Test 2 Flashcards
Which are the 2 major genera that produce endospores?
Bacillis and Clostridium
Genera?
Obligate anaerobe living in the GI tract of
animals
-Tetanus, Gas Gangrene, Botulism
Clostridium
Genera?
- Obligate aerobe living in the soil
- Anthrax
- Forms calmodulin dependent adenylate cyclase exotoxin known as edema factor along with lethal factor
- Increase cAMP, responsible for sever edema
Bacillis
Resistance to adverse conditions is due to the endospore’s
Dipicolinic acid, a calcium ion chelator only found in spores
produces tetanosplasmin
causative agent of tetanus, disease
characterized by painful muscular spasms
that lead to respiratory failure
C. tetani
produces gas in tissues in
gangrene, necrotic damage, specific to
muscle tissue, enter through significant
skin damage
Gas Gangrene
is found most often among
those who inject street drugs or through
ingestion of food with the spores
Botulism
cause of infectious diarrhea due to spore forming bacteria, this can happen when patient is under antibiotics that destroy the normal flora
Difficile Colitis
Describe the composition of a spore?
o Dipocolinic acid is incorporated into the endospore
o Spore coat composed of keratin like protein forms around the cortex
Most common microorganism in our stool:
Gm(-) P. Aeruginosa
leading cause of UTI
Gm(-) E. Coli
Frequently found in root canal treated teeth 30%-90% of cases
Gm (+) E. Faecalis
Associated with perforation of the intestinal wall, is an important cause of peritonitis
B. Fragilis
inflammation of the thin tissue that lines the inner wall of the abdomen and covers most of the abdomen organs
Peritonitis
which type of bacteria has Techoic acid?
Gm(+) Bacteria
which type of bacteria has LPS
Gm(-) Bacteria
Responsible for endotoxic fever and shock
Lipid A (endotoxin) released in the
blood stream when Gram negatives
are lysed
LPS Composed of:
- Outer carb chain 1-50
oligosaccharides, O-specific side chain - Center core polysaccharide
- Lipid A (endotoxin)
This type of bacteria has a Periplasmic space filled with beta lactamase to digest beta lactam drugs, has
outer membrane lipid bilayer containing
Lipopolysaccharide (LPS)
Gram Negative
The 4 possible stains that are involved in a gram stain
Pour crystal violet stain (blue dye)
Pour Iodine solution (Iodine forms a complex with the crystal violet)
Wash off with Acetone/Alcohol
Counterstain with Safranin (red)
What colors do Gm(+/-) Stain?
Gm (+) Blueish Purple
Gm (-) Orangish/pink
Enterotoxins: Exotoxin that act on GI tract to cause diarrhea by inhibiting NaCl resorption, activate NaCl secretion and kill intestinal epithelial cells, osmotic pull of fluid into the intestines.
Also responsible for Infectious diarrhea, bacteria colonize and bind to GI tract, continuously releasing their
enterotoxins
V. Cholerae, gram positive
Responsible for Clenched fist injuries. Part of normal human flora in the mouth and upper respiratory tract.
Eikenella Corrodens, gram negative
Caused by lipid A endotoxin of gram negative bacteria
Septic Shock
Most common UTI causing bacteria. Flagella play a role in the pathogenesis by propelling the bacteria up the urethra into the bladder.
E.Coli
Responsible for Endocarditis on prosthetic heart valves. Leading cause of subacute bacterial endocarditis. Organisms can enter the bloodstream at the time of dental surgery and attach to damaged heart valves.
Viridans Strept
- Polysaccharide that is secreted by many bacteria
- Covers the surface and allows the bacteria to adhere firmly to various structures
- Mediates Strept Mutans to surface of teeth
- Important role in formation of dental plaque/caries
Glycocalyx (slime layer)
What is the most dominant normal flora in the vagina?
lactobacillus species
What is the most dominant normal flora in the oral cavity
Viridans Strept
A member of viridans group is found in large numbers in dental plaque, precursor of
dental caries
Strept mutans
What characteristic immune cell for calling out different types of cytokine, qb cell in cascades of cytokines Interleukin -1 and TNF-alpha
macrophages
- Protein produced by T
lymphocytes and Natural Killer Cells - Potent stimulus for macrophage activation and cytokine production
- Helps in viral killing
Interferon
- Direct cell migration of
inflammatory cells at sites of tissue injury - stimulate germinal centers of lymph nodes (B cells) recruitment of lymphoblasts to B cell lymphocytes
- Inflammatory: produced in
response to IL1 and TNF and interferon, recruits leukocytes during
Chemokines
- Produced by macrophages
- Regulation of immune responses, inflammatory responses and hematopoiesis
Interleukins
T cells (cell-mediated immunity) eliminate antigens by releasing toxic substances (________) and activating other cells (_____________)
lymphokines
neuts, monocytes, macrophages
What’s the predominant immunoglobulin/antibody in the mucociliary escalator?
Lining epithelium of mucous membranes contains cilia and mucus with secretory IgA that propels
organisms to either be coughed or sneezed
Name the Type of inflammation and example
- Mild inflammation
- Clear fluid serum
- Herpes (vesicles filled withserum)
- Second degree burns
Serous Inflammation
Ex. 2nd degree burns
Describe Fibrinous Inflammation and name it’s best example
- Exudate rich in fibrin
- Severe inflammation
- Does not resolve easily
- Macrophages invade to lyse fibrin
- Blood vessels proliferate
- “organization” of blood vessels
- Macrophages stimulate fibroblasts to cause even more adhesion
Best Eg… FIBRINOUS PERICARDITIS
Describe Granulomatous Inflammation
- Special form of chronic inflammation
- Seen in TB
- Nodules, granuloma, encased to wall off infection
- Fibrosis caused by chronic inflammation effects organ function due to scarring
Hallmark cell of acute inflammation?
Neutrophils, sudden onset and short duration
Hallmark cell of chronic inflammation?
Macrophages, monocytes, lymphocytes, plasma cells
What makes up granulation tissue?
Vascularized connective tissue that is rich in macrophages, myofibroblast, angioblast, fibroblast is called granulation tissue
What are the 3 cells responsible for wound healing
Myofibroblasts
Angioblasts
Fibroblasts
Myofibroblasts Function
Shows up within first few days of healing. Enable contraction, holding the margins of tissue within close approximation, and lays down collagen.
Angioblasts Function
Precursors of blood vessels that proliferate like sprouts from several small blood vessels at the
margins of the wound (5th-6th day)
Collagen is alive and needs to be bathed with nutrients which is why we have blood in the
wound
Fibroblasts Function
Cells that produce most of the ECM
Produce: Fibronectin, and Collagen
Importance of Collagen in wound healing…
Type III initially that is immature or young laid down by fibroblasts
Type I collagen is mature, several weeks later, most mature collagen in wound healing, scar tissue
What is the Significance of Fibronectin in regards to wound healing?
important in providing the tensile strength to connective tissue matrix
Also has the ability to glue other substances and cells together
The most important cells that are involved in wound healing are the…
Leukocytes, Macrophages, ConnectiveTissue Cells and Epithelial Cells
What are Keloids?
excess scar formation of collagen type III, never matures to type I
What could prevent a wound from healing?
- The type of tissue
- Infection
- Mechanical Factors
- Age
- Circulatory status: ischemic issues, common in diabetics (microangiopathy) delays wound healing
- Nutritional and metabolic factors
In acute inflammation, touching hot stove, what 2 tissues/cells responsible for surface adhesion molecules anchoring the neutrophils to the inner column of the capillary, sticky protrusions?
Leukocytes and Endothelial cells
During inflammation, the surface components of leukocytes and endothelial cells are activated by…
Soluble mediators of inflammation or (interleukins)
What cells do margination and pavementing?
White blood cell’s marginate and become attached to the edge of endothelium ( becoming leukocytes) a phenomenon called “pavementing”
Name the form of ulcerative inflammation that is combined with fibrinopurulent exudation, and an example of a disease.
Pseudomembranous Inflammation
Eg. Clostridium difficile - causes psuedomembranous colitis
What organism is responsible for Pseudomembranous Inflammation?
Clostridium Difficile Colitis: infectious diarrhea due to a type spore forming bacteria
Continuously dividing cells that divide
throughout the entire lifespan
Labile Cells
Cells that do not divide regularly, but can be stimulated to divide if necessary eg.. Parenchymal organs, Liver/kidney
Stable Cells and/or Quiescent Cells
Non-dividing cells, not have capacity to
proliferate under any circumstances
Permanent cells
What’s a very common reason for a purulent inflammation? Give examples of purulent/supparative
inflammation.
o Typically caused by pus-forming bacteria, such as staph/strept
o Viscous yellow fluid composed of dead dying neutrophils/PMN’s and necrotic tissue debris
o Localized collection of pus with an organ or tissue is called an abscess
o TB, acute cerebral abscesses, peritonitis, meningitis, crohns disease
What cells are involved in phagocytosis, what is the process, and how does it work?
o Cells arrive at site of inflammation by chemotaxis, attach to antigen by recognition or by
complement/antibodies opsonization
o Phagocyte cell surface invagination phagosome
o Phagosome fuses with granules/lysosomes of the cell phagolysosome
o Antigen/microbe destruction
What is Fibrosis?
The heart uses this to repair damage
Formation of excess fibrous connective tissue in an organ or tissue in reparative or reactive process
In response to injury this is called scarring
Excess deposition of fibrous tissue, collagen
Fibroblasts are called to lay down collagen
Occurs everywhere except CNS/Brain/Neurons
What is Gliosis?
Protein that is laid down by certain cells in the brain by astrocytes
“astrogliosis”, glial cells response to damage to CNS, glial scar
Fibrous scarring within the brain
The increased permeability of the vessel
walls of the capillaries and venules lasts for
several hours to several days and is usually
accompanied by leakage of fluid from the
vessels into the interstitial spaces.
Transudation
Contains much more protein than a Transudation, and contains inflammatory cells that emigrate across the vascular wall.
Exudate
When wound edges are brought together (sutured/glued) so that they are adjacent to each other. This minimizes scarring.
Most surgical wounds heal by this intention. The Surgeon will directs closure of the wound by approximating wound edges
Primary Intention:
o The wound is allowed to granulate
o Granulation results in a broader scar
o Healing process can be slow due to presence of drainage from infection
o Prolonged healing
o Characteristic of infected wounds o Wound contraction cannot be accomplished by myofibroblasts
Secondary Intention:
Surgical complication in which wound ruptures along surgical suture, insufficient collagen strength
Wound dehiscence
What is considered leukocytosis clinically, number wise?
o Normal blood has less than 10,000 leukocytes/wbc’s
o When numbers > 12-15,000 this is leukocytosis and in acute inflammation, neutrophils dominate
When an organized collection of macrophages attempts to wall off a substances that it perceives as foreign but is unable to eliminate.
Granuloma
Diseases that result in granulomas and cause fever…
TB
Crohn’s Disease
Sarcoidosis
Giant Cell Arteritis
What are the 3 components of lps,
- O-specific antigen made of 1-50 oligosaccharide
- Center core polysaccharide
- Lipid A (endotoxin)(toxic fatty acid) responsible for endotoxic fever and shock
Of the Components of lps, which is considered the most toxic component?
Lipid A (endotoxin)(toxic fatty acid) responsible for endotoxic fever and shock
Recruits A LOT OF CYTOKINES
Interleukins and TNF build up is bad for our blood vessels»_space;> massive vasodilation, hypotension,
reduces tissue perfusion tissue hypoxia sepsis
What class of drugs commonly cause neuroleptic malignant syndrome?
Adverse reaction to neuroleptic or anti-psychotic drugs like Thorazine, Haldol, Reglan, inhibits dopamine receptors
phenothiazines, haloperiodol, metoclopramide
What is Malignant Hyperthermia?
Autosomal dominant abnormality of skeletal muscle SR releasing calcium affecting hypothalamic set point of temperature after administering anesthesia (halothane, succinylcholine)
Cell walls are common to all Bacteria except…
Mycoplasma
Peptidoglycan layer is much thicker in…
Gram positive bacteria
Polysaccharide fibers that act as surface antigen for serologic ID in only Gram Positive bacteria
Teichoic acid
Gram+ does NOT have___________, but might have a___________ space
beta-lactamases
periplasmic
is a concentrated gel-like matrix in the space between the inner cytoplasmic membrane and the bacterial outer membrane
periplasmic space
Community-acquired pneumonia (CAP) is one of the most common infectious diseases addressed by clinicians. What causes it?
St. pneumoniae, H. influenzae, and M. catarrhalis
is the #1 cause of sepsis and UTIs (also causes neonatal
meningitis
“Good o’l” e. Coli
A gram (+) bacteria, that is commensal on the skin, but is responsible for majority of infection from heart valve?
Staphylococcus epidermidis keeps staph aureus in check. If the this balance ins disrupted heart valves may be affected
is an enzyme that kills bacteria by disrupting cell walls
lysozyme
help destroy microbes when engulfed into the cell
peroxidases
Sequesters iron from microorganisms. Iron essential for microbial growth. This is Found in saliva, some phagocytes, blood and tissue fluids.
Lactoferrin
– Antimicrobial peptides inserted into microbial
membrane
– Found on mucous membranes and in phagocytes
defensins
When a Phagocyte is drawn to bacterial wall sugars, or By complement/antibodies which is bound to pathogen and acts like an Opsonin (tasty) by coating bacteria to enhance efficiency of phagocytic process for better destruction
chemotaxis
loss of epithelial lining due to inflammation of body surfaces or mucosa of hollow organs (e.g.. Stomach, intestines)
Ulcerative inflammation producing an Ulceration
Defect involving epithelium
Ulcerative inflammation producing an Ulcer
Eg. Peptic (gastric) ulcer
Inflammations dominated by pus formation are
called…
purulent or suppurative inflammations.
The 2 most common opsonins
C3b and and the Fc portion of immunoglobulin (IgG or IgM)
Which organism causes pseudomembranous colitis
Clostridium difficile
C. Diff
3 body systems account for 80% of infections/fevers with an unknown cause.
respiratory, urinary, skin + soft tissue
Define Toll-like receptors (TLRs) and role in inflammation
Microbial stimulation of these receptors leads to synthesis/secretion of these endogenous cytokines
Initiates inflammatory response → further recruitment of blood infection fighters (PMNs)
act on the thermoregulator centers in the Hypothalamus, which serves as a thermostat.
Substances called
Interleukin-I and Tumor Necrosis Factor
(TNF)
