Term
Syphilis
-Etiology, Description |
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Definition
Treponema pallidum
GRAM NONREACTIVE – Lipid coating doesn’t stain well
-Might be considered G-
Spirochete
Hypotroph: Obligate parasite (something alive to grow it in) [bunnies in labs]
ID50 = 57 |
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Term
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Definition
-STD/STI – Humans are the only natural host
-Lesions: (Rash) Dental hygienist spread through hands 20 diff patients w/o gloves
-Fomites: Dies within minutes in environment, Unlikely to transmit
-STORCH: Go through placenta and infect child
-Hard to transmit by blood
-Light abrasion (rubbing, not even a cut):
Genital area |
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Term
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Definition
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Term
Syphilis
-Morbidity
-Mortality |
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Definition
40,000 reported
Unreported = 80% more
People don't know b/c are healthy carriers so they don't report it and also spread it
100 syphilis deaths
-If you get 1, you can get all of them, 1 leads to an increase of others b/c break down immune system |
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Term
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Definition
Primary Phase
Primary Latent Phase
Secondary Phase
Latent Phase
-Early Latent
-Late latent
Tertiary Phase
-Destroy tissues
-Cardiovascular
-Neurosyphilis |
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Term
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Definition
Chancre (lesion) develops at point of abrasion/transmission [genital, eyes, lips]
Hard nodule develops and breaks open into a shallow ulcer w/organisms spilling out
Lasts 4-5 weeks, transmitting all the time
-Indolent: No pain
-Males scratch: E. coli, Staph in chancre causes it to burn
-Females: Chancre is in vaginal area = Healthy carrier b/c can’t see and there are no symptoms |
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Term
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Definition
Latent = hidden, Blood sample would have antibodies in it
“Teflon pathogen” = Antibodies not produced due to lipid coating
0-6 months: The longer this phase is, the more antibodies produced, More body wins against it |
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Term
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Definition
Flu-like syndrome, Indolent Rash (prominent, all over body, spreads disease), Lymphadenopathy (swollen lymph nodes)
Lasts weeks to months after PLP depending on who has it
Might miss this stage or mistake it for some other issue
-As long as you have the rash, you are infectious |
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Term
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Definition
Hidden most of the time
Early latent: First 2-4 years having it
-Could have outbreaks of secondary phase
Late latent phase: After 4 years having it
-Can only transfer mother Fetus
-Usually in US antibiotic treatment ends disease before it gets to this stage
-25% Cases = Completely cured, No organism, No symptoms, No antibodies
-25% Cases = Remain in Late Latent phase indefinitely (as long as not take antibiotics)
Can’t isolate organism, but can detect by DNA (hypersensitivity)
Slow destruction of tissues
-50% Cases = Progress to tertiary stage, Rapid destruction of tissues |
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Term
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Definition
Lesions
Gumma: Granulomatous, Indolent, Hypersensitivity (can only detect in DNA)
-Destroys tissues, Locally destructive (hole in nose tissue)
-Cardiovascular: Damages heart, Aorta enlarged, Aneurysms (bubbles/weak areas in vessels that can burst)
-Neurosyphilis: Nervous system, Go blind, Deaf, Dementia |
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Term
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Definition
| Syphilis lesion at site of abrasion |
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Term
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Definition
| “Congenital syphilis” Prenatal syphilis |
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Term
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Definition
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Term
Neonatal Syphilis:
Transmission: |
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Definition
Mother Fetus through placenta in 5th month of pregnancy
-50% chance w/o antibiotics
-2% with treatment |
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Term
Neonatal Syphilis
Incidence |
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Definition
500,000 (50% of cases where organism passes through placenta) = Neonatal syphilis, survive
-60% born with latent cases – Positive for antibodies
-40% have -early lesions (rash within few weeks of birth) or
-late lesions (gummas of tertiary syphilis develop 2-3 years later)
250,000 (25% cases) = Stillborn, Die in utero b/c infection is so bad
250,000 (25%) = Babies miscarried (heavy infection, early birth, die) |
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Term
Neonatal syphilis
Symptoms |
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Definition
Stigmata: Hutchinson’s Triad
-Hutchinson’s incisors = Teeth have notch in them
-Interstitial keratitis = Eye cornea scarred, Lead to vision loss/blindness
-8th nerve deafness =
Beethoven may have had this (bananananana) |
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Term
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Definition
-Microscopic examination: Dark field microscope (or fluorescent)
Scrape fluid from chancre or rash to see spirochetes swimming around
-X-ray: Detect gummas
-Serological Test for Syphilis: Looking for antibodies, Kit has antigen to test |
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Term
Diagnosis of syphilis
Serological tests |
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Definition
Screening Test: “Nontreponemal” (not growing out organism b/c would require rabbits)
-Rapid Plasma Reagin (RPR): Tube test
-VDRL (vineral disease research laboratory test): Slide test
Take sample of blood + Cardiolipin (from membrane of mitochnodria, syphilis affects mitochondria causing them to release cardiolipin)
Reagins/Wasserman/Immunoglobulins (IgG, IgM): Antibodies produced to clean up cardiolipin from disease
-Test detects antibodies produced b/c syphilis or other causing antibodies against cardiolipin to be produced
16-18% false positives – Other diseases/vaccines
10% false negatives –
(This test is cheap)
Specific Test: Have to grow out Treponema pallidum (antigen)
-Take blood sample + organism
-Flourescent Treponemal Antibody Absorption test: Reiter strain used
-Hemagglutination Treponema Test for Syphilis: Nikol strain used
Almost no false positives b/c more sensitive so # false negatives is down |
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Term
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Definition
Benzathine Penicillin G (not resistant yet)
-1 dose for less than a year
-More than 1 for over a year
EPT (Expedited partner Treatment): Partner will re-transmit disease back to cured Index (first) patient
-Give Index patient medication for partner as well, so they both get cured |
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Term
Gonorrhea – “The Drip”
Etiology: |
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Definition
Neisseria gonorrhoeae
GRAM –
Diplococci
Capneic incubation: Microaerophilic O2 CO2
-Enriched media: Chocolate agar (blood with nutrients)
-Thayer Martin Selective Agar (isolation in clinical lab),
-Inhibit w/ Vancomycin (G+) Colistin (Polymyxin B, G- rods) Nystatin (yeast) so organism may grow out |
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Term
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Definition
STD
-Opthalmia neonatorum: Get in baby eyes from birthing canals
-Fomites: Dies within hour, Unlikely |
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Term
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Definition
| 350,000 each year reported (most unreported, probably millions) |
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Term
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Definition
[Common for all types of urethritis/urethra irritation from STD to E. coli]
Males: 10-20% asymptomatic (healthy carriers) – Shedding disease but don’t have symptoms
-Purulent urethral discharge: Pus (neutrophils loaded w/ organism as WBCs phagocytize it) out uthethra
-Dysuria: Painful urination, G- neissera dies and releases endotoxin irritating the urethra
-Frequency of urination: When irritated, want to pee more often
-Convalescent carrier: Recovering from symptoms you once had, Still shedding organism in recovery
-Complications: Urethral stricture – Narrowing due to scar tissue buildup
-Get gonorrhea over and over, Mutates, No resistance builds
Sterility: Epididymus inflamed and damaged (where sperm multiplies)
Chronic prostatitis: Prostate gland inflamed |
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Term
Gonorrhea
Symptoms - Female |
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Definition
Females:
-Purulent urethral discharge
-Dysuria (endotoxin pain)
-Frequency of urination
-Invade cervix: Cervicitis – UTI (could also be caused by E. coli from thong)
-PID (Pelvic Inflammatory Disease): Uterus (endometritus) – Hysterectomy needed
Fallopian tubes (salpingitis) - Sterility: Scar tissue buildup
750,000 cases PID reported, 75,000 (10%) turn sterile
-Some caused by chlamydia trachomatis, E. coli |
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Term
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Definition
: Anal gonorrhea – Rectum
Pharyngeal gonorrhea – Pharynx
Gonococcal arthritis: 16-50 years old
-Septic arthritis: Organism involved [Aseptic = No organism involved, Pain from overwork, knee] |
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Term
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Definition
Microscopically: Check for GRAM – Intracellular Diplococci
-Check the pus dripping out during acute phase
-Males = 99% accurate
-Females = 50% accurate b/c many organisms growing
Cultural: Thayer Martin Selective Agar – Antibiotics make only gonorrhea grow out
(-Nothing actually inhibited, they just grow slower says Mr. Smith)
-Males = 60%
-Females = 40%
Biochemical Tests: Oxidase Positive (like pseudomonas and others)
-Carbohydrates
Antigen-Antibody Reactions: -Serology: Not effective b/c Neisseria gonorrheae keeps mutating
PCR: DNA from urine sample where organism is |
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Term
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Definition
PPNG – Penicillinase Producing – DOC = Ceftriaxone (works against your syphilis too)
(+Chalmydia trachomatis) = Ceftriaxone does NOT work Post gonococcal utethritis
Doxycycline or Azithromycin to go along with
-Azithromycin no longer effective against syphilis |
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Term
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Definition
Opthalmia neonatorum DOC = Erythromycin
-Adults = Education, Trace contacts to make EPT possible
Test all females = Most likely to be healthy carriers (2/3 – ¾ asymptomatic) (67%-75%)
Test everyone positive for 1 STD to test for all STDs |
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Term
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Definition
Neisseria meningitidis
Epidemic (contagious), Spread by droplet infection, 1%
99% healthy carriers
Will develop natural immunity! – Individual immunity |
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Term
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Definition
| -Penicillin G = DOC – Given IV for systemic infection like this, High doses |
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Term
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Definition
Given to susceptible patients (like college dormers)
-Prophylactic: Ciprofloxacin |
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Term
Pseudomonas aeruginosa
Occurrence: |
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Definition
Ubiquitous (all over all the time)
-Opprotunists: Need an opportunity for it to enter body
-Nosocomial infections: 9% |
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Term
Pseudomonas aeruginosa
Resistance: |
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Definition
Antibiotic sensitivity testing
-Some doctors would rather treat you concurrently instead of testing
-Pseudomonas aeruginosa sometimes grows in antibiotics! = Very resistant, Live in eye
-Triclosan: Antimicrobial agent psesudomonas is (10-15% more resistant than it should be), Protein coagulator |
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Term
Pseudomonas aeruginosa
Super infection: |
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Definition
| Resistant nonfermenter will grow even if antibiotics are present, Grow on top of another infection (Secondary infection) |
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Term
Pseudomonas aeruginosa
Examples of Infections: |
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Definition
Wound infections
Superficial skin infections
Genito-Urinary tract
Eye
"Others" |
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Term
Pseudomonas aeruginosa
Examples of Infections: Wound |
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Definition
Burn – Burnt skin is like open culture medium (Pseudomonas, Proteus, Staph)
Septicemia: Poor prognosis b/c hard to clear out Pseudomonas, 75% death by infection (14% by pseudomonas infections) |
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Term
Pseudomonas aeruginosa
Examples of Infections: Superficial skin |
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Definition
/”Pseudomonas pyoderma”: Green pus/mucus, Smell like grapes
Athlete’s foot
Bed sores
Eczema
Hot Tub Dermititis: Rash when pores open up and go down hair follicles, Self-limiting b/c aerobic and can’t spread deep |
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Term
Pseudomonas aeruginosa
Examples of Infections: Genito-urinary |
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Definition
UTI, Nosocomial, Instrumentation (dirty catheter, ect.)
Is this complicated or uncomplicated?
Complicated = Reason you get this, Area plugged up |
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Term
Pseudomonas aeruginosa
Examples of Infections: Eye |
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Definition
Ulceration of eye attacks cornea
Contact lenses |
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Term
Pseudomonas aeruginosa
Examples of Infections: "Others" |
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Definition
Pneumonia (intubation @ hospital)
Meningitis
Osteomyelitis – Bone infection
Otic infections – Swimmer’s ear (pseudomonas, staph) |
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Term
Pseudomonas aeruginosa
Treatment: |
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Definition
Do an antibiotic sensitivity test (Kirby Baur, MIC) while treating patient concurrently
UTI caused by pseudomonas – Ciprofloxacin (DOC)
“Others” – Ticarcillin (cell wall) + Gentamicin (protein synthesis)
Pipericillin (cell wall) + Gentamycin (protein synthesis)
Synergistic: Work well together??? |
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Term
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Definition
“Whooping cough,” Hard spasmatic coughing, Gasping for breath, More severe in children under 7
Lung collapse, Convulsions, Death [In children]
Less severe cough [Older children to adults] |
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Term
Bordetella pertussis:
Prevention |
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Definition
DTaP (high dose) – Pediatric dose (Diptheria, Tetanus, acellular Pertussus), 5 shots,
Tdap (booster) – 11/12 years old (adolescents), Replacement for adult vaccine
Td (adult vaccine) – 16-64 years old, Given every 10 years |
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Term
Bordetella pertussis:
Treatment |
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Definition
| Erythromycin, Azythromycin, Clarithromycin (any one of the three are DOC) |
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Term
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Definition
“Legionnaire’s disease” (1976/Bicentenial)
-Atypical pneumonia
-Over 30 people died
-GRAM – rod/bacullus = Legionella pneumo (lung) philia (loving)
-Prefer cool water
-Simbiotic relationship with amoeba
-Droplet infection: ID50 = 1 rod
-Dirty air conditioner
-Individual resistance
-Common in males over 50 years old (older servicemen)
Cruise ship, Playboy party fog machine |
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Term
Legonella pneumophilia
Treatment: |
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Definition
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Term
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Definition
Salmonella food poisoning/Gastroenteritis: Food infection (feces in it), Grow in small intestine lined with epithelial cells, which spread cell to cell causing septicemia
-5 million deaths a year by diarrhea
Very young, Very old – Lose fluids and electrolytes |
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Term
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Definition
Salmonella enterica – Infect warm blooded animal
Salmonella enteriditis (SE) - Found in chicken eggs, Get in before shell is formed
Salmonella typhimurium – Most common (serovar of S. enterica)
“Salmonella enterica serovar typhimurium” is best way to write
“Salmonella enterica serovar enteriditis” |
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Term
Salmonellosis
Transmission: |
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Definition
ID50 = 10^5 (100,000 to 1 billion) but acid can kill them before infect
-Disease of “lower animals” (not human-human), Dogs and cats spread it via feces, In food
Birds – Turkey, chicken, Put dead bird in vat with feces coming out, Defeather
Reptiles – Wild turtles w/salmonella, Zoo petting animals |
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Term
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Definition
3 days
-Diarrhea, Vomiting, Severe abdominal cramps
-Headache b/c septicemia |
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Term
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Definition
None
Young children, Immunocompromised (AIDs) – Ceftriaxone, Cefotaxine
Will spread Salmonella for up to 6 months after cure b/c still in cells |
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Term
Salmonellosis
Complications: |
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Definition
| Replace fluids and electrolytes lost |
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Term
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Definition
Salmonella typhi
“Salmonella enterica serovar typhi” = New
-Humans are only host (must have ingested human feces)
1,000 to 10,000 bacilli (small dose) |
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Term
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Definition
-Diarrhea, Vomiting, Headache, Fever, Severe abdominal cramps
-Ulcerations: Perforations, Actual holes
15% mortality rate |
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Term
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Definition
Ciprofloxacin (DOC), Ceftriaxone (DOC)
-Keep from becoming carrier |
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Term
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Definition
Bacillary dysentery - GRAM – ROD/BACILLUS, Blood and mucus sloughed off in diarrhea
Shigella sonnei – Northern US
Shigella flexneri – Southern US
Shigella dysenteria – Asiatic strain, Shigatoxin (hemorrhagic bleeding, danger in blood loss) *Most dangerous*
-GRAM – BACILLI
-Endotoxin
-Exotoxin: Enterotoxin |
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Term
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Definition
ID50 = 200 bacilli (resistant against stomach acid)
-Food/water contaminated with human feces
Symptoms: Incubation period = 1-14 days
-Large intestine irritated: Job is to absorb water, so if interrupted water comes out w/stool, blood, mucus, Shigatoxin
-Does not cause septicemia (stays in one area of body) |
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Term
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Definition
1/3 cases require Hospitalization due to diarrhea = Shigella
-Fluids, Electrolytes
DOC: Ciprofloxacin |
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Term
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Definition
Look in water analysis
-Coliform: GRAM -, Bacillus, Ferment lactose to produce gas (CO2)
-Enteric: GI tract of mammals
Can get into watershed (source of water) from nearby animals’ feces getting into water
-Stool tool: Can tell if there is feces in the water
-Strains: Over 150 strains, Differentiate strains through serology |
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Term
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Definition
Over 150 strains, Differentiate strains through serology
Most are not pathogenic
Some opportunistic – 24% Nosocomial infections from people not washing their hands
Some pathogenic -
Enterotoxigenic (ETEC) = Strain of E. coli, Enterotoxins present to irritate bowels, Lots of water loss through diarrhea (Cholera)
LT = Heat labile
ST = Heat stable
Enteroinvasive (EIEC) = Invade large intestine, (Shigella)
Enteropathogenic (EPEC)
Enterohemorragic (EHEC) = Lots of bleeding due to Shigotoxin
EC0157:H7 = Strain of eneterohemoragic variety |
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Term
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Definition
Cystitis
Epidemic diarrhea/Summer diarrhea/Infantile
Traveler’s diarrhea/Tourista
Peritonitis
"Others" |
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Term
E. coli
Infections: Cystitis |
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Definition
UTI in the bladder
Uncomplicated – Does not involve patient on antibiotics (wiping out normal flora like E. coli), No instrumentation (catheters), No obstruction (mucus, dirt)
-E. coli causes 85% uncomplicated cystitis infections
-Proteus is #2
Complicated –
-Proteus is #1 cause
-Females more likely to get these diseases anatomically |
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Term
E. coli
Infections: Epidemic diarrhea |
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Definition
Epidemic diarrhea/Summer diarrhea/Infantile: Hot in the summer, Bacteria grow well, Baby wearing cloth diaper
-Enteropathogenic, Enterohemorrhagic (specific strain) |
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Term
E. coli
Infections: Traveler's Diarrhea |
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Definition
Traveler’s diarrhea/Tourista: Don’t drink water in foreign country
-Enterotoxigenic strain |
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Term
E. coli
Infections: Peritonitis |
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Definition
Peritoneum = Lining on inside of body
-If intestines or appendix is perforated, leaks out peritonitis
-Appendicitis: Blind pouch can be blocked with feces or objects, Inflamed and burst, E. coli is one cause |
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Term
E. coli
Infections: "Others" |
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Definition
| E. coli is opportunist, Will cause infection wherever it enters |
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Term
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Definition
Ceftriaxone, Cefotaxine, Cefepime
-What if they don’t identify this and realize it’s uncomplicated GI tract infection?
Bactrim (Sulfamethoxazole, Trimethoprim) |
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Term
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Definition
| Klebsiella pneumonia – Enteric (intestines), Coliform (grows slowly in water analysis), Capsule (looks like someone sneezed if on plate) |
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Term
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Definition
Diseases:
Nosocomial pneumonia: 10% of cases, Sticks to things like intubation tube and will grow
Pediatric wards: Septicemia cause (from not washing hands) |
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Term
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Definition
| Cefalosporin = Ceftriaxone, Cefotaxime, Cefepime |
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Term
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Definition
Drug companies look for plants to use
-Very resistant based on antibody testing
Diseases: |
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Term
Proteus Group
Diseases: + Treatment |
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Definition
Proteus mirabilis – Cystitis, #1 strain isolated, #1 in burn patient infections
Treat = Ampicillin
Proteus vulgaris – Less commonly isolated, Cause cystitis and burn patient infections
Morganella morganii/Proteus morganii – Infantile diarrhea
Providencia stuartii/Proteus inconstans – Involved in burns
Treatment for these three = Cefalosporin like Ceftriaxone, Cefotaxime, Cefepime |
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Term
Proteus
Proteus mirabilis
Disease + Treat |
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Definition
Proteus mirabilis – Cystitis, #1 strain isolated, #1 in burn patient infections
Treat = Ampicillin |
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Term
Proteus
Proteus vulgaris
Disease + Treat |
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Definition
Less commonly isolated, Cause cystitis and burn patient infections
Cefalosporin - Ceftriaxone, Ceftoaxime, Cefepime |
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Term
Proteus
Proteus/Morganella morganii
Disease + Treat |
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Definition
Infantile diarrhea
Cefalosporin - Ceftriaxone, Ceftoaxime, Cefepime |
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Term
Proteus
Proteus stuartii/Providencia inconstans
Disease + Treat |
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Definition
Involved in burns
Cefalosporin like Ceftriaxone, Cefotaxime, Cefepime |
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Term
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Definition
-Flu is caused by virus: When trying to grow out on plate, virus wouldn’t multiply, but this would grow
GRAM – Rod, Capsule, Chocolate agar to grow out (enriched), Capneic incubation (increase CO2, decrease O2)
-Found in respiratory tract |
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Term
Haemophilus influenzae
Diseases: |
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Definition
Meningitis
Otitis media
Acute bacterial epiglottitis
"Other" |
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Term
Haemophilus influenzae
Diseases: Meningitis |
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Definition
Caused by (#1) Streptococcus pneumonia, (#2) Neisseria meningitides, (#3) Haemophilus influenza (old people)
-Decreasing b/c of antibiotics and vaccinations
-Cases today are increasing for people who didn’t vaccinate their kids in fear of autism
-90% mortality rate
25-35% Sequalae (consiquences) after disease (deafness, mental retardation) |
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Term
Haemophilus influenzae
Diseases: Otitis media |
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Definition
Middle ear infection, Can lead to deafness, Children sniffle mucus back damaging ear
Caused by (#1) Strep pneumo, (#2) Haemophilus influenza |
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Term
Haemophilus influenzae
Diseases: Acute bacterial epigottitis |
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Definition
Epiglottus = Flap reflex to keep food out of lungs, May swell and suffocate you
Within 24 hours can cause death |
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Term
Haemophilus influenzae
Diseases: "Other" |
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Definition
Does this cause flu? NO!
Pneumonia/Upper respiratory infection |
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Term
Haemophilus influenzae
Treatment: |
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Definition
Life threatening = Ceftriaxone, Cefotaxine
Non-life threatening = Bactrim (Sulfamethoxazole, trimethoprim) |
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Term
Haemophilus influenzae
Diseases: Those extra ones + Treatment |
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Definition
Haemophilus aegyptius: Pink eye, Eyelid swelling, Spread by Fingers, Fomites (microscope eyepiece)
Treat = Tetracycline, Sulfonamide
Haemophilus ducreyi: Tropics/warm areas, Cause Chancroid (STD) = Soft chancre
Treat = Ceftriaxone |
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Term
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Definition
-Still considered spirochete, though it looks like a rod with a bend
-Cholera: Severe diarrhea
Pandemic: 19th century (1800s), On every continent
Endemic (today): Persistently found in certain area-Parts of Asia
-Like salty, alkaline water
-No spore, but hardy and will survive
Epidemic: Pass from one area to another (get on a plane) |
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Term
Vibrio cholera
Transmission: |
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Definition
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Term
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Definition
CT (Cholera Toxin) produced – Enterotoxin (exotoxin)
-Rice water stools produced: Water
-Vomitting, diarrhea |
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Term
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Definition
| 50% die w/o support (fluids & electrolytes) |
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Term
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Definition
| Tetracycline, Doxacycline |
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Term
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Definition
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Term
Yersinia Pestis
Transmission: |
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Definition
Fleas of rats, rodents, prairie dogs jump off and transmit
-Flea bites, spread to lymphatic system, Darkening
-100 million people died! (1/4-1/3 of world population)
-“Bubonic Plague” |
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Term
Yersinia Pestis
Mortality: |
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Definition
70-90% death rate
-“Pneumonic plague”: Next step after the black plague doesn’t kill you, In lungs, Spread by droplet infection
Delta 32 Mutation of the CCR5 gene may have protected people from plague
Still happens today in CA or NV, from prairie dogs |
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Term
Yersinia Pestis
Treatment: |
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Definition
| Streptomycin (DOC) (+/- Tetracycline) |
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Term
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Definition
-Domain: Bacteria
-Phylum: Proteobacteria
-Prokaryotic
-Hypotrophs: Obligate parasites, Grow on chicken eggs |
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Term
Rickettsial Infections
Transmission: |
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Definition
Bite of arthropod vector (ticks, fleas, mites)
Incubation: 1-2 weeks
-Circulatory, lymphatic systems |
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Term
Rickettsial Infections
Symptoms: |
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Definition
Alternate b/w chills and fever, Rashes,
Can cause death through circulatory collapse (overwhelmed by so many organisms-failure) |
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Term
Rickettsial Infections
Diagnosis: |
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Definition
| Serology – Check blood to see if producing antibodies against these diseases |
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Term
Rickettsial Infections
Treatment: |
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Definition
| Tetracycline (Doxacycline) |
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Term
Rickettsial Infections
Louse-born |
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Definition
Epidemic typhus – Body lice, Spread in homeless/during war/prison (no shower)
-Mortality: 50%, especially in older individuals |
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Term
Rickettsial Infections
Flea-born |
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Definition
Endemic typhus/Marine typhus – Rat fleas, Atlantic and Gulf Coast
-“Endemic” b/c confined to waterfront areas
-Mortality: Mild, no deaths reported |
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Term
Rickettsial Infections
Tick-born |
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Definition
Rocky Mountain Spotted Fever- Ticks (off dogs, whatever), Common in spring when ticks wake from winter, Occur through summer and fall
-Wrist rash, Ankle rash
-Mortality: 20% w/o treatment 5% w/treatment |
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Term
Rickettsial Infections
Mite-born |
|
Definition
Scrub typhus/Chiggers – Mice
-Chigger = Baby mite, Larvae
-US has chiggers, but they do not carry this Scrub typhus (Australia, Asia have)
-Mortality: 50% untreated |
|
|
Term
| Rickettsial-like Infections |
|
Definition
Q-Fever: Coxiella burnetii
Cat Scratch Fever: Bartonella henselae |
|
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Term
|
Definition
Q-Fever – Coxiella burnetii: Unpasteurized milk, Ticks
-Many get infected, few get symptoms
-People constantly exposed most likely to get it
Treatment: Tetracycline (doxacycline) |
|
|
Term
|
Definition
Cat Scratch Fever – Bartonella henselae
-Pus filled sores
-AIDs indicator Become systemic, Septicemia
Treatment: Azythromycin |
|
|
Term
|
Definition
Chlamydia trachomatis
Nongonococcal utethritis
Ocular trachoma
Inclusion conjuncitivitis
Chlamydophila psittaci |
|
|
Term
Chlamydial Infections:
Chlamydia trachomatis |
|
Definition
-Domain: Bacteria
-Phylum: Chlamydia
-Prokaryotic
-Hypotroph: Obligate parasite
-Grow out in chicken eggs |
|
|
Term
| Chlamydial Infections: Nongonococcal urethritis |
|
Definition
| UTI not caused by Neisseria gonnorhoeae Post gonococcal urethritis: Same thing, depends on timing, From STD Adult treatment for STD: Tetracycline (doxacycline) or Azythromycin |
|
|
Term
Chlamydial Infections:
Ocular trachoma |
|
Definition
Adult, touch genitals then eyes, Leading cause of preventable blindness
-BOTH involve Chlamydia trachomatis in eye
Treatment: Azythromycin |
|
|
Term
Chlamydial Infections:
Inclusion conjunctivitis |
|
Definition
Baby through birth canal (Opthalmia nenonatorum), Picks up bacteria and damage eye
-BOTH involve Chlamydia trachomatis in eye
Treatment: Erythromycin |
|
|
Term
Chlamydial Infections:
Chlamydophila psittaci |
|
Definition
Psittacosis
Ornithosis
“Parrot fever”
Atypical pneumonia – Inhale bird droppings in lungs
Treatment: Tetracycline (doxacycline) |
|
|
Term
Chlamydial Infections:
Chlamydophila pneumoniae |
|
Definition
-CAP = Community acquired pneumonia
3 causes: Chlamydophila pneumonia, Streptococcus pheumoniae, Mycoplasma pneumonia
Treatment: Tetracycline, Azithromycin, Erythromycin, Clarithromycin |
|
|
Term
|
Definition
No: Cell Theory = Smallest unit of living thing is a cell
Cell membrane, Cytoplasm w/ ribosomes, Nucleus/Nucleoid, DNA |
|
|
Term
|
Definition
Nucleic Acid Core
Protein Coat/Capsid
Envelope
Helical
Icosahedral/Polygon |
|
|
Term
Virus Structure
Nucleic Acid Core |
|
Definition
RNA or DNA (not both)
-Single stranded or double stranded |
|
|
Term
Virus Structure
Protein Coat/Capsid |
|
Definition
Contained in container, Protection, Host recognition (what to infect)
-Capsomeres: Individual building blocks of capsids
Rod shaped
Triangular
-Nucleocapsid: Combination of Nucleic Acid Core and Capsid, All contain |
|
|
Term
|
Definition
Lipids, proteins, carbohydrates (found in cell membranes), As virus leaves cell it picks up these from animal cells, Protection
-Spikes: Extend from envelope, Host cell recognition |
|
|
Term
|
Definition
Helical
Icosahedral/Polygon
Complex |
|
|
Term
|
Definition
Rod shaped capsomere, Looks cylindrical
-Rabies (bullet shape), Flu, Measles |
|
|
Term
Virus Shapes
Icosahedral/Polygon |
|
Definition
|
|
Term
|
Definition
Don’t fit one category or another, Bacteriophage-Infect bacteria
-Head looks like polygon -Body looks helical -Legs |
|
|
Term
|
Definition
-Filters standard 0.2µm/200nm supposed to remove all prokaryotes (and things larger), But not all viruses
Filterable: Viruses are 20nm-450nm – Smaller viruses will pass through filter
-Giant Viruses: Missing critical enzymes so not alive |
|
|
Term
|
Definition
-Viruses don’t have all those enzymes so can’t use regular tests
DNA or RNA?
Single or Double Stranded?
Envelope or no?
Helical or polygon or what?
Size? |
|
|
Term
|
Definition
-Not all are important in human viruses
-Cell Fast: Once virus enters body, Stay for life, Cannot clear it out
Goes into DNA and incorporate its genome into your DNA
-Grow latent: Symptomatic individuals, Symptoms go away but are still there, Can be reactivated (low immune response causes it to flare up) |
|
|
Term
Human Herpes Virus Type I
Common Name |
|
Definition
|
|
Term
Human Herpes Virus Type I
Cause |
|
Definition
Fever bliters, Cold sores, Herpes labialis (lips)
-Milder blisters |
|
|
Term
Human Herpes Virus Type I
Transmission |
|
Definition
Easily transmitted, Children (1-5 yrs old), Saliva, Not washing hands
-90% of us will test positive for the antibodies
-US: 4 million people symptomatic |
|
|
Term
Human Herpes Virus Type I
Symptoms |
|
Definition
Itching/Tingling in skin (mildest form of pain, nerves), Blisters (fluid leaking out), Crusting lasts 2-3 weeks
-Stress lowering immune system induces: Fever, cold/flu, sunlight |
|
|
Term
Human Herpes Virus Type I
TREATMENT |
|
Definition
| Acyclovir (reduce symptoms by half a day) |
|
|
Term
| Human Herpes Virus Type I Complications |
|
Definition
Herpetic gingivostomatitis: Lips, gums, throat, More painful Herpetic keratitis: Eyes, Common in AIDs patients -Vision loss depending on immune system
30% Neonatal encephalitis: Infects brain, STROCH, From simplex1 -H=Herpes simplex, Caused by 1 and 2 -Cause retardation, death |
|
|
Term
Human Herpes Virus Type II
Common name |
|
Definition
“Herpes simplex 2”, “Genital Herpes”
(Goes adult to adult) |
|
|
Term
Human Herpes Virus Type II
Occurrence |
|
Definition
| CDC: 1 in 5 adults infected from age 12 up |
|
|
Term
Human Herpes Virus Type II
Symptoms |
|
Definition
Pain, Malaize (nausea) before blisters, Blisters begin in genitals and go down buttocks and legs
-More severe than herpes 1 |
|
|
Term
Human Herpes Virus Type II
Complications |
|
Definition
-Associated with Cervical Cancer: Human Papiloma Virus (STD)
Can auto inoculate self by touching one are and then the other
-Not always lead to cancer, but when combined with herpes, doubles risk factor of getting it
-70% Neonatal Encephalitis
-Cesarean section: As baby comes out of birth canal it can get herpes
Prevent through c-section |
|
|
Term
Human Herpes Virus Type II
Reactivation |
|
Definition
-Stress
-Lower immune system
-Menstruation |
|
|
Term
Human Herpes Virus Type II
TREATMENT |
|
Definition
|
|
Term
| Human Herpes Virus Type III |
|
Definition
Chicken Pox – Varicella
Shingles – Zoster / “Herpes zoster” |
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Morbidity |
|
Definition
| 90% by age of 10 have been exposed |
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Transmission |
|
Definition
Easy to transmit making it common, Breathe in through respiratory tract
-Sputum/saliva/coughing, Microaerosals during eating (clang utensils on plate)
-Blisters on sheets and towels inhaled
-Can transmit 1-3 days before symptoms, All throughout, Up to 6 days after crop of blisters (long time) |
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Incubation |
|
Definition
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Symptoms |
|
Definition
-1-2 days blisters
-Blisters with straw-like fluid
-6 days of crops of blisters on body (painful, infectious)
Crater: Scratching causes E. coli to get into blister |
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Reduce Symptoms |
|
Definition
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Complications |
|
Definition
Reye’s Syndrome – Inflammation of brain, Swelling, Lead to death
-Not give Aspirin b/c increase chances of getting this |
|
|
Term
Human Herpes Virus Type III
Chicken Pox – Varicella
Immunity |
|
Definition
-Vaccine provides long term protection, Maybe even against shingles
-Rare to get Chicken Pox twice |
|
|
Term
Human Herpes Virus Type III
Shingles – Zoster / “Herpes zoster”
What it is and Morbidity |
|
Definition
-Reactivation of Chicken Pox
10-20% get Chicken Pox, then Shingles
-Older people get it, but some young people as well
-Reactivated by decreased immune system (stress) |
|
|
Term
Human Herpes Virus Type III
Shingles – Zoster / “Herpes zoster”
Symptoms |
|
Definition
One side of the body, hide in the nerves (Up shoulder, along arm, )
Painful (burnt by a lit cigarette, hurts to wear clothes)
-You can’t give someone Shingles, but you can give someone Chicken Pox and spread that which may reactivate |
|
|
Term
Human Herpes Virus Type III
Shingles – Zoster / “Herpes zoster”
Complications |
|
Definition
| Post herpetic neuralgia – When blisters disappear, still feel pain (up to 1 year) |
|
|
Term
Human Herpes Virus Type III
Shingles – Zoster / “Herpes zoster”
Treatment |
|
Definition
|
|
Term
Human Herpes Virus Type IV (4)
Name |
|
Definition
Epstein-Barr Virus
“Infectious mononucleosis” = Spread by saliva, “Kissing disease” |
|
|
Term
Human Herpes Virus Type IV (4)
Symptoms |
|
Definition
Sore throat, fever, Lymphadenopathy (swollen), Lymphocytosis ( WBC)
Burkett’s Lymphoma: B cell malignancy (cancer), Africa, -Swollen cheek area, belly |
|
|
Term
| Human Herpes Virus Type V (5) |
|
Definition
CMV – Cytomegalovirus
CMV Mononucleosis
Congenital CMV
Disseminated CMV |
|
|
Term
Human Herpes Virus Type V (5)
CMV – Cytomegalovirus |
|
Definition
| -Most are asymptomatic (Everyone has it and the antibodies) |
|
|
Term
Human Herpes Virus Type V (5)
CMV Mononucleosis |
|
Definition
| -Symptoms: Sore throat, fever, lymphadenopathy, lymphocytosis, NO cancer |
|
|
Term
Human Herpes Virus Type V (5)
Congenital CMV |
|
Definition
-STOR”C”H=Cytomegalovirus through placenta
Death, Mental retardation |
|
|
Term
Human Herpes Virus Type V (5)
Perinatal CMV |
|
Definition
-As baby comes through birth canal, picks up CMV
-Less severe |
|
|
Term
Human Herpes Virus Type V (5)
Disseminated CMV |
|
Definition
-No resistance against CMV
-Common in immunocompromised patients (HIV+ AIDs) |
|
|
Term
| Human Herpes Virus Type VI (6) |
|
Definition
“Human T-lymphotrophic virus”
-Infants less than a year old get Roseola
Rash, fever
Self limiting
May lead to Multiple Sclerosis |
|
|
Term
| Human Herpes Virus Type VII (7) |
|
Definition
Orphan virus = Doesn’t cause disease, just a rash
Kaposi’s Sarcoma – AIDs patients get purple hemorrhagic tumors (cancer)
Not as common anymore b/c medications today |
|
|
Term
|
Definition
-Hepa = Liver
-Alcoholic hepatitis from drinking too much
-INH, used for Tuberculosis, can cause severe Hepatitis
Liver produces too much bile - Fever, jaundice (yellow skin), brown urine |
|
|
Term
|
Definition
RNA
"Infectious Hep"
Fecal/Oral
Acute: 2-3 weeks |
|
|
Term
|
Definition
DNA
"Serum"
-Needles
-Mosquito
-ST”O”RCH
Blood-
Last dry for at least a week
(Mosquito, passive vector, can pass on dried blood)Chronic: 6%
Mortality: 2%
-Hepatoma (cancer)
Vaccine prevents
TREATMENT:Alpha interferon
-Side effects
-“Cure” = Can’t detect virus particles
Tenofovir (AIDs drug, Oral)[DOC] |
|
|
Term
|
Definition
RNA
"Classic non A non B"
Blood-
Post-transfusion Hep
-70-80 day delay detecting antibodies
1/100,000 chance
-Firefighters get blood on
Chronic (75-85%)
TREATMENT
"Cure" = Suppress virus particles
Peg interferon + ribavirin [DOC]
+Telaprenovir (Protease inhibitor) |
|
|
Term
|
Definition
RNA
"Delta Agent"
Blood-
Alone: Not infectious
Coinfection with other Hep (like B)=
-Increased liver damage
Vaccine for B will protect against D
-Treatments don’t always work |
|
|
Term
|
Definition
RNA
"Infectious non A non B"
Fecal/Oral
Same symptoms as Hep A
Pregnant women = higher death rate |
|
|
Term
|
Definition
RNA
Blood1995
Mild to death
-Flu die
G+C or HIV will slow down progression/damage |
|
|
Term
HIV: Human Immunodeficiency Virus
Etiology: |
|
Definition
HIV1 – Most common
HIV2 – Africa, Less virulent, Longer incubation period (live longer)
AIDs – Acquired Immune Deficiency Syndrome
2-15 years before show severe symptoms |
|
|
Term
|
Definition
| Actually just a variant of C |
|
|
Term
|
Definition
HIV
Multiplies by reverse transcriptase
-Take single stranded viral RNA and make double stranded viral DNA |
|
|
Term
|
Definition
-2 single strands of RNA
-Enclosed by Capsid
-Surrounded by Envelope
-Spikes sticking through Envelope (how attach to cells) |
|
|
Term
|
Definition
30-60 million world
45 million
12 million children (through placenta) |
|
|
Term
|
Definition
5% don’t progress – Delta 32 mutation of CCR5 coreceptor
95% turn into AIDs
-63% individuals die (1995)
-18% mortality (1998) |
|
|
Term
|
Definition
Bloodborne pathogen – If spilled need significant amount of blood
-Outside cell: 6 hrs survive
-In macrophage: 1.5 days survive
Unprotected sexual contact: Semen, vaginal secretions = 10-50 viral particles/mL
Parenteral: Blood, Transfusions, 1000-100,000 particles/mL
Placenta
Breast milk
Not dangerous: Sweat, saliva, perspiration, tears, vomit, feces, <1 virus/mL (according to CDC and OSHA) |
|
|
Term
HIV
Incubation + What happens |
|
Definition
8 year, average
-Virus particles attacked by dendritic cells (engulf and modify but not kill virus)
-Dendritic cells hand virus off to WBCs, where virus can multiply
CD4 Cells: “T-Helper Cells,” Macrophages, Major cells virus multiplies in
500-1,000/mL = Normal levels
-When down to 200 CD4 cells/mL: HIV+ AIDs (highly symptomatic) |
|
|
Term
|
Definition
Category A
Category B
Category C |
|
|
Term
|
Definition
First 3 years of infection, Mononucleosis-like symptoms for few weeks, Asymptomatic
Viremia: Septicemia of a virus, Can transmit to others |
|
|
Term
|
Definition
”Early symptomatic” Year 4-8
-Chronic lymphadenopathy, Cadidiasis (Candida albicans), Thrush, Plaque in back of throat |
|
|
Term
|
Definition
|
|
Term
|
Definition
“T-Helper Cells,” Macrophages, Major cells virus multiplies in
500-1,000/mL = Normal levels
-When down to 200 CD4 cells/mL: HIV+ AIDs (highly symptomatic) |
|
|
Term
|
Definition
-Extrapulomonary TB – Mycobacterium avium
-Herpes zoster – Shingles multiple times
-Herpes simplex outbreaks over and over
-Cytomegalovirus (CMV) becomes systemic b/c immune system can’t control it |
|
|
Term
|
Definition
| -Toxoplasmosis – Cat litter sickness, Goes systemic in AIDs patients Encephalitis (infect brain) |
|
|
Term
|
Definition
-Candidiasis – Candida albicans
-Pneumocystis jiroveci (carinii) pneumonia (PCP) – Pneumonia, used to be leading cause of death
-Cryptococcosis – Cryptococcus neoformans, Level 3 danger, Cause meningitis, Yeast
-Penicillinosis – Penicillium marneffei
In Asia, most common infections are Extrapulmonary TB, Cryptococcosis, Penicillinosis |
|
|
Term
|
Definition
| -Kaposi’s Sarcoma: Hemorrhagic tumors due to Herpes 8, Interferon use fights it |
|
|
Term
|
Definition
Adsorption: First step
-Spikes on HIV fit into Receptors on WBC to dock
Penetration (fusion): Get through membrane
-Enzymes at every step
Replication: Make more Nucleic Acid and Capsid
-Made separately
Maturation: Put together
-Put NA in Capsid (done by enzymes)
Release/Budding: Get out of cell |
|
|
Term
|
Definition
-Maraviroc (MVC)
-Binds to CCR5 Coreceptor, making non-functional
-CXCR4 strain hits that coreceptor instead, and this drug is not going to help (mutation) |
|
|
Term
|
Definition
Fusion inhibitor
-Enfuvirtide (ENF)/Fuzion
GP (Glycoprotein) 41 on spike blocked from transforming membrane and gaining entry |
|
|
Term
AIDs
Reverse Transcriptase Inhibitors |
|
Definition
NRTI/NaRTI: “Nucleoside analogue reverse transcriptase inhibitor”
NNRTI: Non-nucleoside reverse transcriptase inhibitors |
|
|
Term
Reverse Transcriptase Inhibitors
NRTI |
|
Definition
NRTI/NaRTI: “Nucleoside analogue reverse transcriptase inhibitor”
-Chemically similar to nucleoside but modification puts wrong chemical in making different/bad RNA
-Azidothymidine, Zidovudine (AZT):
Naïve patients that are pregnant, Give at birth to prevent AIDs from transferring to fetus
-Lamivudine (3TC): Well tolerated (few treatment toxicities)
-Emtricitabine (FTC): Naïve patient treatment
-Tenofovir (TDF): Also used for Hep B, Naïve patients |
|
|
Term
Reverse Transcriptase Inhibitors
NNRTI |
|
Definition
Non-nucleoside reverse transcriptase inhibitors
-Bind to enzyme and change structure to turn non-functional
-Efavirenz (EFV)
-Nevirapine (NVP) |
|
|
Term
| Azidothymidine, Zidovudine (AZT) |
|
Definition
NRTI
Naïve patients that are pregnant, Give at birth to prevent AIDs from transferring to fetus |
|
|
Term
|
Definition
NRTI
Well tolerated (few treatment toxicities) |
|
|
Term
|
Definition
NRTI
Naïve patient treatment |
|
|
Term
|
Definition
| Also used for Hep B, Naïve patients |
|
|
Term
|
Definition
Blocks maturation step of assembling nucleic acid with capsule with protease
-Indinavir (IDV)
-Ritonavir (RTV)
BOTH for Naïve patients: Never treated before |
|
|
Term
|
Definition
| Blocks Budding, Virus can’t get out of cells |
|
|
Term
|
Definition
Highly Active Anti-Retroviral Therapy (cocktail)
AZT + Reverse Transcriptase Inhibitor + Protease inhibitor |
|
|
Term
AIDs
-Naïve patient treatment |
|
Definition
Tenofovir, emtricitabine (NRTI) and Efavirenz (NNRTI)
-Patients who use this get a decrease in number of viral particles
-Decrease virus becomes resistant to drugs
-Increase in number of CD4 cells (less other infections) |
|
|
Term
|
Definition
1 strand RNA
Hemagglutinin H1, H2, H3
Neuraminidase N1, N2 |
|
|
Term
|
Definition
| Amantadine, rimantadine, Zanamivir (Relenza), Tamiflu |
|
|
Term
|
Definition
Epidemic parotitis
(Paramyxovirus) |
|
|
Term
|
Definition
Rubeola from mribillivirus
Koplik's spots |
|
|
Term
|
Definition
HDCV = Human diploid cell vaccine
HRGI = Human rabies immune globulin (put in wound to slow spread) |
|
|
