TCM 1 Flashcards

1
Q

Gastritis, Gastric Ulcers, Gastric Carcinoma & Gastric MALT Lymphoma Pathogen

A

Helicobacter pylori - produces urease allowing neutralization of stomach acid

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2
Q

Esophagitis (major contributers)

A

Candida albicans - superficial fungal infection forming pseudomembrane with yeast and pseudohyphae in immunocompromised
Herpes simplex virus (HSV) - punched out ulcers with nuclear viral inclusions
Cytomegalovirus (CMV) - superficial ulcers with nuclear and cytoplasmic viral inclusions in enlarged cells

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3
Q

Enteritis and Colitis

A

Viral
Norovirus (Norwalk) - #1 cause of gastroenteritis in U.S. (post rotavirus vaccine use); outbreaks on cruise ships
Rotavirus - #1 cause of gastroenteritis worldwide (childhood gastroenteritis); have vaccinations for rotavirus (given in infancy)
Adenovirus - diarrhea; adenovirus vaccine exists but approved only for use in military personnel

 Bacterial Vibrio cholera - human to human fecal transmission causing "rice water stools" Vibrio vulnificus - More common than V. cholera in U.S. and associated with seafood consumption
Campylobacter jejuni - enteroinvasive diarrhea from contaminated water, milk or food
Clostridium difficili - overgrowth of pathogen with pseudomembrane post broad-spectrum antibiotics Tropheryma whipplei - Non-motile facultative intracellular gram positive bacillus that primarily is known for gastroenteritis & a malabsorption syndrome (Whipple disease); fecal-oral & respiratory transmission Staphylococcus aureus - food poisoning via heat stable enterotoxin (lunch meats, sandwiches, etc.) Enterobacteriaceae (previously covered so you are expected to already know these pathogens)
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4
Q

Enterobacteriaceae bacteria

A

gram negative include:
Salmonella enterica enterica, serovar Enteritidis
Enteroinvasive gastroenteritis - Infected via food (poultry, eggs), water or pet turtles
S. enterica enterica, serovar Typhi
Enteric (typhoid) fever -may mimic appendicitis
S. enterica enterica, serovar Choleraesuis
Diarrhea
Shigella dysenteriae
Enteroinvasive bacillary dysentery - watery, bloody diarrhea
Y. enterocolitica and Y. pseudotuberculosis
Enteroinvasive self-limited ileitis, gastroenteritis that may mimic appendicitis
Klebsiella oxytoca
Colitis
Escherichia coli
Pathogenic diarrheal E. coli

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5
Q

dysentery definitoin

A

diarrhea with blood

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6
Q

treponema morphology

A

Helically coiled (spirochete) and stain very poorly (weakly gram negative), best seen with silver impregnation (e.g. Warthin-Starry stain)

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7
Q

treponema pallidum associated disease

A

syphilis-painless highly contagious hard chancre, generally found on the genitals (primary syphilis)

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8
Q

congenital syphillis

A

Infantile form - symptoms present in first 2 years of life and are variable based on organs infected during dissemination (rash, condyloma latum, desquamation of palms and soles, saddle nose, saber shin)
Tardive form - symptoms appear after 2 years of age with Hutchinson triad [interstitial keratitis, notched incisors (Hutchinson teeth) and sensorineural (VIII) hearing loss] and other symptoms

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9
Q

what is hutchinson triad?

A

appears with tardive form of congenital syphilis

[interstitial keratitis, notched incisors (Hutchinson teeth) and sensorineural (VIII) hearing loss] and other symptoms

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10
Q

neisseria morphology

A

Morphology: Gram-negative “coffee bean” diplococci

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11
Q

DX for N. gonorrhoeae = gonococcus

A

Urethral exudate containing gram negative intracellular diplococci, nucleic acid hybridization tests, PCR (nucleic acid amplification test), fastidious to culture (Thayer-Martin VCN lysed RBC media)
Rx: Rx: Ceftriaxone + azithromycin or doxycycline for gonorrhea. Historically used penicillin and quinolones but now have resistance to both.

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12
Q

chlamydia morphology

A

Coccoid to short rod gram negative intracellular bacteria

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13
Q

chlamydia group characteristics

A

Obligate intracellular parasite
Infectious elementary bodies attach and are internalized by susceptible host cells
Intracellular reticulate (initial) bodies = replicative form
Chlamydia cannot produce ATP
Steels host cell’s ATP via ATP/ADP translocator
Reorganize back into elementary bodies and released via cell lysis 1-3 days post infection

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14
Q

C. trachomatis

A

diseases: Serovars D-K - Nongonococcal urethritis, epididymitis, cervicitis, pharyngitis, salpingitis, endometritis, pelvic inflammatory disease, inclusion conjunctivitis (paratrachoma), and neonatal pneumonia
:Serovars L1, L2, & L3 - sexually transmitted lymphogranuloma venereum which is reported more commonly in men where early infection is more easily detected with small, painless papule or pustule followed by tender lymphadenitis (buboes)

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15
Q

diagnosing of C trachomatis

A

Dx: Nucleic acid amplification testing for C. trachomatis, identification on pap smear, cell cultures

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16
Q

Haemophilus morphology

A

Morphology: Gram-negative coccobacilli

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17
Q

H. ducreyi disease pathology

A

Painful soft chancre (chancroid) and lymphadenitis

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18
Q

H. Ducrey diagnosis

A

Dx: Gram stain of scraping smears and cultures

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19
Q

Klebsiella morphology

A

Morphology: Gram-negative bacilli

20
Q

Klebsiella granulomatis characteristics

A

Minute encapsulated coccobacillus (Donovan bodies in mφs in smears)

21
Q

donovanosis pathology

A

Donovanosis = granuloma inguinale
Painless genital ulcers
Can progress to scarring with lymphatic blockage (lymphedema of genitalia
Dx: Cultures, smear examination, PCR

22
Q

Mycoplasmataceae (mycoplasma and ureaplasma) morphology

A

Morphology: No cell wall (but appear coccoid and red on gram stain)

23
Q

M. genitalium, M. hominis and Ureaplasma urealyticum pathology

A

Species special characteristics: Commonly found in sexually active people
Ureaplasma produce urease
Diseases: non-gonococcal urethritis, cervicitis and pelvic inflammatory disease

24
Q

Gardnerella morphology

A

Morphology: Small gram-variable* coccobacilli (diptheroid)
Group characteristics: *Cell wall is in reality gram positive

25
Q

Gardnerella vaginalis pathology

A

Detected as “clue cells” in bacterial vaginosis

Diseases: Associated with bacterial vaginosis
Bacterial vaginosis - ↓lactobacilli →↑anaerobic bacteria (e.g., Prevotella sp. and Mobiluncus sp.) & Gardnerella vaginalis (clue cells), as well as ureaplasma, mycoplasma, etc.
“ Thin vaginal discharge and itching
“ “Fishy” vaginal odor
“ Burning during urination
“ May be asymptomatic
“ Association with number of sexual partners

26
Q

herpesvirus morphlogy

A

Morphology: dsDNA, large and enveloped
Group characteristics:
Produce intranuclear inclusions and multinucleated giant cells
Capable of latency and can lead to recurrent infections

27
Q

HSV-2 pathology

A

-Genital herpes - blistering skin/mucosal lesions
-Neonatal herpes - local or disseminated (50% mortality if untreated)
-Whitlows - erythematous lesions on toes or nail cuticle
-Herpetic meningitis & encephalitis also occur
Generally transmitted by sexual contact or during delivery
Increases risk of subsequent HIV infection

28
Q

HSV-1 pathology

A

-Genital herpes - blistering skin/mucosal lesions
-Herpes labialis - “cold sores”
-Gingivostomatitis - oropharyngeal blister in kids
-Herpetic keratitis - can lead to corneal scarring and blindness
-Fatal sporadic encephalitis - #1 cause of viral encephalitis in U.S.
Usually transmitted by saliva
Dx: Cytology, immunostaining, PCR

29
Q

Papillomaviridae (p.k.a. Papovariedae morpholgy

A

Morphology: Circular dsDNA, naked
Group characteristics:
Trophic for epithelial cells of the skin and mucus membranes

30
Q

papillomaviridae -Human papillomavirus (HPV) associated diseases

A

Verrucae (skin warts), condyloma (genital warts), papillomas, as well as cervical, anal & pharyngeal cancers

31
Q

Low risk HPV- types 6 and 11 cause what

A

cause condylomas and oropharyngeal papillomas

32
Q

High-risk HPV- types 16 and 18

A

responsible for most cancers and high grade dysplasias

33
Q

Retroviridae morphology

A

Morphology: +ssRNA, enveloped/ Retrovirus RNA is transcribed in a retrograde fashion requiring a viral reverse transcriptase (RNA-dependent DNA polymerase)

34
Q

Retroviridae- HIV- spread how?

A

Spread by fluids (sex, transfusions, contaminated needles) or during pregnancy
Attach to CD4 receptor & CCR5 (mφ) or CXCR4 (TH cell) coreceptors

35
Q

HIV-1 pathology

A

Lymphadenopathy, fever, weight loss and malaise
Acquired Immunodeficiency Syndrome (AIDS)
AIDS dementia: mimics Alzheimer disease, may involve HIV infection of the brain
Wasting syndrome (“slim disease”) common in Africa.

36
Q

HIV-2 pathology

A

HIV-2 is similar to HIV-1 infection but restricted to W. Africa

37
Q

Poxviridae moprphology

A

Morphology: dsDNA, envelope
Group characteristics:
Replicate in the cytoplasm of host cell

38
Q

Poxviridae= Molluscum contagiosum virus diseases

A

Huge intracytoplasmic inclusions (molluscum bodies)
Diseases:
Molluscum contagiosum
Common self-limited viral disease
Spread by direct contact, particularly seen among young children and adults
0.2 -0.4 cm umbillicated nodules on face, trunk and anogenital area

39
Q

Flaviviridae Morphology:

A

Morphology: +ssRNA, envelope

40
Q

Flaviviridae= zika virus diseases

A

Spread predominantly by Aedes spp. mosquitoes (fly low and bite around ankles during the day) but is also transmitted transplacentally and by sexual intercourse for months post-infection
= Guillain-Barre syndrome (immune-mediated ascending paralysis)
TORCH syndrome agent with congenital malformations (microcephaly, hearing loss, brain & ocular malformations) similar to those caused by other TORCH syndrome infectious agents

41
Q

Trichomonas morphology

A

Morphology: Flagellated unicellular protozoan
Motility: Corkscrew motility

42
Q

Trichimonas vaginalis diseases

A

Species special characteristics: 4 flagella and undulating membrane for motility of trophozoite
Diseases: Trichomoniasis - urethritis in males or vaginitis in females
Can have watery yellowish-green purulent vaginal fluid that is malodorous
Can have vaginal irritation and painful intercourse; or may be asymptomatic
Burning on urination or ejaculation in males

43
Q

Anoplura (Sucking Lice) morphology

A

Morphology: 1-2 mm, rounded body insect 6 legs

44
Q

anopluyra- Phthirus pubis diseases

A

Found in pubic hair of sexually active people

Diseases: Pediculosis pubis (crabs) - itching, moving lice, nits, possible rash

45
Q

mites morpholgy

A

Morphology: Microscopic rounded arachnid

8 legs

46
Q

mites= Sarcoptes scabiei diesease

A

Species special characteristics: Microscopic superficial skin pathogen
Diseases: Scabies (“itch”, mange) with burrows in superficial epidermis and itchy rash of wrists, dorsa of feet, genitalia, etc.