Slide Deck 4 Flashcards

1
Q

What are obligate intracellular bugs?

A

Stay inside (cells) when it is Really CHilly and COld. Rickettsia Chlamydia Coxiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are facultative intracellular bugs?

A

Some Nasty Bugs May Live FacultativeLY. Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kid has cats, what happened, what bug? after you diagnose with serolgoy, how do you treat?

Patients present with bacillary angiomatosis. What is this, and why?

A

Cat scratch disease, caused by Bartonellosis henselae , flea transmitted or traumatically – most frequent of the Bartonellosis

leads to inflamed lymph node is shown

proliferation of endothelial cells, by NF-kB activation

patients present with little tumors that bleed on contact, comprised of endothelial cells “bacillary angiomatosis”

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is verruga peruana?

A

the chronic delayed stage of infection by Bartonella bacilliformis.

It is a vasoproliferative manifestation of the infection characterized by 1–2 cm cutaneous nodules that are engorged with blood.

(Carrions disease: fever, headache, abdominal pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Endocarditis that doesn’t grow any bacteria?

A

Bartonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The lone star tick bite spreads what? What are the symptoms, and what patients are most likelyaffected?

A

Ehrlichiosis

fever, red eyes (conjunctival injection), rash, fatigue, musle aches, nausea/vomiting/diarrhea

generally affects organ transplant and blood transfusion patients; it’s actually in 12% of people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are these in your blood smears of monocytes? If they’re in the blood smears of granulocytes, then what is it an indicator for? How are these diseases transmitted?

A

Ehrlichiae! microcoloneis in monocytes are called morulae.

Morulae in granulocytes are an indicator for anaplasma, vector is Ixodes tick

MEGA berry

“Monocytes = Ehrlichiosis; Granulocytes = Anaplasmosis”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Between Anaplasmosis and Ehrlichiosis, which tick is responsible for which?

A

Ehrlichiosis: Lone Star

Anaplasmosis: Ixodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the two groups of Rickettsia?

A

Typus group – includes prowazekii

Spotted fever group: includes typhii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tick bite trasmission leads to fever, pain, systemic vasculitis: rash in 35-60%

What do you suspect, how do you diagnose? thereapy?

A

Rocky Mountain spotted fever (rickettsia)

Clinical–skin biopsy with NAAT

doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes epidemic typhus, and what does it look like? How do you treat it?

A

Rickettsia prowazekii

rash from trunk to extremities

can persist (Brill-Zinsser Disease)

tetracycline therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which Rickettsial strain causes disease scrub typhus ? What does it follow?

A

Scrub typhus

Orienta tsutsugamushi

follows mite bite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

infilitrate in lungs (pneumonia), headache, endocarditis (rare), fever, hepatitis, was around animals!

A

Coxiella burneti (no rash! Q fever!)

obligate intracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does coxiella burneti infect humans?

A

Spores are contained in animal feces

Transmitted to humans via aerosol transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

observed is a cell from anal area with lots of inclusion bodies. How is this grown on media? What type of stain do you have to use?

A

It can’t be. Chlamydia is an obligate intracellualr pathogen.

Giemsa stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does chlamydia enter cells, and what type secretion pathway?

A

It binds the outer membrane protein OMPc to glycosaminoglycans (GAGs), uses a type III secretion pathway.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three forms of Chlamydia?

A

Chlamydia trachomatis, pneumoniae, psittaci (from birds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the elementary and reticulate body of chlamydia?

A

Elementary body: smaller infectious form. Enters cell

Reticulate body: larger, replicative form. Replicates in cell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

For Chlamydia: Serovars D-K, what are the symptoms?

A

Women: vaginal discharge, dysuria, and pelvic inflammatory disease

Men: Urethral discharge, dysuria, testicular swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you suspect Chlamydia, what do you do? If it is diagnosed, how do you treat?

A

diagnose with NAAT

but test for gonorrhea, bc it’s usually accompanied by that!

Macrolides, doxycycline

21
Q

What is lymphogranuloma venereum, and what causes it? If you suspect it, what should you test for?

A

Serotypes L1-L3 of chlamydia trachomatis, also STD

Women: vaginal discharge, dysuria, pelvic inflammatory disease

Men: urethral discharge, dysuria, testicular swelling

Test for HIV infection, >70% coinfection in MSM

22
Q

Which form of clamydia causes scarring of the cornea? How is it transmitted?

This is the leading cause of infectious blindness

A

trachoma: serotypes ABC of chlamydia trachomatis

inturned eyelashes is why the scarring happens.

, follicular conjunctivitis

Direct contact between humans

23
Q

If a person has pneumonia symptoms but not a high fever, this is atypical pneumonia. How do you treat?

Which chlamydia is associated?

A

Macrolides: azithromycin, erythromycin

Chlamydia pneuomniae

24
Q

Inhalation of dried secretions from parrots results in

A

Chlamydia psittaci, which is a form of atypical pneumonia

25
Q

_________ is the smallest free living extracellular bacteria . Diagnosis involves a positive ___ test.

A

Mycoplasma pneumonieaie. Cold agglutinins, IgM antibodies

26
Q

What are the major symptoms that are associated with a reactivation of TB? What are the risk factors?

A

cough, chest pain, bloody sputum, weakness, weight loss, chills, low grade fever, night sweats

Risks: HIV infection, diabetes, alcohol, or drug abuse

27
Q

What is the treatment for latent TB?

A

RIPE

Rifapentine and isoniazid for 3 months

or isoniazid for 9 months

requires patient compliance!

28
Q

Where does tuberculosis divde?

A

organisms replicate in naive alveolar macrophages, killing the macrophages until cell mediated immunity.

Associated with caseating granuloma

29
Q

How do you look at mycobacterium tuberculosis?

A

Need acid fast or Ziehl-Neelsen stain

It is a facultative intracellular organism

30
Q

What do you see in this picture?

A

Ghon complex , which is calcified focus of infection and an associated lymph node, sign of primary pulmonary tuberculosis

31
Q

PPD test, zone of induration of what threshold is a positive test? What does a positive mean?

A

10 mm

previous vaccination with BCG, Bacille Calmette Guerin (live attenuated), or infection

32
Q

____ agar is used to culture M. tuberculosis. While it is the most sensitive, it is very slow (4-6 weeks)

A

Loewenstein-Jensen agar

33
Q

Rapid, not sensitive way to diagnose M. tuberculosis in sputum?

A

Acid fast stain

34
Q

What is miliary tuberculosis

A

Minimal immune response, so tiny “millet”-like granuloma

disseminating widespread tuberculosis

35
Q

What happens if you swallow tuberculosis?

A

Pott’s disease: gets into the spine/bones

36
Q

Who can be vaccinated against tuberculosis? What is the name of the vaccine? Does it work?

A

Bacillus Calmette Guerin (BCG)

only tuberculin negative individuals (newborns) can be vaccinated

it prevents severe tuberculosis 70% but not the more common forms/infection

37
Q

What percentage of Tuberculosis patients progress to active disease? What is active disease?

A

Cough, chest pain, bloody sputum, weakness, weight loss, chills, low grade fever, night sweats

15%

38
Q

What is the gram stain of Tb?

A

None!

39
Q

What is Hansen’s disease? What proportion of the human population is resistant?

A

Mycobacterium leprae

95% of people are resistant

40
Q

What are symptoms of leprosy? How do you daignose?

A

skin discoloration, numnbess in extremities (the bacteria prefers the cold)

won’t grow in vitro, you must do skin biopsy or staining

41
Q

Differentiate between tuberculoid and lepromatous. What cell does this invade?

A

Tuberculoid: granuloma form, Th1 (strong immunity): fewer lesions

Lepromatous: humoral, Th2 (weak cell-mediated immunity): many lesions, leonine face (lose nasal septum, lose eyebrows

Invades the Schwann cell, so nerve symptoms

42
Q

In what form of leprosy is the lepromin skin test positive?

A

Skin test is positive in tuberculoid, because it tests cell mediated immunity

43
Q

Jaw trauma is associated with what bacteria? What is required before this bacteria can proliferate?

A

Actinomyces israelii, requires other infection and anaerobic condition

44
Q

How is actinomyces diagnosed?

A

Detected because of production of sulfur granules

45
Q

Between nocardia and actinomyces, which are around o2?

A

Nocardia is the obligate aerobe

46
Q

Who does nocardia affect, and what do the symptoms look like?

A

affects the immunocompromised,

Madura foot, requires antibiotic therapy

pneumonia, brain abcesses

47
Q

How do you treat nocardia? Actinomyces?

A

sulfonamides for nocardia, penicillin for actinomyces

48
Q
A