirus
- Herpes simplex II
- Other- coxsackievirus, syphillis, varicella zoster virus, HIV, parvovirus, B 19 and lsiteria
Flavivirus
causes what disease
transmission
- also calles arboviruses
- arhtropodborne - yellow fever 1st human disease assoc. with virus
t: person to person via mosquitoes
- can also infect non human primates
*severe hemorrhagic ilness
Yellow fever
sx
prevention
sx: abrupt HA, fever, muscle pain
* most patients recover after symptoms abate in 3-5 days
lines can re-appear as: nausea, hiccups, black vomit, jaundice, derlium, hemorrhaging of gums/mouth/nose, 50% of patients enter a coma and die from internal hemmorghaging
*2 vaccines, no therapuetic drugs
Dengue virus Overview (4)
Dengue fever occurs in 4 types
- serotypes: DEN-1 -> DEN-4
- recovery from one types does not confer immunity to others
- transmitted by 2 species of mosquitos
- 2.5% mortality, 20% if left untreated
Dengue fever
sx
complications
sx; high fever, HA, prostration, muscle pain, maculopapular rash, scar pains and sensations
c: unusual, unless of the the 3 other types enter body later
- hemmorrhagic fever: rash from skin hemorrhages appear-> severe vomiting,sschok, decreases BP
Lassa fever
where does it occur in world
transmission
sx
tx
- occurs in w. Africa
t: rodents that cary- humans in contact with urine or droppings
sx: fever, exhaustion, patchy blood-filled lesions on throat
*fever can last weeks
-internal hemorrhaging common
-
tx: ribarvirin effective
Ebola hemorrhaic fever (EHS)
reservoir
transmission
MOA
sx
filoviridiae family member
50-90% mortality
- zoonitc, fruit bats possible recevoir
t: with contact of blood or secretions from infected person or contaminated objects
M: damages endothelial cells, causing massive internal bleeding and hemorrhaging
sx: fever, HA, joint/muscle pain, weakness, n/v/d, sometimes visible bleeding but can be internal
CV effects COVID-19
- ind. w pre-excisting CV disease at increased with for morbid and mortal complications due to COVID-19
- hypertension and coronary artery disease - clinical: asymptomatic heart disease, ECG, imaging or lab findings, myocardial infarction, heart failure, pulmonary or venous clot (thromboembolismO
Systemic protozoal Disease
what parasite
causes what diseases
speciel population
- plasmodium parasite infects blood
malaria affects 300-500 people
- trans. by infected mosquitoes
- control mosquito population can help
children most susceptible
4 species plasmodium that cause malaria
- p. vivax
- p. ovale
- p. malariae
- p. falciparum
pathogenesis malaria
- enter host
- go to liver, undergo transformation into merozoites
- merozites from to RBCs
- thousands RBCs disrupted, merozoites emerge causing cycles of fevers and chills. some merozoites eventually develop into gametocytes that continue in cycle
- anopheles mosquito bites infected individual and aq. plasmodium
Malaria complications
tx
RBC become infected and lyse, producing more parasites and toxins.
death can occur due to lack of RBCs or clustering in small vessel, causing clots
tx: chloroquin or artemisinin-based (if resistant)
Babesiosis
contracted where in world
transmission
complications in host
parasitic diseases contracted in northeaster US
- malaria-like disease
- caused by babes microti
- transmitted by ticks
parasite invades RBC:
-anemia, HA, meningitis
Tyrpanosomiasis
what 2 diseases?
transmission?
moa?
name for diseases caused by tyrypanosoma
- african sleeping sickness
- Chagas disease
- caused by t. Cruzi
- transmitted by reduviid bug (insecT)
- infected feces contaminate and tier sites where buds bite host
- 20-30% individuals develop chronic disease that develops 10-3 years after infection
- damaes intestinal tract, cardia nerves (sudden heart failure)
Epidemic Typhus
pathogen
transmission
sx
caused by rickettsia prowazekii
t: feces of body lice (not head lice) that flourish when sanitation and hygiene is poor
sx: maculopapular rash starts on trunk and progresses to extremities
- high fever, hallucinations, delerium
- permamnet damage to blood vessels, heart, kidney, lungs
Brill-Zinsser disease
appears to be a relapse of epidemic typhus
Endemic typhus
pathogen
transmission
sx
(mexican typhus, murine typhus)
cause by rickettsia typhus
- carried by oriental rat fleas
sx: fever, HA, maculopapular rash spreading from trunks to limbs
SBP
Spontaneous Bacterial Peritonitis
infection of ascitic fluid in the absence of any intra-abdominal, surgically treatable source of infection
