M5 PART 9 Flashcards

1
Q
  • Long, slender, helically coiled, spiral, or corkscrew-shaped bacilli.
  • Has an outer sheath or glycosaminoglycan coating
  • Outer membrane which has peptidoglycan
  • Endoflagella (axial filaments) for corkscrew-like motility
  • An inner cytoplasmic membrane
  • A series of cytoplasmic tubules (body fibrils)
A

SPIROCHETES

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2
Q

SPIROCHETES

shape

A

helically coiled
spiral
corkscrew-shaped

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3
Q

SPIROCHETES

has an outher sheath or ____

A

glycosaminoglycan coating

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4
Q

SPIROCHETES

outer membrane has ____

A

peptidoglycan

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5
Q

SPIROCHETES

endoflagella for ____ motility

A

corkscrew-like motility

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6
Q
  • Slender spirals measuring about 0.2 µm in width and 5-15 um in length
  • They are not readily seen using an ordinary compound microscope
  • Stained by a silver impregnation method
  • Cannot be cultivated using artificial media
  • Rapidly immobilized and killed by trivalent arsenical, mercury, and bismuth
  • Cardiolipin is an important component of the treponemal antigens
  • Prepared using the modified Steiner silver stain method
A

TREPONEMA PALLIDUM

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7
Q

TREPONEMA PALLIDUM

Stained by a ____

A

SILVER IMPREGNATION MEETHOD

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8
Q

TREPONEMA PALLIDUM

Rapidly immobilized and killed by

A

TRIVALENT ARSENICAL
MERCURY
BISMUTH

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9
Q

TREPONEMA PALLIDUM

an important component of the treponemal antigens

A

CARDIOLIPIN

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10
Q

TREPONEMA PALLIDUM

prepared using the modified ____

A

STEINER SILVER STAIN METHOD

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11
Q

TREPONEMA PALLIDUM | SEROLOGIC TESTS

  • Detects “reagin,” a non-specific antibody-like substance released during T. pallidum infections
  • Universally used because it is rapid and inexpensive
  • Disadvantage: False-positive results can occur with many other diseases (the test is non-specific)
  • Results: (+) – develop 2 – 3 weeks after untreated infection, (-) – develop 6 – 18 months, 3 years after effective treatment
A

NONTREPONEMAL TESTS

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12
Q

TREPONEMA PALLIDUM | SEROLOGIC TESTS

mixture of IgG and IgM antibody

A

REAGIN

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13
Q

TREPONEMA PALLIDUM | SEROLOGIC TESTS

  • specific
  • Measure antibodies against T. pallidumantigens;
  • Disadvantage: expensive and complicated
  • The test remains positive for life even after the treatment is done.
A

TREPONEMAL ANTIBODY TESTS

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14
Q

TREPONEMA PALLIDUM | NONTREPONEMAL TESTS

  • antigen with cardiolipin, cholesterol, & lecithin + antibody (comes from the patient)flocculation, the antigen is made to react with an antibody with a serum or the CSF sample of the patient with the antibody to form a flocculation
  • microscopic
A

Venereal Disease Research Laboratory [VDRL]

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15
Q

TREPONEMA PALLIDUM | NONTREPONEMAL TESTS

  • macroscopic
  • flocculation, antigen has charcoal
  • modified version of the VDRL
A

Rapid Plasma Reagin [RPR]

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16
Q

TREPONEMA PALLIDUM | TREPONEMAL TESTS

most widely used; T. pallidum antigen with gelatin + antibodies → agglutination

A

T. pallidum-particle agglutination (TP-PA) test

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17
Q

TREPONEMA PALLIDUM | TREPONEMAL TESTS

  • These two methods use sheep erythrocytes or sheep blood cells
  • The RBCs are coated with treponemal antigen and they are made to react with the antibodies from the patient
A

T. pallidum hemagglutination (TPHA)
Microhemagglutination T. pallidum (MHA-TP)

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18
Q

TREPONEMA PALLIDUM | TREPONEMAL TESTS

the test uses indirect immunofluorescence to detect reactive antibodies, including killed T. pallidum and the patient’s serum

A

Fluorescent treponemal antibody absorbed (FTA-ABS)

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19
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

disease

A

syphilis

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20
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

transmission

A

sexually transmitted

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21
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

  • Presents with “hard chancre,” painless
  • Infectious
A

PRIMARY SYPHILIS

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22
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

  • Consist of a red maculopapular rash anywhere on the body (usually in palm & soles)
  • Moist, pale papules in the anogenital region, axillae, and mouth (condylomata lata)
  • Low grade fever and general malaise accompanied
  • Infectious
  • There are only few diseases that can present as rashes on the palm and soles
A

SECONDARY SYPHILIS

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23
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

  • can last for 1 – 2 years;
  • symptoms of secondary syphilis can reappear
  • noninfectious
A

EARLY LATENT PERIOD

24
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

  • can last for many years;
  • no symptoms occur
A

LATE LATENT PERIOD

25
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

  • Development of granulomatous lesions (gummas) in the skin, bones, and liver
  • Complications: neurosyphilis, cardiovascular syphilis, ocular syphilis, congenital syphilis
  • Exaggerated tissue response that may be attributed to the hypersensitivity reaction against the organism
A

TERTIARY SYPHILIS

26
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

  • Transmitted via placenta
  • Some of the infected fetuses die, and miscarriages result; others are stillborn at term.
  • Others are born live but develop the signs of congenital syphilis in childhood
  • Hutchinson’s teeth – one of the complications that may arise
A

CONGENITAL SYPHILIS

27
Q

TREPONEMA PALLIDUM | PATHOGENESIS & CLINICAL FINDINGS

CONGENITAL SYPHILIS:
complications

A

HUTCHINSON’S TEETH

28
Q

TREPONEMA PALLIDUM |TREATMENT

DRUG OF CHOICE

A

PENICILLIN G (benzathine)

29
Q

TREPONEMA PALLIDUM |TREATMENT

A typical reaction that may occur within hours after treatment is begun.
* Indication that the penicillin is now destroying spirochetes

A

JARISCH-HERXHEIMER

30
Q
  • Form irregular spirals 10 – 30 um long and 0.3 µm wide
  • Highly flexible and move both by rotation by twisting.
  • stain readily with bacteriologic dyes
A

BORRELIA

31
Q

BORRELIA

motility

A

rotation by twisting

32
Q

BORRELIA

stain readily with

A

bacteriologic dyes

33
Q
  • Transmitted by:
    o Body louse (epidemic form)
    o Ornithodoros ticks (endemic form)
  • Incubation period: 3 – 10 days
  • Disease: “relapsing fever
A

BORRELIA RECURRENTIS

34
Q

BORRELIA RECURRENTIS

TRANSMISSION:
epidemic form

A

BODY LOUSE

35
Q

BORRELIA RECURRENTIS

TRANSMISSION:
endemic form

A

ORNITHODOROS TICKS

36
Q

BORRELIA RECURRENTIS

INCUBATION PERIOD

A

3 - 10 days

37
Q

BORRELIA RECURRENTIS

DISEASE

A

relapsing fever

38
Q

BORRELIA RECURRENTIS

DRUGS OF CHOICE

A

tetracycline
erythromycin
penicillin

39
Q
  • Transmitted by the bite of Ixodes tick
  • The outer membrane has unique outer surface proteins (Osps)
  • Disease: Lyme Disease
A

BORRELIA BURGDORFERI

40
Q

BORRELIA BURGDORFERI

TRANSMISSION

A

Ixodes tick

41
Q

BORRELIA BURGDORFERI

the outer membrane has unique ____

A

outer surface proteins

42
Q

BORRELIA BURGDORFERI

DISEASE

A

Lyme disease

43
Q

BORRELIA BURGDORFERI

DRUGS OF CHOICE

A

doxycycline
amoxicillin
cefuroxime axetil
14 - 21 days

44
Q

BORRELIA BURGDORFERI

Lyme disease is named after the town of ____ where the cluster of cases the cases of Borrelia burgdorferi were found in children

A

LYME CONNECTICUT

45
Q

BORRELIA BURGDORFERI | STAGES OF LYME DISEASE

  • Erythema chronicum migrans (also called erythema migrans)
  • early localized stage – the manifestation is local, appears near the tick bite
A

STAGE 1

46
Q

BORRELIA BURGDORFERI | STAGES OF LYME DISEASE

  • cardiac and neurologic involvement
  • early disseminated, can lead to neurologic manifestations, bilateral facial nervy palsy – highly suggestive of Lyme disease, myopericarditis
A

STAGE 2

47
Q

BORRELIA BURGDORFERI | STAGES OF LYME DISEASE

chronic skin, nervous system, or joint involvement, late disseminated stage

A

STAGE 3

48
Q

BORRELIA BURGDORFERI | STAGES OF LYME DISEASE

occur in some patients already treated for Lyme disease

A

CHRONIC LYME DISEASE

49
Q
  • Tightly coiled, thin, flexible spirochetes with very fine with hook at its end
  • Grows in aerobic conditions at 28 – 30°C
  • Obtains energy by oxidation of long-chain fatty acids and nitrogen requirement from ammonium salt
  • Survive for weeks in water particularly at high pH
  • Transmitted through injured skin and mucous membranes
A

LEPTOSPIRA INTERROGANS

50
Q

LEPTOSPIRA INTERROGANS

INCUBATION PERIOD

A

1 - 2 weeks

51
Q

LEPTOSPIRA INTERROGANS

  • leptospiremic phase
  • fever, chills, intense headache, and conjunctival suffusion
A

early phase

52
Q

LEPTOSPIRA INTERROGANS

  • aseptic meningitis
  • in severe cases, liver damage (jaundice) and impaired kidney function.
A

second “immune” phase

53
Q

LEPTOSPIRA INTERROGANS

  • liver and kidney become seriously infected
  • kidney failure is the common cause of death for individuals reaching this phase of leptospirosis
A

Weil’s disease

54
Q

LEPTOSPIRA INTERROGANS | TREATMENT

MILD LEPTOSPIROSIS

A

doxycycline
ampicillin
amoxicillin

55
Q

LEPTOSPIRA INTERROGANS | TREATMENT

moderate to severe leptospirosis

A

IV penicillin / ampicillin

56
Q

LEPTOSPIRA INTERROGANS | TREATMENT

if exposed

A

doxycycline 200mg once a week