TCM 1 Flashcards
Gastritis, Gastric Ulcers, Gastric Carcinoma & Gastric MALT Lymphoma Pathogen
Helicobacter pylori - produces urease allowing neutralization of stomach acid
Esophagitis (major contributers)
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
Enteritis and Colitis
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)
Enterobacteriaceae bacteria
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
dysentery definitoin
diarrhea with blood
treponema morphology
Helically coiled (spirochete) and stain very poorly (weakly gram negative), best seen with silver impregnation (e.g. Warthin-Starry stain)
treponema pallidum associated disease
syphilis-painless highly contagious hard chancre, generally found on the genitals (primary syphilis)
congenital syphillis
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
what is hutchinson triad?
appears with tardive form of congenital syphilis
[interstitial keratitis, notched incisors (Hutchinson teeth) and sensorineural (VIII) hearing loss] and other symptoms
neisseria morphology
Morphology: Gram-negative “coffee bean” diplococci
DX for N. gonorrhoeae = gonococcus
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.
chlamydia morphology
Coccoid to short rod gram negative intracellular bacteria
chlamydia group characteristics
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
C. trachomatis
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)
diagnosing of C trachomatis
Dx: Nucleic acid amplification testing for C. trachomatis, identification on pap smear, cell cultures
Haemophilus morphology
Morphology: Gram-negative coccobacilli
H. ducreyi disease pathology
Painful soft chancre (chancroid) and lymphadenitis
H. Ducrey diagnosis
Dx: Gram stain of scraping smears and cultures