Slide Deck 4 Flashcards by Afia Khan

What are obligate intracellular bugs?

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

How well did you know this?

Not at all

Perfectly

What are facultative intracellular bugs?

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

How well did you know this?

Not at all

Perfectly

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?

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?

Not at all

Perfectly

What is verruga peruana?

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?

Not at all

Perfectly

Endocarditis that doesn’t grow any bacteria?

Bartonella

How well did you know this?

Not at all

Perfectly

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

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?

Not at all

Perfectly

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?

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?

Not at all

Perfectly

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

Ehrlichiosis: Lone Star

Anaplasmosis: Ixodes

How well did you know this?

Not at all

Perfectly

What are the two groups of Rickettsia?

Typus group – includes prowazekii

Spotted fever group: includes typhii

How well did you know this?

Not at all

Perfectly

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

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

Rocky Mountain spotted fever (rickettsia)

Clinical–skin biopsy with NAAT

doxycycline

How well did you know this?

Not at all

Perfectly

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

Rickettsia prowazekii

rash from trunk to extremities

can persist (Brill-Zinsser Disease)

tetracycline therapy

How well did you know this?

Not at all

Perfectly

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

Scrub typhus

Orienta tsutsugamushi

follows mite bite

How well did you know this?

Not at all

Perfectly

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

Coxiella burneti (no rash! Q fever!)

obligate intracellular

How well did you know this?

Not at all

Perfectly

How does coxiella burneti infect humans?

Spores are contained in animal feces

Transmitted to humans via aerosol transmission

How well did you know this?

Not at all

Perfectly

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?

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

Giemsa stain

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

What are the three forms of Chlamydia?

Chlamydia trachomatis, pneumoniae, psittaci (from birds)

How well did you know this?

Not at all

Perfectly

What are the elementary and reticulate body of chlamydia?

Elementary body: smaller infectious form. Enters cell

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

How well did you know this?

Not at all

Perfectly

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

Women: vaginal discharge, dysuria, and pelvic inflammatory disease

Men: Urethral discharge, dysuria, testicular swelling

How well did you know this?

Not at all

Perfectly

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

diagnose with NAAT

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

Macrolides, doxycycline

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

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

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

This is the leading cause of infectious blindness

trachoma: serotypes ABC of chlamydia trachomatis

inturned eyelashes is why the scarring happens.

, follicular conjunctivitis

Direct contact between humans

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

Which chlamydia is associated?

Macrolides: azithromycin, erythromycin

Chlamydia pneuomniae

Inhalation of dried secretions from parrots results in

Chlamydia psittaci, which is a form of atypical pneumonia

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

Mycoplasma pneumonieaie. Cold agglutinins, IgM antibodies

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

cough, chest pain, bloody sputum, weakness, weight loss, chills, low grade fever, night sweats Risks: HIV infection, diabetes, alcohol, or drug abuse

What is the treatment for latent TB?

**RI**PE Rifapentine and isoniazid for 3 months or isoniazid for 9 months requires patient compliance!

Where does tuberculosis divde?

organisms replicate in naive alveolar macrophages, killing the macrophages until cell mediated immunity. Associated with caseating granuloma

How do you look at mycobacterium tuberculosis?

Need acid fast or Ziehl-Neelsen stain It is a facultative intracellular organism

What do you see in this picture?

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

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

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

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

Loewenstein-Jensen agar

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

Acid fast stain

What is miliary tuberculosis

Minimal immune response, so tiny "millet"-like granuloma disseminating widespread tuberculosis

What happens if you swallow tuberculosis?

Pott's disease: gets into the spine/bones

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

Bacillus Calmette Guerin (BCG) only tuberculin negative individuals (newborns) can be vaccinated it prevents severe tuberculosis 70% but not the more common forms/infection

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

Cough, chest pain, bloody sputum, weakness, weight loss, chills, low grade fever, night sweats 15%

What is the gram stain of Tb?

None!

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

Mycobacterium leprae 95% of people are resistant

What are symptoms of leprosy? How do you daignose?

skin discoloration, numnbess in extremities (the bacteria prefers the cold) won't grow in vitro, you must do skin biopsy or staining

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

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

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

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

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

Actinomyces israelii, requires other infection and anaerobic condition

How is actinomyces diagnosed?

Detected because of production of sulfur granules

Between nocardia and actinomyces, which are around o2?

Nocardia is the obligate aerobe

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

affects the immunocompromised, Madura foot, requires antibiotic therapy pneumonia, brain abcesses

How do you treat nocardia? Actinomyces?

sulfonamides for nocardia, penicillin for actinomyces