Mechanisms of Pathogenesis Flashcards
Chapter 14 and Chapter 15
Define Pathology
scientific study of disease
Define Etiology
Cause of a disease
Define Pathogenesis
How a disease develops (structural/functional)
Define Infection
Invasion/Colonization of the body by a pathogenic microbe
Define Disease
Infection changes the normal status of health
Define Host
Organism that harbors another organism
Define Normal Flora
Permanent, (typically) nonpathogenic microbes
What is resident flora?
Microbes that are always present on/in the human body
What is transient flora?
Microbes that come and go
Do babies in the womb encounter microbes?
No
When do babies begin encountering microbes?
At birth
What common microbes do babies encounter? (2)
- lactobacilli (mother’s vagina)
- feeding and breathing (URT and GIT)
(T/F) There are more cells than bacteria in the body
False, bacteria > cells
Define symbiosis
Association between 2+ species
Example of Symbiosis
Host and Normal Flora
Define Commensalism
One organisms benefits, other organism not affected
Example of Commensalism
Staphylococcus epidermis (on our skin)
Define Mutualism
Both organisms benefit
Example of Mutualism
E. coli in the intestines (produce vitamins for the body)
Define Antagonism
Competition between the microorganisms
Define Competitive Exclusion
Normal Flora vs Pathogen over resources (food)
Example of Antagonism
Bacteriocins in the large intestine (inhibit other bacteria)
Define Parasitism
One organism benefits, other is harmed
Example of Parasitism
Any successful pathogenic microorganism
Describe Probiotics
Live microbial cultures are applied/ingested to benefit the host
Define Opportunistic
Become pathogenic under certain circumstances
What are ways opportunistic pathogens are given opportunity? (3)
- normal flora disrupted/destroyed
- defense mechanisms compromised
- normal protective barriers disrupted
Examples of Opportunistic Pathogens (3)
- S. aureus (TSS)
- Pneumocystis jirovecii (pneumonia in AIDS patients)
- E. coli (UTI if moved to urethra)
Define Symptoms
Changes in body functions (pain and malaise)
Define Signs
VISIBLE changes (rash, fever, swelling)
Define Syndrome
Specific symptoms and signs associated with a disease
Define Infectious
Caused by bacteria, viruses, fungi, protozoa, and helminthes
Define Communicable Infectious Diseases
Contagious (directly or indirectly)
Define Non-Communicable Infectious Diseases
Caused by individual’s normal flora, ingestion or preformed toxins, organisms in the environment (not contagious)
Define Non-Infectious
Caused by any other factor than infectious organisms
Define Incidence
Number of new cases contracted within a set population during a set time period
Define Prevalence
TOTAL number of people infected within a population at ANY time
Define Sporadic
Occurs occasionally in a population
Define Endemic
Disease that is always found in the region
Define Epidemic
Disease that many people acquire in a very SHORT period of time
Define Pandemic
An epidemic that is worldwide
Define Acute Disease
Symptoms develop rapidly, lasts a SHORT time
Define Chronic Disease
Symptoms develop slowly
Define Subacute Disease
Intermediate (between acute-chronic)
Define Latent Disease
Inactive until activation, then produces symptoms
Define Herd Immunity
Immunity in MOST of a population
(T/F) Pathogens can live without a host
False
Define Reservoir
Continual source of the disease causing organisms (living or inanimate objects)
Describe Human Reservoirs (3)
- transmit microorganisms directly/indirectly
- carries (asymptomatic people)
- convalescing patients (gradual recovery)
Describe Animal Reservoirs (3)
- wild and/or domestic
- zoonoses (primarily in animals, possible in humans)
- transmitted: bites, contaminated hides/feathers, food, insect vectors
What are examples of nonliving reservoirs of infection? (2)
- soil (fungal diseases)
- water (feces)
What are the modes of disease transmission (3)
- contact
- vehicle
- vector
Where do pathogens leave the host from?
The same way it came in (portal of entry)
What is direct transmission?
person-to-person
What is congenital transmission?
mother to fetus/newborn
What is indirect transmission?
fomites (nonliving objects)
What is droplet transmission?
coughing, sneezing, talking
What is vehicle transmission?
Through a medium
How is water a vehicle of transmission?
fecal contamination
How is food a vehicle of transmission?
incompletely cooked food or improperly refrigerated foods; food poisoning
How is air a vehicle of transmission?
mucus droplets by droplet nuclei
What are the four vehicles of transmission?
- water
- food
- air
- body fluids and blood
What is vector transmission?
Through an arthropod (insect)
What are two examples of vector transmission?
- biological
- mechanical
What is an example of biochemical transmission?
- bitten by infected insect (lyme disease, malaria)
What is an example of mechanical transmission?
- transfer of microbe from feet or other body parts of insects to food/skin of person
- passive; no replication of microbe within vector (shigellosis, typhoid fever)
What are nosocomial infections?
Acquired in a hospital/medical facility
What are the three factors of nosocomial infections?
- microbe in hospital
- compromised patient
- chain of transmission
What are common bacterial nosocomial infections? (5)
- S. aureus (urinary and respiratory)
- Pseudomonas aeruginosa (burns & surgical wounds)
- E. coli (urinary tract, neonatal meningitis)
- Enterococcus (urinary tract & wound)
- Clostridium difficile (diarrhea)
What plasmids are antibiotic resistant?
R Plasmids
What causes endogenous infections?
Opportunistic microbes in an individual’s normal flora
What causes exogenous infections?
Microbe that enter an individual through the environment
What increases an individual’s risk to infection? (4)
- broken skin/mucous membranes
- surgery
- burns
- catheters
What suppresses an immune system? (4)
- drugs
- diabetes
- stress
- HIV
What are 4 ways a disease can be transmitted to a patient in a hospital?
- hospital staff
- other patients
- fomites
- ventilation system
How can we control the spread of nosocomial infections? (3)
- educate personnel
- practice good aseptic techniques
- monitor for drug resistance
What are emerging infectious diseases?
New or changing diseases
What causes emerging infectious diseases? (7)
- new strain (more virulent)
- overuse of antibiotics (resistance)
- global warming (increases survival rates of reservoirs/vectors)
- modern transportation
- natural transportation
- animal control measures
- failure to comply with public health measures
4 Contributing Factors to Emerging Infectious Diseases:
- genetic recombination
- evolution of new strains
- overuse of antibiotics
- changes in weather patterns
What is pathogenicity?
Ability of organism to cause disease
What is virulence?
Degree of pathogenicity
Steps for microbes to cause infection/disease are (4)
- ENTER organism
- ADHERE to tissues
- PENETRATE tissues
- DAMAGE cells
What are 3 portals of entry?
- mucous membranes
- skin
- parenteral route
What are examples of mucous membranes? (4)
- respiratory
- gastrointestinal
- genitourinary tract
- conjuncitva (eyes)
Describe skin
Largest organ & outermost protective layer
Examples of the parenteral route (4)
- bites
- punctures
- burns
- injections
How many microbes are needed to cause disease?
Number varies from person to person
What is ID50
Infectious dose for 50% of population, indication of virulence
What is LD50
Lethal dose of a toxin in 50% of population
Define Adhesins
Surface molecules on pathogen that bind to receptors on host cells/tissues
Where are adhesins found? (4)
- capsules
- fimbriae
- capsid
- virus envelope
What are biofilms?
Masses of microbes
Pathogen exits the GI tract by (2)
- diarrhea
- vomiting
Pathogen exits the Urogenital tract by (2)
- sexual contact
- urine
Pathogen exits blood by (2)
- insects
- needles
Pathogen exits the Respiratory tract by (3)
- coughing
- sneezing
- speaking
How do most bacteria cause disease?
Penetrating tissues
What are virulence factors?
Characteristic that help microbes cause infection/disease
Structural example of a virulence factor:
Pili (adhesion)
Physiological examples of a virulence factor (2):
- enzymes
- toxins
Describe adhesins
Proteins/glycoproteins that adhere to host
Describe Colonization of microbes
Microbe growth on epithelial cell surfaces (skin, mucous membranes)
Describe Invasiveness
Degree that microbe can invade and grow in host tissues
Describe Toxins
Poisonous substance to other organisms
What do capsules do
Resist Host Defenses
- phagocytosis
- complement
What are Streptococcus pyogenes cell wall made of?
Protein M
What are Mycobacteria cell wall made of?
Waxes (mycolic acid)
What are Neisseria gonorrheae cell wall made of?
Fimbriae (Opa proteins)
How do extracellular enzymes help microbes?
Breakdown and dissolve material found near cells
What does Hyaluronidase do?
Digests hyaluronic acid (bacterial cell membranes)
What does Coagulase do?
Increases clotting
What do IgA Proteases do?
Destroy antibodies
What does Streptokinase do?
Dissolves clots (digests fibrin)
What does Collagenase do?
Breaks down collagen
What do Hemolysins do?
Destroys RBCs
Alpha Hemolysis
Partially digests hemoglobin (green)
Beta Hemolysis
Completely digests hemoglobin (clear)
Gamma Hemolysis
No digestion
What do Leukocidins do?
Destroy neutrophils
(T/F) If phagocytosis occurs after entry, no damage occurs
True
What causes damage to the host cells (4)
- using host nutrients (siderophores)
- direct damage by injury (cell rupture)
- toxins
- causing hypersensitivity reactions
What uses a host cell’s nutrients?
Siderophores
What are toxins?
Poisonous substances made by some microbes
What do toxins cause (5)
- fever
- cardiovascular disturbances
- neurological disturbances
- diarrhea
- shock
What is Toxemia?
Toxins in the blood
What is Intoxication?
Disease caused by ingestion of toxin
What are Exotoxins?
Produced INSIDE bacteria, released into SURROUNDING medium
What are Endotoxins?
Lipid A portion of LPS released from cell wall of GRAM NEGATIVE bacteria
Where are endotoxins located
Outer portion of the LPS (lipopolysaccharide) of gram - bacteria (Lipid A)
When are endotoxins released
When the gram - cell dies (cell wall breaks)
Symptoms of endotoxins (6):
- chills
- fever
- weakness
- aches
- shock
- death
Explain how Disseminated Intravascular Coagulation (DIC) occurs:
Endotoxins activate clotting cascade causing blockage of blood supply = tissue death
Outcomes possible because of endotoxins:
- fever/pyrogenic response
- septic shock
How do endotoxins cause pyrogenic/fever response? (5)
- Macrophage eats Gram - cell (phagocytosis)
- cell degrades = endotoxin released
- endotoxin stimulates macrophage to secrete IL-1
- IL-1 causes hypothalamus to produce prostaglandins
- PGs causes body temperature to rise
What does IL-1 stand for?
Interleukin 1 (Endogenous pyrogen)
What else could the macrophage secrete during endotoxic shock? (2)
- Tumor Necrosis Factor (TNS)
- Cachetin
What causes the release of Mediators?
Tumor Necrosis Factor & IL-1
What do Mediators cause? (3)
- increased permeability of capillaries (loss of fluids)
- rapid decrease in B.P.
- Impaired blood flow to kidneys
What does Endotoxic Septic Shock cause? (8)
- chills
- fever
- vomiting
- diarrhea
- rapid decrease in blood pressure
- convulsions
- shock
- death
Which bacteria are major producers of Endotoxic Septic Shock? (6)
- P. aeruginosa
- E. coli
- Klebsiella
- Proteus
- Enterobacteria
- Salmonella typhi
What are Exotoxins?
Proteins/Enzymes produced by Gram + bacteria (& some Gram -) that destroy/inhibit parts/functions of cells
How can we destroy Exotoxins?
Heat or chemicals
Where are Endotoxin genes carried in? (2)
- plasmids
- bacteriophages
What are antitoxins?
Things the body produces that gives immunity against exotoxins
What are toxoids used for? (2)
- vaccines
- stimulate antitoxins
How are Exotoxins named?
According to the cell they attack or the disease they are associated with
What pathogen secretes Diphtheria Toxin?
Corynebacterium diptheriae
What do Diphtheria toxins do?
Inhibits protein synthesis (A-B toxin)
What pathogen secretes Erythrogenic Toxin?
Streptococcus pyogenes
What do Erythrogenic Toxins do?
Damages blood capillaries under the skin
What pathogen secretes Botulinum Toxin?
Clostridium botulinum
What do Botulinum Toxins do?
- prevents nerve impulses
- inhibits release of acetylcholine
- flaccid paralysis
Describe Clostridium botulinum (4)
- gram +
- spore forming
- anaerobic rod
- found in soil, canned foods, water, intestinal tracts of animals
How long does it take for symptoms of Clostridium botulism to appear?
12-46 hours
What are the symptoms of Clostridium botulism? (5)
- poor vision
- difficulty swallowing
- weakness
- faulty speech
- death
How would you treat a patient with the Adult Form of Botulism?
Trivalent antitoxin to A,B, & E
How can we prevent Infant Botulism?
Do not give infants honey
What do Tetanus Toxins do?
Inhibit nerve cell impulses form muscle relaxation
What pathogen secretes Tetanus Toxins?
Clostridium tetani
What do Vibrio Entertoxins (Cholera Toxin) do?
Release large amounts of fluid & electrolytes (“rice water stools”)
What do Staphylococcal Enterotoxins do?
(Superantigen) Affects intestinal tract in releasing fluid & electrolytes
What do Staphylococcal TSS Toxin do?
(Superantigen) Toxic Shock Syndrome Toxin
What gram bacteria do endotoxins occur in?
Gram -
What are exotoxins made of?
Protein
What are endotoxins made of?
Lipid
What gram bacteria do exotoxins occur in?
Gram + and Gram -
Which toxins can be made into toxoids?
Exotoxins
Which toxin is found in LPS of gram - cells?
Endotoxins
Can Endotoxins be destroyed by heat?
No
Can endotoxins be made into toxoids?
No
How are viruses able to avoid host defenses? (2)
- grow inside cells where the immune system cannot reach
- they attack immune cells (HIV)
What are the Cytopathic Effects (CPE) of viruses?
- kills cell
- inhibits protein, DNA, RNA synthesis
- toxic to cells
- syncytia formation
- antigenic changes cause destruction by immune system
- chromosomal damage can activate oncogenes