Test #1 (Immune System, Infectious Disease and a taste of CV) Flashcards
The body system that defends against foreign invaders.
The immune system
Problems such as allergies and hypersensitivities arise when the response to an invader is ___________
Excessive
When the body’s own tissue is perceived as foreign or dangerous.
Auto-immunity
A type of microorganism that is too small to see with the unaided eye; ex. bacteria, viruses, fungi.
Microbe
A microbe that causes disease.
Pathogen
A substance that tends to kill or damage microbes – ex. lysosomal enzymes released by immune cells.
Anti-microbial substance
Large molecules (usually proteins or polysaccharides) on cell surfaces that elicit specific responses from hosts.
Antigen
T/F: Antigens are always on foreign-cells
False: Antigens can be on self-cells and foreign-cells
A specific, discrete component of an antigen that is used as an identifier and binding site by host immune cells.
Epitope
A protein in the immune system that is responsible for binding to an epitope and initiating the destruction of the associated organism.
Antibody
The immune system has two responses. Can you name them???
- The innate response
2. The adaptive response
The _____ ________ is something that we are born with. It is our non-specific initial line of defence.
Innate response.
Which of the following is untrue of the innate immune response:
• It’s a rapid, early response
• It’s always the same (non-specific)
• It’s made in Santa’s workshop
• It primarily reacts to microbes
• It relies on phagocytes and antimicrobials
• It includes external physical barriers like the skin and mucous membranes
• It’s fairly easy for microbes to adapt to it
• It stimulates adaptive responses
It’s made in Santa’s workshop
The first line of defence is the ____ and our ____ _________.
The skin and our mucous membranes.
_____ on the skin forms a protective film that inhibits the growth of certain microbes.
Sebum
______ can trap microbes which can be then expectorated or sneezed out of the body.
Mucous
Tears and saliva contain ________, an enzyme that breaks down the cell wall of some bacteria.
Lysozyme
The ______ ____ __ ______, or internal defences consists of antimicrobial substances, natural killer (NK) cells, and phagocytes. It involves activation of the complement system.
The second line of defence.
____________ substances include interferons, iron binding proteins, and antimicrobial proteins.
Antimicrobrial
This is a specific response. It develops with exposure to various organisms and substances.
The Adaptive Response
Which of the following statements about the adaptive response is untrue:
• It’s slower to kick in and develops in response to specific attributes of an invader
• It works with the innate response system to enhance reactivity
• It attacks microbes and antigens
• It attacks elves and friendly reindeer
• It generates immunologic memory, meaning that subsequent exposures lead to a more rapid response
It attacks elves and friendly reindeer
The primary cells of adaptive immunity are _____________, and _______________.
B-Lymphocytes (B-cells), and T-Lymphocytes (T-cells).
Lymphocytes act as __________ cells, which assist in controlling and orchestration of the immune response (ie. by activating other cells).
Regulator
Lymphocytes also act as __________ cells, by killing and eliminating the microbe or antigen.
Effector
_________ cells are phagocytes (macrophages, neutrophils, eosinophils) that kill or break apart an invader.
Accessory
________ cells present antigens and epitopes to killers.
Dendritic
There are always a high number of immune cells and other immune materials (like antibodies) circulating in the blood and lymph. This is known as _______ ________.
Humoral immunity.
Which of the following is not a place where Immune cells are found: • Lymph nodes • Bone marrow • Thymus • Tonsils • Spleen • Christmas presents • Skin • Mucosa • Vital organs
Christmas presents
_________ are key players in humoral immunity. They are very good at recognizing microbes and antigens (assisted by T-helper cells). They also produce antibodies.
B-Cells
When a B-cell binds to its associated _______, it becomes activated. Upon activation, it selects the type of clone needed: plasma cell or memory cell.
Antigen
When it reaches full maturation, ______ cells produce and secrete antibodies (aka immunoglobulins) designed for a specific antigen. Antibodies bind to epitopes and either kill or neutralize the invader, or present them to T-cells or macrophages.
Plasma
_______ cells do not participate in the initial immune response. They stay in the body to respond quickly if a secondary exposure to the same antigen occurs.
Memory
Which immunoglobulin is:
• The only Ig to cross the placenta (protects neonates) à passive immunity in newborn
• Diffuses readily out of the vascular zone into the tissues
• Antiviral, antitoxin, antibacterial actions
• Activates killer cells
• Activates the complement system
IgG
75% of antibodies are ____.
IgG
Which immunoglobulin is:
• Predominant in saliva, tears, nasal, GI, and respiratory secretions
• Found in breast milk (protects neonates)
• Blocks entry of organisms to the eyes, gut, respiratory, and urinary tracts
• Protects mucosa
IgA
Which immunoglobulin is: • Early responder • First Ig formed after immunization or initial exposure to a pathogen • Activates the complement system • Forms natural ABO antibodies • Doesn’t leave the blood or lymph
IgM
Which immunoglobulin is:
• Present in small amounts in serum
• Needed for B-cell maturation
IgD
Which immunoglobulin is: • Found in tiny amounts in plasma • Binds to mast cells and liberates histamine and other inflammatory substances • Attracts eosinophils • Responds to parasites
IgE
Cells that bind to and/or break down antigens. They present epitopes on their surfaces, or alter the antigen to make it more recognizable. B-cells, macrophages, and dendritic cells all act as presenting cells. Also, the antibodies can work in the same way.
Antigen Presenting Cells
_______ are responsible for what is called cell-mediated, or cellular immunity. They work via cell- to-cell contact or by secreting messenger compounds that communicate with immune system cells.
T-Cells
The key regulatory cells of the immune system. They release various T-messenger compounds that activate and regulate the activities of the other cell types. They activate B and T cells correctly depending on the type of immune challenge. Up-regulation.
T-Helper cells (a.k.a. CD-4 cells)
These suppress/modify immune responses. They decrease immune cell production. They control the mechanism to help ensure the response matches the situation, and that healthy self-cells are not killed. Down-regulation.
Regulatory T-cells (a.k.a. Tregs)
These destroy identified/presented antigens. They kill virus- infected cells by various means (lytic enzymes, cytotoxins, perforins, interferon). They are involved in attacking cellular problems that antibodies cannot influence.
T-cytotoxic cells (a.k.a. CD-8 cells)
In order for T-cells to recognize and respond to an antigen, it must be presented by another cell or an antibody. It must be coded by a ________ ________ _________.
Major Histocompatibility Complex (MHC)
MHC are a group of genes on chromosome 6 that determine tissue and blood compatibility. In humans, they are often called _____ _______ ________.
Human Leukocyte Antigens (HLA)
There are two classes of HLA. Class I are on ___ _____ ______. Class II are on ____ ________ _____.
Class I are on all cell surfaces.
Class II are on immune system cells.
HLA are key factors in determining self from ________
Non-self
Immunity that develops through direct exposure to an antigen and the in response, the immune system develops antibodies.
Active natural immunity
Immunity that develops when the body is purposefully introduced to an antigen and subsequently reacts by developing antibodies (ie. vaccines).
Active artificial immunity
Immunity that is passed from a mother to fetus, to protect the infant during the first few months of life as they develop their own immune system (ie. IgG crossing the placenta, IgA passed on in breast milk).
Passive immunity
Immunity wherein antibodies are injected from one system to another; used to help fight a current infection if the individual has not been immunized against the specific organism (ex. hepatitis B infections; rabies antiserum, snake antivenom)
Passive artificial immunity
The ability to distinguish between self- and non-self antigens.
Immunologic self- tolerance
The attacked body tissue may have similar characteristics to a microbe the immune system has just battled (ex. ________ _______). In this case, the foreign antigen is believed to be immunologically similar to auto-antigens (shares some of the same epitopes).
Rheumatic fever
Some HLA inheritance corresponds to activation of autoimmune disease. Exposure to a microbe or foreign material (like a breast implant) can initiate an autoimmune disease. Some examples would be:
Rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, and diabetes.
Sometimes there is an over response of immune activities. For instance, in _________ there is a hyper-reactivity of B-cells and an overproduction of antibodies. SLE may be triggered by a hyper reactivity to UV light.
SLE (lupus)
Sometimes there is a reduced T-cell suppressor response (ex. _________ ________ exacerbations are associated with drops in T-suppressor cell counts).
Multiple Sclerosis
In _________ __________, there is an autoimmune response to self-IgG. The resulting body is called rheumatoid factor.
Rheumatoid arthritis (RA)
Rheumatoid arthritis involves an immune system attack on ________ _________ of joints, eventually leading to bone erosion and joint deformities.
Synovial membranes
In MS, auto-antibodies create an immune attack on self-myelin in the CNS’s neurons (specifically the neuroglial cell: ________________).
Oligodendrocytes
In ________ ______, acetylcholine receptors at the neuromuscular junction are destroyed by immune cells after having been bonded by auto antibodies.
Myasthenia Gravis
Auto antibodies bind with self molecules to create ______ _________.
Immune complexes
__________ ________ refer to excessive or inappropriate activation of the immune system to exogenous and endogenous antigens that produce inflammation and cause tissue damage.
Hypersensitivity disorders
Type of hypersensitivity response mediated by IgE which leads to the release of inflammatory mediators from sensitized mast cells. The reaction takes place with the second and subsequent exposures to the antigen, not with the initial exposure.
Immediate Hypersensitivity
Immediate Hypersensitivity begins rapidly, often within minutes of an antigen challenge. Often referred to as _______ __________, the antigen in this case would be referred to as an allergen.
Allergic Reactions
Type I responses vary in severity:
• Mild, but annoying (ex. _______ _______)
• Severely debilitating (ex. ________)
• Life threatening (ex. ___________)
- Mild, but annoying (ex. seasonal allergies)
- Severely debilitating (ex. asthma)
- Life threatening (ex. anaphylaxis)
Type I response characterized by edema and hypersecretion of mucosal lining of the nasopharyngeal cavities by allergens like pollen.
Allergic Rhinitis
Lung disorder characterized by bronchoconstriction, edema, and increased secretion of thick mucus in the bronchi à constriction of airways.
Asthma
Type I response characterized by local wheals and erythema in the upper dermis.
Urticaria (hives)
Generalized edema of skin, lips, face, tongue, pharynx, and/or mucosa.
Angioedema (aka Quincke’s edema, Angioneurotic edema)
A systemic life-threatening hypersensitivity reaction. An acute generalized reaction characterized by itching, generalized flushing, headache, difficulty breathing, and a drop in blood pressure which can lead to shock and loss of consciousness.
Anaphylaxis
Type of hypersensitivity response mediated by IgM or IgG, this response is directed against target antigens on cell surfaces or in extracellular tissue. These reactions commonly involve the formation of antibodies directed against blood cells and their destruction.
Type II - Antibody Mediated Hypersensitivity (aka Cytotoxic Hypersensitivity
This is a hemolytic disease that affects neonates hemolytic anemia/erythroblastosis neonatorum in neonates
Erythroblastosis Fetalis
Type II response where antibodies produced by a patient’s own body are responsible for the hemolysis of erythrocytes.
Autoimmune Hemolytic Anemia
This type II response is triggered when an incompatible blood type is administered.
Blood Transfusion Reactions
Type II response where the body produces antibodies that are directed against platelets.
Autoimmune Thrombocytopenia (AITP)
Type of hypersensitivity response mediated by formation of antigen-immunoglobulin complexes, complement fixation, and localized inflammation; this response involves IgM and IgG antibodies.
Type III - Immune Complex Mediated Hypersensitivity
Type III response; performed for experimental purposes and involves the injection of a foreign substance. This usually results in complex formation and localized skin reactions (edema, hemorrhage, necrosis).
Arthus Reaction
Type III response caused by animal serum or drugs (ex. penicillin).
Serum Sickness
Type III response where an acute streptococcal infection is responsible for the formation of antibodies.
Glomerulonephritis
This disease is characterized by the inflammation and necrosis of medium-sized arteries with secondary ischemia of the tissues supplied by the affected blood
vessels.
Polyarteritis nodosa
Type of hypersensitivity response mediated by specifically sensitized T-lymphocytes, this response manifests as sub-acute or chronic inflammation with infiltration of the tissue by the lymphocytes and macrophages, resulting in variable degrees of necrosis.
Type IV - Delayed or Cell-Mediated Hypersensitivity
An acute or chronic delayed type of hypersensitive response to allergens placed on the skin surface.
Contact Dermatitis
Development of chronic inflammation because of infiltration of the graft by lymphocytes and macrophages. This leads to necrosis of the graft.
Graft Rejection
Latex allergies can be Type _ and/or Type _ Hypersensitivity
• Type _ latex reactions are immediate and often life-threatening
• Type _ latex reactions are more common and tend to manifest as contact dermatitis
Type I and/or Type IV
• Type I latex reactions are immediate and often life-threatening
• Type IV latex reactions are more common and tend to manifest as contact dermatitis
Organisms so small they are invisible to the naked eye and can only be seen with a microscope. Can be pathogens or non-pathogens.
Microorganisms
T/F: All microbes are microorganisms, but not all microorganisms are microbes
True
The presence and multiplication within a host of another living organism with subsequent injury to the host.
Infection
The ability of an organism to enter, multiply, and survive in a host.
Infectivity
Any organism capable of supporting the nutritional and physical growth requirements of another organism. (For this class, the term refers to humans supporting the growth of microorganisms.)
Host
The act of establishing a presence within a host.
Colonization
The disease producing potential of an invading organism.
Virulence
An organism so virulent that it is rarely found in the absence of disease.
Pathogen
A multitude of non-harmful bacteria inhabiting the internal and external exposed surfaces of the human body.
Microflora
Free living organisms that obtain nutrition from dead or decaying organic materials in the environment.
Saphrocytes
An organism which produces an infectious disease only when the health and immunity of the host have been severely compromised.
Opportunistic Pathogen
The multitude of non-harmful bacteria inhabiting the internal and external exposed surfaces of the human body (microflora) acquire survival needs from the host, but the host is not adversely affected by this relationship.
Commensalism
Which of the following is not a location of normal flora in the human body: • Skin • Nose/Pharynx • Mouth • Big burly white beard • Colon/Rectum • Vagina/Distal Urethra/Perineum
Big burly white beard
An interaction in which colonizing organism and host both derive benefits. E.g., Some bacteria that live in the intestines and feed off of undigested food also produce vitamins beneficial to humans.
Mutualism
An interaction in which a colonizing organism benefits and the host sustains injury.
Parasitic
Protein particles that lack any kind of demonstrable genetic material. They are mutated forms of a normal host protein. They may affect other normal proteins and alter them. They aggregate in the brain and form plaques.
Prions
It is hypothesized that humans can acquire
prions by eating animals that are infected
by a _____ disease like Mad Cow Disease.
Prion
Tiny gram negative bacteria that live inside a host cell (obligate intracellular parasites). They are transmitted by insect vectors and cause diseases like typhus, and Rocky Mountain Spotted Fever. They cause a typical rash, and cause small hemorrhages.
Rickettsia
A primitive organism related to bacteria that lack many of the enzymes needed for metabolic processes. It causes a very common sexually transmitted infection which can lead to pelvic inflammatory disease, and sterility in women. Infants born to infected mothers can develop eye infections and pneumonia.
Chlamydia
Causes Q fever, and illness that presents with flu-like symptoms, and cause progress to become systemic affecting the heart, lungs, and GI.
Coxiella
Commonly cause pneumonia. These organisms lack a cell wall, therefore they are not affected by antimicrobial drugs.
Mycoplasmas
Free living eukaryotic saprophytes found in every habitat on earth.
Fungi
Type of Fungi. Single celled organisms about the size of RBCs. They reproduce asexually through a budding process.
Yeast
Type of Fungi that grow in long filaments called hyphae.
Molds
The term ________ has evolved to designate members of the animal kingdom that infect and cause disease in other animals.
Parasite
Unicellular eukaryotes that may reproduce sexually or asexually. Most are saprophytes. Some are pathogenic to humans (e.g., malaria, amoebic dysentery, giardiasis, trichomonas vaginitis).
Protazoa
The study of factors, events, and circumstances that influence the transmission of infectious disease in human populations.
Epidemiology
Infection acquired form the host’s own microbial flora, as in the case of opportunistic infection.
Endogenous
Infection acquired from sources in the external environment, such as water, food, soil, and air.
Exogenous
______ born transmission – animals, or biting arthropods transmit microbes to humans.
Vector
When infection is acquired during hospitalization, or from a health care facility, they are known as _________ infections (or hospital acquired infections).
Nosocomial
Any disruption in the integrity of the body’s surface barrier (skin or mucous membrane) is a potential site for invasion.
Penetration
Pathogens are transmitted directly from infected tissue or secretions to exposed, intact mucous membranes.
Direct contact
Entry of infectious agent occurs through oral cavity and GI tract.
Ingestion
Entry of infectious agents through respiratory tract.
Inhalation
The capacity of a microorganism to cause disease (can make you sick).
Pathogenicity
Which of the following are not used to control transmission of infection:
• Universal precautions include hand washing, wearing gloves, and personal protective clothing. Hand washing is the most effective way to stop the spread of most common pathogens.
• Reservoir or source of infection must be located and removed.
• Portal of exit of microbes should be blocked (like by covering your mouth when you
cough)
• Knowledge of the mode or modes of transmission of a pathogen is essential to block transmission.
• Telling Santa it’s fine if he doesn’t wear a face mask.
• Adequate cleaning of surroundings and clothing.
• Use of disinfectants (that destroy microorganisms and their toxins on inanimate objects) and antiseptics (that are applied to the skin, to destroy microorganisms)
• Sterilization of fomites – inanimate objects capable of transmitting pathogens – by methods such as autoclaving.
Telling Santa it’s fine if he doesn’t wear a face mask.
Refers to the collection of signs and symptoms expressed by the host during the disease course.
Symptomatology
The disease course can be divided onto several distinguishable phases.
- _________ period – pathogen begins active replication without producing symptoms
- ________ stage – initial appearance of symptoms
- _______ stage – the host experiences maximum impact of the infectious process – host experiences the most symptoms.
- __________ stage – containment of infection, progressive elimination of the pathogen, repair of damaged tissue, and resolution of associated symptoms
- __________ stage total elimination of pathogen from the body with no residual s/s.
- Incubation period
- Prodromal stage
- Acute stage
- Convalescent stage
- Resolution stage
Continuous s/s for months or years without a convalescent stage.
Chronic infection
________ are microscopic, single celled organisms (prokaryotes). There are thousands of different kinds, and they live in every conceivable environment.
Bacteria
Bacteria may be classified by the colour they turn after they are treated with certain chemicals (stains). The most common stain is Gram Stain.
• Gram-positive bacteria turn ______ when stained.
• Gram-negative turns ____ when stained.
- Gram-positive bacteria turn purple when stained.
* Gram-negative turns pink when stained.
All bacteria may be classified as one of 3 basic shapes.
- _______ (cocci)
- _____ (bacilli)
- _______ (spirillum)
- Spheres (cocci)
- Rods (bacilli)
- Spirals (spirillum)
T/F: Facultative bacteria need oxygen to live
False: Facultative can live with and without oxygen
Some bacteria have _______ (whips) attached to the cell wall to provide motility.
Flagella
Tiny hair like structures found on some bacteria, usually the gram- negative class.
Pili or fimbriae
A latent form of bacteria with a coating that is highly resistant to heat and other adverse conditions. It provides bacteria with a long survival time. Tetanus and botulism can remain dormant in soil. If they enter the body, they may return to a vegetative state.
Spores
Usually secreted by gram positive bacteria, these diffuse through the body. Examples include neurotoxins secreted by tetanus bacillus, and enterotoxins secreted by enteric bacteria.
Exotoxins
Present in the cell wall of gram negative bacteria. They are released when the bacteria dies. Endotoxins cause fever, general weakness, and serious circulatory effects like endotoxic shock.
Endotoxins
Produced by some bacteria and cause damage to the host tissue. E.g. hemolysin produced by hemolytic streptococci cause damage to red blood cells.
Enzymes
Some bacteria secrete a substance that helps them to attach to other bacteria, cells, or body tissues. Dental plaque is an example.
Biofilm
Some bacteria are enclosed in a protective capsule. This helps to protect them from ingestion by macrophages.
Capsule
There are more than 30 strains of staphylococcus. Which of these is not an example:
• Skin infections, like furuncles (boils)
• Cellulitis, an acute infection of subcutaneous tissue
• Pneumonia
• Food Poisoning
• Whatever the Grinch has that makes him so green
• Breast abscesses in nursing mothers
• Postoperative infections
• Toxic shock syndrome
• Blood infections (bactemia)
Whatever the Grinch has that makes him so green
Group __ strep is a bacterium commonly found in the throat and on the skin. Can cause a range of infections from relatively mild sore throats and skin infections to life threatening invasive disease.
Group A
Cause of strep wherein bacteria resides in the nose and throat. May spread person to person from inhaling droplets that are coughed or sneezed out of an infected person. Droplets on the hand of an infected person may be spread to another by hand shaking (wash your hands).
Strep throat
Severe inflammation and tissue necrosis due to infection by a highly virulent strain of strep A. It invades tissues rapidly, reducing the blood supply and secretes enzymes that digest tissue. Systemic toxicity may lead to organ failure.
Necrotizing Fasciitis
Group _ strep is carried by most people without causing illness. However, when the body’s immune system is weakened, it can cause serious infection. May be transmitted to newborns from their mothers. It is the most common cause of blood infections and meningitis in newborns.
Group B
An inflammatory disease that may develop after a strep infection (e.g., strep throat or scarlet fever). The disease may affect the heart, joints, skin, and brain. It may lead to endocarditis, and be an issue later in life.
Rheumatic Fever
S/S of Rheumatic Fever include all of the following, EXCEPT:
• Abdominal pain
• Fever
• Cardiac problems that may be asymptomatic, or present with dyspnea (shortness of breath) or chest pain
• Joint pain, joint swelling
• Nosebleeds (epistaxis)
• Taking from the bottom tray of the gross Christmas chocolates before the top tray is finished
• Shin nodules
• A ring, or snakelike rash
Taking from the bottom tray of the gross Christmas chocolates before the top tray is finished
A serious infection of the protective membranes of the brain and spinal cord (meninges). (Often caused by hemophilus influenzae type b, Neisseria meningitdis, or streptococcus pneumoniae bacteria (DW)).
Bacterial Meningitis
Which of the following statements is FALSE:
Upper respiratory tract infections include infections like strep throat.
Middle respiratory tract infections include crying so hard during the scene where Tiny Tim dies that you can’t breathe.
Lower respiratory infections include bacterial pneumonia and bronchitis.
Middle respiratory tract infections include crying so hard during the scene where you find out Tiny Tim died that you can’t breathe.
___________ is an infection caused by mycobacterium tuberculae. It is a bacteria with a waxy capsule that makes it hard for macrophages to destroy them.
Tuberculosis
With tuberculosis, bacteria may remain dormant in granulomas in the lungs called ____ ____.
Ghon Foci
Enteric bacterial infections are infections of the intestines. Which of the following is not a bacteria that causes enteric selections:
• Escherichia coli (e. coli)
• Vibrio cholera (causes cholera)
• Salmonella
• Shigella
• Coal from the stockings of naughty children
• Anaerobic streptococci
Coal from the stockings of naughty children
T/F: There are more than 2000 varieties of salmonella. Most of them are pathogenic to humans. Most salmonella infections are known as gastroenteritis.
False: Little more than ten of them are pathogenic to humans
Signs and symptoms of salmonella start 12-72 hours after exposure to bacterium. They last for ___ days. It usually resolves without treatment in most people.
507 (!!!) days
A few varieties of salmonella can lead to _______ fever. This is sometimes a deadly disease more common in developing countries.
Typhoid
________ ________ (a.k.a. Shillosis) is a common infection settings where hygiene is poor. It is spread via the fecal oral route (gross).
Shigella Infection
These infections affect the urethra, urinary bladder, ureters, and kidneys. They are commonly caused by e. coli, pseudomonas aeruginosa, and klebsiella.
Bacterial infections of the urinary tract (UTI’s)
The most common tick-borne infection in the northern hemisphere.
Lyme’s Disease
________s are the smallest obligate intracellular pathogen. They have no organized cellular structure. Rather, they consist of a protein coat (a.k.a. capsid) surrounding a nucleic acid core of RNA or DNA.
Viruses
T/F: Viruses are able to replicate outside of a living cell.
False: They must penetrate a living cell and use the biosynthetic machinery of the host cell to produce viral progeny. The virus will attach to a host cell, enter it, and then release its genetic material.
Sometimes the virus will not kill the infected cell, but alter the cell’s function. The cell is at risk of becoming _________.
Cancerous
_________ is an acute viral infection that can affect the nervous system. It may lead to full or partial paralysis.
Poliomyelitis
T/F: Rubella and Rubeola are pretty much the same thing
False: Rubella (German measles) is caused by rubella virus and s/s include fever, headache, general malaise, runny nose, skin rash.
Rubeola (measles) is caused by paramyxovirus and results in a total body skin rash, in addition to the s/s of Rubella
Viral infection that is spread through saliva. Primarily affects parotid glands.
Mumps
A common, preventable childhood infection caused by the Varicella-Zoster virus.
Chicken Pox
This is not a childhood illness, but only occurs in people who have had chicken pox. The virus remains dormant in the dorsal root ganglia for years. It usually gets activated by stress.
Shingles
____ is an illness caused by a new form of coronavirus. It is thought to have originated in civets (a type of cat) in China. The virus is spread by close person to person contact.
SARS - Severe acute respiratory syndrome
There are more than 100 types of ____. Most are harmless, and cause warts (verrucae). Only 30 types give risk of cancer. These types usually affect genitals, and are spread through sexual contact.
HPV (Human Papilloma Virus)
__________ is a diffuse inflammatory disease of the liver. It is caused by several different viruses (HAV, HBV, HCV, HDV, HEV). General S/S are nausea, vomiting, malaise, fever, headache, dark urine, jaundice, enlarged liver, excess bruising, and pain in the abdomen.
Viral Hepatitis
Hep _ • Caused by enterovirus • An acute infection – there is no chronic stage, is not progressive, and does not cause permanent liver damage. • Spread by contaminated food and water • Occurs sporadically, or in epidemics • Incubation is roughly 30 days • Immune system makes antibodies that confer immunity to future infection • Prophylaxis through immunization
Hep A
Hep _
• A more serious health problem – has chronic stage/carrier state.
• 2-6 month incubation period
• Spread by contaminated feces, bodily fluids including saliva, contaminated breaks in the
skin, sex, or contaminated tissue transplant.
• Prophylaxis through immunization
• leads to cirrhosis
Hep B
Hep _
• Serious disease – often becomes chronic and leads to cirrhosis of the liver, and liver
cancer
• Incubation period is 2 weeks to 6 months
• Spread is similar to Hep B
Hep C
Hep _
• Hep D virus is only present with Hep B infection
• Fulminant hepatitis and liver cirrhosis are more common with Hep D infection than with a
Hep B infection
Hep D
Hep _
• Clinically resembles Hep A – no chronic stage
• Transmitted by fecal oral route.
Hep E
Name that STI!
• Caused by Human Papilloma Virus
• Most cases are asymptomatic, and resolve without treatment
• Some infections result in warts on the genitals
• May lead to cervical cancer – possible link to oropharyngeal cancers
• There is currently a vaccine to prevent HPV infection.
Condylomata Acuminata (Genital Warts)
Name that STI!
• Not strictly an STI
• Candida albicans is the most common yeast to cause infection
• Common vaginal infection – 75% of women of reproductive age will experience one in their lifetime
• Men may have candida on their penis, but usually do not experience s/s
• The yeast may also be in the gastrointestinal tract – auto-inoculation is possible
• Causes vaginal pruritis, erythema, swelling, dysuria, and dyspareunia
• Typical vaginal discharge is usually thick, white, and odourless
• Treated with anti-fungal medications.
Candidiasis (Yeast Infection, Thrush)
Name that STI!
• Caused by an anaerobic protozoa.
• A more common infection than Gonorrhea – often considered a marker for high risk sexual behaviour.
• The protozoa can live in the paraurethral glands of both sexes.
• Men generally remain asymptomatic.
• In women, greater than > 75% develop symptoms.
• Symptoms include copious, frothy, malodorous, green or yellow discharge.
• Small hemorrhagic areas may appear on the cervix – known as “strawberry spots”.
• May lead to tubal infertility in women, and atypical pelvic inflammatory disease.
• Can lead to infertility, altered sperm motility, and chronic prostatitis in men.
• Treated with systemic anti-protozoan medications.
Trichomoniasis
Name that STI!
• One of the most common STIs in North America.
• In women, typical symptoms include mucopurulent cervical discharge, urinary frequency, and dysuria. The cervix hypertrophies, and becomes erythematous, edematous, and extremely friable. May lead to fallopian tube damage. Left untreated it may lead to PID.
• In men, s/s include urethritis, meatal tenderness and rubor, urethral pruritis, discharge, and dysuria. Prostatitis and epididymitis may develop and lead to infertility. Left untreated may lead to Reiter syndrome – a reactive arthritis that leads to conjunctivitis, urethritis, and mucocutaneous lesions (can’t see, can’t pee, can’t dance with me).
• 75% of women and 50% of men have no symptoms, so many cases go untreated – it is a good idea for every sexually active person to undergo routine STI screening.
• May be treated with antibiotics.
Chlamydia Infection
Name that STI!
• 90% of cases occur in those between 15 and 44 years old, women are more likely to be
infected compared to men.
• After years of declining rates of infection, incidence is now on the rise.
• Usually spread through intercourse (vaginal or anal), but auto-inoculation to the conjunctiva is possible. Babies born to infected mothers are at risk of contracting gonorrheal conjunctivitis – may lead to permanent blindness.
• In men, the infection starts in the anterior urethra, and may spread proximally in the genital tract. Symptoms include urethral pain, dysuria and creamy yellow or blood urethral discharge. May become chronic and infect the epididymis, and prostate.
• In women, symptoms include unusual vaginal discharge, dysuria dyspareunia, pelvic pain, proctitis, and fever. Symptoms may fluctuate with menses. Chronic infections may lead to salpingitis with subsequent scarring and infertility.
• May invade the circulatory system of both men and women and cause sequelae in joint spaces, heart valves, meninges, and other tissues of the body.
• Many cases are asymptomatic – people may unwittingly spread the infection.
• Currently considered to be resistant to all know antibiotics (pretty scary!)
Gonorrhea
Name that STI!
• Caused by Treponema pallidum bacteria.
• Incidence has been increasing over the past ten years.
• Has three stages. Primary, secondary and tertiary.
Syphilis
The _________ nervous system must appropriately and adequately regulate heart beat and peripheral resistance.
Autonomic
The heart sits in the chest cavity between the two lungs, in the space called the __________. Its placement is largely central—about 60% of the heart lies to the left of the midline.
Mediastinum
The heart is shaped like an inverted cone — the broad top section supports the large blood vessels. The slightly pointed bottom, called the apex, is at the caudal end of the ____ _________.
left ventricle
The location of the heart spans between rib levels - when it is its normal size, which is about the dimensions of a fist
Ribs 3-6
About __% of the body is in a fluid state, half in the tissue interstitial spaces and half in the streaming blood and lymph.
55%
All of the blood in circulation travels out of and back to the heart once per ______ at rest and up to six times during activity
Minute
The heart is the pump that keeps the blood moving through this circuit. It is a closed circuit except that it “leaks” fluid in both directions at the _________s.
Capillaries
The right atrium receives blood from the 1) ________ ____ ____ (venous return {VR} from the body tissues above the diaphragm), the 2) ________ ____ ____ (VR from below the diaphragm) and the 3) ________ _____ (VR from the heart’s own tissues).
1) Superior vena cava
2) Inferior vena cava
3) Coronary sinus
The left atrium receives re-oxygenated blood from the _____.
Lungs
There are two ventricles, right and left. They are the _______ chambers of the heart.
Pumping
The _____ ventricle takes the de-oxygenated blood that has returned to the heart from the body tissues and pumps it into the lungs in order that it can release CO2 and take on fresh O2.
RIght
The left ventricle takes the refreshed blood that has arrived from the lungs and pumps it into the _____, from which it travels along the arterial system for distribution throughout the body.
Aorta
Supply of oxygenated blood to a tissue consistent with its current metabolic need is called _________ (the ventricles are the first step and the power behind this delivery system).
Perfusion
______ act as gateways that sit in open position when blood needs to pass through them, and then close to prevent the blood from backflowing.
Valves
The ________ AV valve is situated between the right atrium and right ventricle.
Tricuspid
The _____/________ AV valve is between the atrium and ventricle on the left side.
Mitral/bicuspid
_________ valves are between ventricles and the pulmonary trunk and aorta.
Semilunar
The _________ SL valve sits between the right ventricle and the pulmonic trunk (becomes the pulmonary arteries).
Pulmonary
The _______ SL valve is located between the left ventricle and the aorta.
Aortic
All the heart’s valves have three cusps except the ______ valve, which has two.
Mitral
The tricuspid and mitral valves are supported by ________ _______s.
Papillary muscles
Papillary muscles are extensions of the ventricle wall that attach to the cusps of their valve via ______ ________.
Chordae tendineae
The _________ valves do not have supporting muscles and close entirely because of their structure, much like the valves in the veins of the leg.
semilunar
Closure of the __ valves creates the first heart sound (lub, or S1).
AV
When the __ valves close, the second heart sound, dub or S2, is made.
SL
When disease/damage causes a valve to open poorly or incompletely, it is referred to as _______.
Stenotic
When a valve is unable to close properly, the valve is called _________ or ___________.
Regurgitative or regurgitating
Each chamber cavity is lined with __________. Its tissue consists of loose areolar connective tissue and endothelial cells, and it is continuous with the inner layer ((intima/interna) of the blood vessels.
Endocardium
The __________ layer consists of specialized cardiac muscle cells, which are responsible for the contraction actions of the heart wall. It is by far the thickest layer.
Myocardial
The ________ __________ (sometimes referred to as the epicardium) is firmly attached to the outer rim of the myocardium.
Visceral pericardium
The ________ ________ is the outer layer of the pericardial sac and fused to its outer surface is the protective, relatively inelastic, fibrous pericardium, which prevents distension/excessive stretching of the myocardial cells.
Parietal pericardium
The __________ ______ is the space between the visceral and parietal layers that contains serous fluid. Its purpose is to reduce friction. This fluid-filled sac design allows the heart to beat in relative freedom while still being anchored within the chest cavity.
Pericardial cavity
The left and right coronary arteries offshoot from the proximal _____ ____ and their branches distribute blood throughout the heart wall.
Aortic arch
The venous drainage of the heart is transported through the coronary vein system, which terminates in the ______ _____, a large vein that empties into the right atrium.
Coronary sinus
The heart is a very metabolically active organ that requires constant, substantial _______.
Perfusion
_______ ______ _______ is common; it is the most common cause of heart attacks.
Coronary artery disease (CAD)
The SA node depolarization wave
travels in two directions: through the RA wall and over to the LA wall via the 1) _________ ______; and to the 2) __________ _____.
1) Bachmann’s bundle
2) Atrioventricular (AV) node
The SA node signal exits the AV node to the AV bundle (______ __ ___), which splits into right and left bundle branches that travel through the septum to supply their corresponding ventricle.
Bundle of His
The bundle branches terminate in _______ _____ that communicate the signal to the muscle cells (usually called fibres) of the myocardium, including the papillary muscles.
Purkinje fibres
The myocardial fibres are specialized for signal conduction through the heart wall. Their membranes contain ________ ____s, which create several points of rapid communication among adjacent cells.
Intercalated discs
Myocardial fibres contract more strongly in response to stress (as per the _____-_______ mechanism). These features are well suited to healthy heart function.
Frank-Starling
Located in the aortic arch and the internal carotid arteries, these are stretch receptors stimulated by distortion of the arterial wall with pressure changes.
Arterial Baroreceptors
Found in large systemic veins, pulmonary vessels, and the walls of the right atrium and the ventricles, these generate signals that influence distribution of blood volume in different parts of the system; involved in managing average (mean) blood pressure.
Low Pressure Baroreceptors
The heart is directly or indirectly responsive to a number of influences. Which of the following is NOT an example:
- physical activity level
- emotional state
- autonomic regulation of visceral activities (e.g. -–
- digestion being prioritized over skeletal muscles)
- endocrine signals (such as from the thyroid)
- afferent inputs (such as from the blood vessel wall receptors)
- shaking the presents under the tree to guess what’s inside
- body temperature
- specific tissue metabolic needs
Shaking the presents under the tree to guess what’s inside
