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
Klebsiella morphology
Morphology: Gram-negative bacilli
Klebsiella granulomatis characteristics
Minute encapsulated coccobacillus (Donovan bodies in mφs in smears)
donovanosis pathology
Donovanosis = granuloma inguinale
Painless genital ulcers
Can progress to scarring with lymphatic blockage (lymphedema of genitalia
Dx: Cultures, smear examination, PCR
Mycoplasmataceae (mycoplasma and ureaplasma) morphology
Morphology: No cell wall (but appear coccoid and red on gram stain)
M. genitalium, M. hominis and Ureaplasma urealyticum pathology
Species special characteristics: Commonly found in sexually active people
Ureaplasma produce urease
Diseases: non-gonococcal urethritis, cervicitis and pelvic inflammatory disease
Gardnerella morphology
Morphology: Small gram-variable* coccobacilli (diptheroid)
Group characteristics: *Cell wall is in reality gram positive
Gardnerella vaginalis pathology
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
herpesvirus morphlogy
Morphology: dsDNA, large and enveloped
Group characteristics:
Produce intranuclear inclusions and multinucleated giant cells
Capable of latency and can lead to recurrent infections
HSV-2 pathology
-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
HSV-1 pathology
-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
Papillomaviridae (p.k.a. Papovariedae morpholgy
Morphology: Circular dsDNA, naked
Group characteristics:
Trophic for epithelial cells of the skin and mucus membranes
papillomaviridae -Human papillomavirus (HPV) associated diseases
Verrucae (skin warts), condyloma (genital warts), papillomas, as well as cervical, anal & pharyngeal cancers
Low risk HPV- types 6 and 11 cause what
cause condylomas and oropharyngeal papillomas
High-risk HPV- types 16 and 18
responsible for most cancers and high grade dysplasias
Retroviridae morphology
Morphology: +ssRNA, enveloped/ Retrovirus RNA is transcribed in a retrograde fashion requiring a viral reverse transcriptase (RNA-dependent DNA polymerase)
Retroviridae- HIV- spread how?
Spread by fluids (sex, transfusions, contaminated needles) or during pregnancy
Attach to CD4 receptor & CCR5 (mφ) or CXCR4 (TH cell) coreceptors
HIV-1 pathology
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.
HIV-2 pathology
HIV-2 is similar to HIV-1 infection but restricted to W. Africa
Poxviridae moprphology
Morphology: dsDNA, envelope
Group characteristics:
Replicate in the cytoplasm of host cell
Poxviridae= Molluscum contagiosum virus diseases
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
Flaviviridae Morphology:
Morphology: +ssRNA, envelope
Flaviviridae= zika virus diseases
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
Trichomonas morphology
Morphology: Flagellated unicellular protozoan
Motility: Corkscrew motility
Trichimonas vaginalis diseases
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
Anoplura (Sucking Lice) morphology
Morphology: 1-2 mm, rounded body insect 6 legs
anopluyra- Phthirus pubis diseases
Found in pubic hair of sexually active people
Diseases: Pediculosis pubis (crabs) - itching, moving lice, nits, possible rash
mites morpholgy
Morphology: Microscopic rounded arachnid
8 legs
mites= Sarcoptes scabiei diesease
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.
