Typhoid Fever

Question 1

Salmonella and Diseases

Answer 1

Gastroenteritis

Enteric Fever

Question 2

Enteric Fever by s Typhii and s paratyphii

Answer 2

Typhoid

paratyphoid

Question 3

Typhoid Epidemiology

Answer 3

Endemic, poor quality water,

Question 4

Typhoid reservoirs

Answer 4

HUMANS ONLLY, school age and young adults

Question 5

Typhoid transmission

Answer 5

Fecal oral

Question 6

Innate resistance

Answer 6

Gastric acid
CFTR heterozygote
IgA
Normal Intestinal Flora

Question 7

Acquired Resistance

Answer 7

circulating IgM or IgG

CD4 or CD 8 Sensitized

Question 8

Sal Typhi Etiology

Answer 8

Gram negative bacilli
Motile
facultative anaerobe
regular medium

Question 9

Sal Typhi Characteristics

Answer 9

H2S producer, non lactose fermenter
Hekoten–diff lactose vs non lactose
McConkey = clear colonies
Infect macrophages

Question 10

Typhi Virulence Factors

Answer 10

Invasive w/ Type III
O antigen
H antigen-- flagella
LPS
SPI -1 and SPI-2 path islands
Vi antigen
Fimbriae- m cells

Question 11

Typhoid Fever Pathogenes 9 steps

Answer 11

1. microbes gain entrance
2. survive acid and bile
   3.attach to m cells
3. induce endocytosis
   5, taken up by macrophages
   6.travel lymphatics
   7.initiate phagocytosis
4. released ito blood stream
5. Repeat RES circuit

Question 12

typhoid and peyers patches

Answer 12

Travel to ileum, find cftr gene of M cells
Induces BME or cell ruffling
Activates Type III sec inside phagolysosome

Question 13

Where does Sal Typhi reside

Answer 13

Macrophages can cause rupture if high enough colony

Question 14

Gall Bladder Enteric Fever

Answer 14

Predisposes, logn term carriage

Question 15

Second INvasion of Peyers patches

Answer 15

Reseeding from bile
Hyperplastic
Necrotic

Question 16

Clinical Manifestations week one

Answer 16

fever pattern, high in day gone by moring or
rise rapidly
• bacteremia
•bradycardia

Question 17

Clinical Manifestations week Two

Answer 17

Abd Pain
Rose Spots
Constipation/Diarrhea

Question 18

Clinical Manifestations week Three

Answer 18

Hepatosplenomegaly
Intestinal Bleeding
Perforation

Question 19

Clinical Manifestations week 4

Answer 19

absence of complication

Some are chronic carriers

Question 20

Chronic Carrier

Answer 20

occurs in women
patients with gall stones or bile
Urine w/ Schistosoma

Question 21

Typhi Diagnosis

Answer 21

Culture Isolation

sensiivity nalidixic acid

Question 22

Recovery Organisms

Answer 22

After 1 week, blood
bone marrow biopsy
• confirmatory
• isolate even after antibiotics

Question 23

Serology Typhi

Answer 23

Widal- O and H antigen
Typhidot – IgM IgG
ELISA VI ANTIGEN

Question 24

Typhi Treatment

Answer 24

Amp/ Tmp/SX Chloramphenicol

Question 25

Treat Chronic Carriers

Answer 25

Cipro or norfloxacin

Question 26

Typhi Prevention

Answer 26

2 vaccins • live attneuated • Injection= Neither totally effective

Question 27

Yersinia Pestis Epidemiology

Answer 27

``` Zoonotic rodents wild Xenopsylla cheopis oropsylla montana Feral mammals Native Americans increased risk Human to Human Transmission ```

Question 28

Yersinia Etiology

Answer 28

``` PESSKY Strains Non Spore Pleomorphic Gram neg coccobacillus Path Island Temp Vairant NON MOTILE ```

Question 29

How do you see Yersinia Microscopically?

Answer 29

Bipolar, SAFETY PIN Wayson Stain Giemsa Stain

Question 30

What antigenic factor does Yersenia have?

Answer 30

F1 factor

Question 31

Where does Yersenia Grow?

Answer 31

Fleas and Mammals | Facultative Intracellular

Question 32

Virulence factors of Yersinia

Answer 32

``` 3 plasmids and chromosome Biofilm synthesis Plasminogen-activating protease F1 protein Type III secretory system Endotoxin ```

Question 33

What is the function of the F1 protein

Answer 33

Fimbrial capsule forming | V and W antigens

Question 34

When does F1 do its job,

Answer 34

Has to be silent to form bubo, | Spreads during dissemination

Question 35

Clinical Manifestations of Yersinia

Answer 35

1. bubonic plaque 2. systemic plague 3. pneumonic plague

Question 36

Bubonic Plague characteristics

Answer 36

``` Most common Sudden Onset Intese pain/swelling in Lns (bubo) Inguinal - Adult Axilla - children Erythema and edema ```

Question 37

Septicemic Plague

Answer 37

``` w/out bubo, no localizing symptoms Febrile and ill hypotension DIC MODS ```

Question 38

Pneumonic Plague

Answer 38

``` Primary or Seconday aerosol droplets Primary, direct inhalation---RARE Secondary=== progression from bubonic plague or septic RAPId Chest pain ```

Question 39

Yersinia Disease Manifestations

Answer 39

Necrosis of small vessels, ecchymosis

Question 40

Yersisnia Diagnosis

Answer 40

``` Aspirate fluid from lymph nodes, Sputum and Stains Immunofluorescence Culture 4x F1 ab titer chest radiograph ```

Question 41

Yresinia Treatment

Answer 41

Streptomycin IV/IM Gentamycin Prophylactic Doxycycline or TMP/Sx

Question 42

S Typhi vaccin

Answer 42

Recombinant - F1 - Lcrv