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MMI133 > MMI133_Lecture14 > Flashcards

MMI133_Lecture14 Flashcards

1
Q

why is skin a poor environment for microbial growth?

A

dry, high salt, sebum
lysozyme (breaks down peptidoglycan)
antimicrobial peptides

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2
Q

most microbial inhabitants of skin are

A

G+

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3
Q

washing reduces #’s of normal flora but does not

A

eliminate normal flora
quickly re-establishes form hair follicles + sweat glands

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4
Q

high moisture areas (like groin, armpits) have

A

large microbial populations

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5
Q

skin + mucous membrane =

A

internal skin

largest organ of body
physical + chemical barrier to infection
would cover football field

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6
Q

both aerobic + some anaerobic bact grow

A

on skin

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7
Q

what are the most common bact on skin?

A

Staphylococcus epidermidis - dominant

other micrococci spp

Diphtheroids (Corynebacterium spp - aerobes on surface) (Propionibacterium spp - anaerobes live under surface in follicles + glands)

some yeasts - Malessezia furfur

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8
Q

mucous membranes

A

line body cavities
internal skin
sheets of epithelial cells attached to basement membrane
goblet cells in skin secrete mucus to protect mucosal surface
cilia on some cells
acidic pH, normal flora must like to live at lower phs

respiratory tract - alpha streptococci
vaginal canal - lactobacillus

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9
Q

conjunctiva

A

thin layer of mucous membrane lining the eyelids + covering the surface of eye

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10
Q

normal flora of eye surface

A

flora of conjunctival surface
micrococcus spp S. epidermidis in small #’s

alpha-hemolytic streptococci in small #s

diphtheroids (Corynebacterium spp) in small numbers

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11
Q

unless infected, the interior of the eye =

A

sterile fluid

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12
Q

eyelids are a

A

mechanical barrier to organisms

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13
Q

tears with lysozyme + IgA are

A

a chemical barrier to organisms

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14
Q

the conjunctiva is especially susceptible to infection

A

vulnerable epithelial surface
covered by eyelid which creates warm + moist conditiosn

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15
Q

conjunctivitis

A

inflammation of conjunctiva - thin layer of mucous membrane lining eyelieds + covering eye surface

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16
Q

bacterial conjunctivitis is characterized by

A

pus = goopy eye

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17
Q

ketatinitis

A

inflammation of cornea

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18
Q

bacterial keratitis is characterized by

A

pus

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19
Q

viral keratitis is characterized by

A

less pus

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20
Q

eyelids are often infected with

A

Staphylococcus aureus

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21
Q

blepharitis

A

inflammation of lid margins +/- infection

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22
Q

stye

A

involvedment of eyelid glands + follicles in infection

super painful

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23
Q

Acanthamoeba keratitis

A

parasite that gets into eye
Acanthamoeba is everywhere in dust
especially prone for contact wearers bec of tiny scratches on cornea due to contacts

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24
Q

Chlamydia trachomatis - trachoma

A

ocular = in eyes = types A - C
genital = types D-K

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25
Q

eye infected with genital Chlamydia

A

inclusion conjunctivitis

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26
Q

Ophthalmia neonatorum

A

gonorrhea in newborn eye infections
mum had gonorrhea, passed on to baby, used to do liquid silver in all babys’ eyes, then antibiotics, now do enough mum tests + cultures to generally know if baby will need anything or not, so all babies don’t need antibiotics

27
Q

vesicle

A

skin lesion where there is a fluid-filled vesicle immediately under the skin < 1cm diameter

herpes vesicles

28
Q

bulla

A

skin lesion directly under skin where fluid-filled bulla is > 1cm

29
Q

macule

A

red rash
accumulation of immune cells in skin that look like red dots

30
Q

pustule = papule

A

pustule is deeper in skin than vesicle and is filled with pus + neutrophils + is close to nerves, so lots of pressure/really painful = smallpox

31
Q

Staphylococcus spp

A

G+ cocci in clusters
non-motile = no flagellum
non spore forming
may or may not be capsules
facultative anaerobic

Staphylococcus aureus = primary pathogen
Staphylococcus epidermidis = opportunistic + most common on skin
Staphylococcus saphrophyticus = primary pathogen in urinary tract infections for young women 14-19 yrs

32
Q

Staphylococcus aureus

A

produces coagulase = differentiating characteristics from other staph spp
converts fibrinogen soluble to fibrin insoluble do wall off bact + protect infection from macrophages

coagulase positive staphylococci = Staph aureus

often yellowish colonies on BAP yellow or golden staphylococci

33
Q

differential media means

A

everything will grow on it, but it will look different

34
Q

MSSA

A

methicillin susceptible Staphylococcus aureus

35
Q

MRSA

A

methicillin resistant Staphylococcus aureus

36
Q

virulence factors of staphylococcus aureus

A

coagulase
adhesion molecs
exotoxins + superantigens
DNase
membrane damaging toxins - leucocidin
capsule (sometimes)
protein A Fc receptor

37
Q

Impetigo

A

infection of epidermal layer of skin
often in newborns + young children + at daycares

caused by staphylococci + streptococci

treatement = removal of crusts + washing of lesions + application of topical antibiotics
- water + soap

only oral antibiotics if infection spreads + goes deeper

38
Q

toxic shock syndrome

A

life threatening multisystem effects
fever, vomiting + sunburn-like rash

superantigen
often exotoxin causing = TSST-1 (toxic shock syndrom toxin-1) = Staphylococcus aureus

first tampon use - now mostly in patients after surgery + intravenous drug abusers

s aureus but can also be GAS - group A streptococcus or streptococcus pyogenes

treatment = as fast as possible via IV antibiotic = semisynthetic penicillin like oxacillin

39
Q

GAS

A

group A streptococcus

streptococcus pyogenes

40
Q

scalded skin syndrom

A

neonatal or 2 degree toxic shock syndrom
Staphylococcus aureus
exfoliative toxin - breaks skin cell connectivity + skin sloughs off

often begins as skin lesion
exfoliative toxin affects junctions betw epidermal cells + causes loosening of cells

treatment with IV antibiotic

41
Q

streptococcus spp

A

facultative G+ cocci in chains

grouping based on hemolytic reactions on blood agar
alpha hemolytic (partial hemolysis - green)
beta hemolytic (complete hemolysis - clear)
gamma hemolytic

42
Q

Landsfield typing

A

grouping of hemolytic streptococci based on cell wall carbohydrates

Beta hemolysis = (group A - streptococcus pyogenes) (group B - streptococcus agalactiae)

43
Q

streptococcus pyogenes

A

beta-hemolytic
important pathogen in skin infections, M protein important

M protein

Group A or GAS - group a streptococci

pharyngitis tonsillitis
impetigo
cellulitis, erysipelas
childbed fever
necrotozing fasciitis

post-infectious disease - acute glomerulonephritis rheumatic fever = heart valve issues due to having strep through without penicillin/antibiotics

44
Q

childbed fever

A

getting sick by being infected by bact from med students from morg when birthing women gave birth at hospital before peopel believed in washing hands

45
Q

streptococcal toxins + enzymes

A

streptokinase (dissolves blood clots - fibrin)
hyaluronidase (breaks down Connective tissue)
deoxyribonucleases (degrade DNA)
proteases (iga protease)
erythrogenic toxin (rash of scarlet fever - superantigen)
spe toxins (superantigens somtimes present in NF strains are exotoxins that cause massive tissue damage + inflammation like fleshing eating disease

46
Q

erysipelas

A

infection of dermal layer of skin
can progress to septicemia + fatal outcome
can begin as pharyngitis

treatment = antibiotic

47
Q

streptococcal impetigo

A

anywhere on body

treatment
removal of crusts, gentle washing + topical antibiotics

48
Q

necrotizaing fasciitis

A

flesh eating disease
streptococcus pyogenes or GAS

when pain is disproportionate to injury

massive tissue damage

G+ cocci in chains + growth of beta-hemolytic streptococci on blood agar plates

speA toxin detected in bacterial isolate

49
Q

flesh-eating disease treatment

A

debrided tissued - all affected tissue removed + IV antibiotics started

50
Q

diagnostic symptom of necrotozing fasciitis or flesh-eating disease

A

disproportionate pain to injury

extremely rapid progressive infection

streptococci invade deep + destroy fascia or muscle sheath, liquifying tissues as progresses
mortality >40% even with timely treatement

very important for quick diagnosis + debridement of necrotic tissue + antibiotics

51
Q

what dissolves blood clots?

A

streptokinase

52
Q

necrotizing fasciitis caused by strep pyognes is transmitted by

A

direct contact

53
Q

warts

A

human papillomavirus HPV
not cancerous

tree man

54
Q

herpesviruses are

A

DNA viruses

herpes = to crawl or creep
8 are human pathogens

55
Q

HSV-1

A

cold cores

typically reactivate when get a cold or something affecting immune system

very common
>90% of pop infected at some point, most in childhood may not know it
oral rout or direct contact transmission
remains latent in nerve endings (trigeminal nerve ganglia) + flares up with stress

56
Q

herpes gladitorium

A

wrestlers - on body

57
Q

herpes whitlow

A

from getting bit
sore on finger
occupational hazard of healthcare workers from getting bit by someone with herpes

58
Q

measles = rubeola

A

maculopapular viral disease
rubeola virus
enveloped paramyxovirus RNA
extremely infectious - airborne
90% attack rate in susceptible households

systemic disease with rash
1 serotype, humans only natural host
no latent or persistent infections

59
Q

measles is often compelcated yb

A

secondary bact infections like staph aureus pneumonia + ear infections

blindness in children with vit A dificiency

60
Q

classiv measles disease

A

rarely subclinical - genearlly have symptoms
respiratory - fever, malaise, anorexia, conjunctivitis, photphobia, myalgia

KOPLIK’s spots = red + wite + blue spots prior to rash in back of mouth

maculopapular rash starts behind ears, spreads to face, upper arms, trunk then legs

intense inflammaion of lymphoid tissue + mucosa of respiratory tract

tracheobronchitis + pneumonia common

61
Q

measles causes

A

immunosuppression

dendritic cells + monocytes are infected, antigen presenint activity compromised

circulating T lymphocytes dec by 50%

messes up cytokine repspones

need Th1 cells, but instead gets too much Th2 AB
reduced macrophage activation

62
Q

measles vaccine

A

95% effective after 1 dose
herd immunity want 95% vax coverage
combined measles mumps, rubella, varicella vax MMRV first dose at 12-15 mo second at 4-6 months

63
Q

fifth 5th disease = B19

A

can lead to stillbirth + spontaneous abortion

parvovirus, DNA, nonenveloped

mild rash disease of childhood, usually no children complications
pink lacy rash, cheeks become very red, which is usually first noticeable sign in children

major complication - TAC (transient aplastic crisis) in pregnant women. parvovirus has tropism (likeing) for nucleated RBCs + invades + destroys RBCs in bone marrow. means that mothers hemoglobin can drop by 30-40% very quickly + fetus will not be getting enough oxygen -

can lead to stillbirth + spontaneous abortion

MMI133 (16 decks)

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