Flashcards About Micro Final Test

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Bacillus Anthracis

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Gram Positive Bacteria, endospore forming, motile rods

  • capsule
  • exotoxins produce edema&death
  • Primary habitat is soil
  • zoonotic disease of sheep, cattle, goats
  • Portal of Entry determines disease

 

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BACILLUS ANTHRACIS

 

(Cutaneous Anthrax)

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skin, black eschar - least dangerous

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BACILLUS ANTHRACIS

 

(Pulmonary)

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Inhaled into lungs - most lethal

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BACILLUS ANTHRACIS

 

(Gastrointestinal)

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Contaminated meat, can be fatal

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BACILLUS ANTHRACIS

 

TREATMENT AND CONTROL

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  • Treated with penicillin, tetracyclin, or ciprofoxacin
  • Vaccines
    • Live spores and toxoid to protect livestock
    • Purified toxoid
      • used for high reisk occupations and military personnel
      • toxoid - 6 innoculations

 

 

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STREPTOCOCCUS PYOGENES
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  • Most serious Streptococcal pathogen
  • Gram positive cocci
  • facultative anaerobes
  • non spore forming, non-motile
  • can form capsules and slime layers
  • 5-15% carry as normal flora
  • Inhabits throat, nasophaynx, occasionally skin
  • strict parasite; human only reservoir
  • sensitive to drying, heat, and disinfectants
  • transmission: contact, droplets, food, formites
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STREPTOCOCCUS PYOGENES DISEASES

 

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  • Pharyngitis, tonsillitis, impetigo, strep, scarlet fever
  • necrotizing fasciitis (flesh eating disease, when bacteria produces enzymes and toxins that destroy tissue)
  • skin infections
  • septicemia
  • Streptocoocal toxic shock syndrome
  • Sequelae

 

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VIRULENCE FACTORS OF

 

STREPTOCOCCUS PYOGENES

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  • C-carbohydrates - protect against lysozyme
  • fimbrae - adherence
  • M-protein - contributes to resistance to phagocytosis
  • Capsule - provokes no immune response
  • Complement 5a protease - blocks complement and neutrophil response
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VIRULENCE FACTORS OF

 

STREPTOCOCCUS PYOGENES

 

EXTRACELLUAR TOXINS

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  • Streptolysins - cause cell and tissue injury
  • Erythrogenic toxin (pyrogenic) - induces fever and rash
  • Superantigens - strong monocyte and lymphocyte stimulants
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VIRULENCE FACTORS OF

 

STREPTOCOCCUS PYOGENES

 

EXTRACELLULAR ENZYMES

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  • Streptokinase - digests fibrin clots
  • Hyaluronidase - breaks down connective tissue
  • Dnase - hydrolyzes DNA
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STREPTOCOCCUS PNEUMONIAE

 

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  • Gram positive cocci
  • often called pneumococcus
  • causes 60-70% of all bacterial pneumonias
  • typical pneumonia
  • causes 35% of otitis media - inner ear infection
  • all pathogenic strains have large capsules
  • vaccine for high risk people
  • Does not survive long outside its habitat
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Mycobacterium Tuberculosis
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  • Gram positive, irregular shaped Bacilli
  • Acid-fast staining
  • Strict Aerobes
  • possess mycolic acids and a unique type of peptidoglycan
  • grow slowly
  • 20 hour generation time
  • does not produce capsules, flagella, or spores
  • produces no exotoxins or enzymes
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Mycobacterium Tuberculosis

 

VIRULENCE FACTORS

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  • complex waxes and cord factor that prevent destruction by lysosomes or macrophages
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Mycobacterium Tuberculosis

 

EPIDEMIOLOGY

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  • inadequate nutrition, debilitation of the immune system, poor access to medical care, lung damage, and genetics
  • 1/3rd world population and 15M in US carry it
  • Bacillus very resistant to drying and disinfectants
  • transmitted by droplets
  • worldwide, leading cause of death from a bacterial infectious disease
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Mycobacterium Tuberculosis

DIAGNOSIS
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  • Mantoux Test- local intradermal injection of purified protein derivative (PPD)
  • look for red wheal to form in 48-72 hours
  • in vivo or tuberculin testing
  • x-rays
  • direct identification of acid-fast bacilli in specimen
  • cultural isolation and biochemical testing

 

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Mycobacterium Tuberculosis

 

Management and Prevention of TB

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  • 6-24 months of at least 2 drugs from a list of 11
  • vaccine based on attenuated bacilli Calmet-Geurin strain of M.Bovis
    • not used in US
    • Used in other countries
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Mycobacterium Tuberculosis

 

Course of Infection and Disease

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  • only 5-10% of infected people develop clinical disease
  • untreated, the disease progresses slowly
  • Majority of cases contained in lungs
  • clinically divided into:
    • Primary
    • Secondary (reactivation or reinfection)
    • Disseminated (extrapulmonary)

 

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Mycobacterium Tuberculosis

 

PRIMARY TB

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  • Infectious dose 10 cells
  • Phagocytosed by alveolar macrophages and multiply intracellularly
  • after 3-4 weeks, immune system attacks, forming tubercles, granulomas consisting of a central core containing bacilli surrounded by WBCs - tubercle
  • if center of tubercle breaks down into caseous lesions, they gradually heal by calcification
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Mycobacterium Tuberculosis

 

SECONDARY TB

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  • If patient doesnt recover from primary tuberculosis, reactivation of bacilli can occur
  • Tubercles expand and drain into the bronchial tubes and UR tract
  • Gradually the patient experiences more severe symptoms
    • Violent coughing, greenish or bloody sputum, fever, anoerexia, weight loss, fatigue
  • untreated, 60% mortality rate
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Mycobacterium Tuberculosis

 

EXTRAPULMONARY TB

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  • During secondary illness, bacilli disseminate to regional lymph nodes, kidneys, long bones, gential tract, braing, and meninges
  • complications are grave
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BORDETELLA PERTUSSIS

 

VIRULENCE FACTORS

 

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  • Small gram-negative coccobacillus
  • capsule, adhesion molecules bind to ciliated respiratory epithelial cells, exotoxins destroy host cells
  • causes pertussis, whopping cough- only vaccine preventable disease on the rise in the US
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Hemophilus Influenzae

 

VIRULENCE FACTORS

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  • tiny, gram-negative pleomorphic rods
  • fastidious, sensitive to drying, temperature extremes, and disinfectants
  • Hib-subunit vaccine available
  • sensitive to drying, temp extremes, and disinfectants
  • caues acute bacterial meningitis, epiglottitis, otitis media, sinusitis, pneumonia, and bronchitis
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Mycoplamsa Pnuemoniae
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  • have no cell wall
  • highly pleomorphic
  • filamentous, moldlike appearance, very small, slow growing
  • causes primary atupical, or walking pnuemonia
  • becomes a membrane parasite that adheres tightly and fuses with the host cell surface
  • fusion makes destruction & removal difficult
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Gram Positive Bacteria of Respiratory System
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  1. Streptococcus pyogenes
  2. Streptococcus pneumoniae
  3. bacillus anthracis
  4. Mycobacterium tuberculosis
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Gram Negative Bacteria of Respiratory System
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  1. Bordetella pertussis
  2. Haemophilus Influenzae
  3. Mycoplasma pnuemoniae
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MRSA
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  • methicillin-resistant Staphyloccus aureus
  • carry resistance to many antibiotics
  • often treated with Vancomycin as last resort
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HA-MRSA

(Healthcare Associated MRSA)

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  • occur in people who are or have been in a hospitl or other health care facility within the past year
    • typically associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints
    • bloodstream infections, surgical-site infections, or pnuemonia

 

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Community Associated MRSA

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  • occur in otherwise healthy people who have not recently been in the hospital (athletes, daycare, military)
    • mainly skin infections
    • numberof CA-MRSA cases rising
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Sinuses/Sinusitis
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  • sinuses have no normal flora
  • inflammatory condition of any of the 4 pairs of sinuses
  • when sinus openings become lbocked or too much mucus builds, bacteria can grow and form a biofilm
  • allergies and cold viruses can cause increased secretions and bacteria may grow

 

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Defenses of the Respiratory System

 

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  • coarse hairs in nose filter large particles from air
  • mucus traps microbes (1-2 quarts)
  • cilia moves microbes toward mouth
  • lymphoid tissue of tonsils and adenoids
  • alveolar macrophages in lungs engulf and destroy microbes
  • coughing
  • secretory IgA
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Rhinovirus

 

VIRULENCE FACTORS

 

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  • Causues over 50% of common cold
  • exacerbates asthma
  • over 100 types
  • incubation of 1-2 days
  • grows in temp found in the nose and large airways (33-35 degree C)
  • 1 virus = infectious dose
  • Bind to cell surface receptor ICAM-1 of the UR tract and dendritic and macrophages cells (attachment to the cells triggers anti-inflammatory response and dampens the immune response
  • host inflammatory response causes symptoms and not RV directed cytopathic effects
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Rhinovirus

 

Suspceptibility to bacterial infection

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  • RVs disrupt epithelial cell barrier by destroying tight junctions facilitating the transmigration of bacteria
  • RVs promote S. Aureus internalization
  • RVs stimulate Strep. Pneu. adhesion to tracheal cells
  • RVs suppress macrophages and dendritic cells
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Coronavirus

 

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  • Enveloped, crown appearance
  • large RNA genome, mutations are common
  • causes 10-20% of common colds
  • Usually mild human pathogen, but can mutate
    • SARS
    • MERS
  • Common serious vetrinary pathogen
  • large animal reservoir
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SARS/MERS SYMPTOMS
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  • Severe acute respiratory illness with symptoms of fever, cough, shortness of breath, diarrhea
  • SARS mortality 12%
  • MERS mortality 43%
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PNEUMONIA

 

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  • inflammation of lungs - caused by many microbes
    • influenza virus
    • RSV
    • Streptococcus Pneumonia - typical
    • Haemophilis infulenza (Hib)
    • mycoplasma pneumonia - atypical (walking pnuemonia)
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Influenza Virus

 

Virulence Factors

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  • Enveloped
  • 8 RNA segments
  • Hemaglutinin and Neuramidndase spikes
  • virus attaches and infects cells in trachea - results in localized damagem, NO viremia
  • kills 36K Americans/year
  • antigenic drift and shift- virus changes&immune system doesn't recognize it
  • large waterfowl reservoir
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INFLUENZA VIRUS

 

HEMAGLUTTININ (H)

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  • (H) spike binds to host cells
  • Mutations through antigenic drift and shift allow it ot avoid immune response and crossover to new speices
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TYPICAL INFLUENZA PATHOGENESIS
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  • droplet transmission
  • virus attaches to respiratory tract
  • attaches to the ciliated comunar epithelial cells lining the sinuses and airways
  • replication and inflammation
  • localized infection
  • no viremia
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FLU VACCINE
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  • Trivalent vaccine each year (3 strains)
  • includes 2 A and 1 B strain
  • grown in ebryonated chicken eggs, purified H
  • takes about 6 mos to produce
  • ideal time for vaccination - October through mid-November
  • routine annual influenza vaccination recommended for all persons aged 6 mos or older who do no have contraindications
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INFLUENZA TREATMENTS

 

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  • One of few viruses for which there is treatment available
  • 4 anti-influenza drugs
    1. amantadine
    2. rimantadine
    3. relenza spray - blocks neuraminidase
    4. tamiflu= capsuel blocks neuraminidase
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RESPIRATORY SYNCYTICA VIRUS (RSV)
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  • most common resp. virus in infants
  • infects virtually all by the age of 2 years
  • usually causes cold like symptoms
  • most common cause of bronchiolitis
  • infects UR tract and produces giant multinucleated cells
  • epithelia of nose and eye portal of entry- replicates in the nasopharynx
  • fever, rhinitis, pharyngitis, otitis, croup
  • treatments - Synagis - a monoclonal anitbody that blocks attachement and ribavirin antiviral drug
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HA RNA 

 

Hemagluttinin

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  • Encodes the production of a viral envelope glycoprotein called hemaguttinin, which plays a role in binding to host cell receptors
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NA RNA

(Neuramidase)

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  • Encodes the production of neuramindase, which breaks down the protective mucus in the respiratory tract and plays many roles in viral reproduction
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DPT Vaccine
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A toxoid; an inactivated toxin (Td or Tdap).  Booser needed every 10 years.

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Gram postive dieases of the Digestive Sytem and the accessory glands

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  1. Clostridium difficile
  2. S. aureus
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Gram negative diseases of the digestive system and accessory glands.  LPS - ENDOTOXIN

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  1. H. pylori
  2. Salmonella
  3. E.coli
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Viruses of the digestive system and accessory glands

 

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  1. norovirus
  2. hep a virus
  3. hep b virus
  4. hep c virus
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Clostridium Difficile
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  • gram positive, endospore forming rods
  • produces endotoxis A and B
  • minor normal resident of intestine
  • when antibiotics kill off normal flora, C. diff overgrows
  • antibiotic associated coliltis- diarrhea, inflammed color, sloughs off pseudomembrane of fibrin and cells
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Defense mechanisms of the GI Tract
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  • saliva
  • normal flora of mouth and large intestine (microbial antagonism
  • mucous secretions
  • IgA
  • acidity of stomach
  • bile
  • rapid movement of material exept through large intestine
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C. Difficile Infection
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  • water diarrhea
  • fever
  • loss of appetite
  • nausea
  • abdominal pain and tenderness
  • 80% healthcare related
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What does c. diff do to the gut?

 

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  • damages cells, triggering inflammation and fluid buildup
  • inflamed cells burst and die
  • c. diff spores leave colon via diarrhea and await next host
  • endospores spread around hospital
  • hands must be washed with soap and water; sanitizer does not kill spores
  • if possible, stop antibiotics and/or treat with metronidazole or vancomycin
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Staphylocoocus Aureus
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  • Gram positive cocci
  • Normally inhabits skin and mucous membranes
  • withstands high salt
  • produces several enzymes
    • hemolysins
    • leukocidins
    • enterotoxins
    • exfoliative toxin
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Staph Auerus Dieases
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  • localized to systemic diseases
  • abscesses, boils, empetigo, osteomyelitis
  • pneumonia, bacetermia, endocarditis, toxic shock syndrome
  • food poisoning, intoxication:  enertotoxin requiers 100 degrees C for 30 min to activate
  • hands to food ----> temp abuse --> Staph multiplies and releases toxin and 1-6 hours symptoms
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S. Aureus - Exfolitative Toxin
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Cutaneous lesions and scaled skin syndrome in newborn

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S Aureus Osteomyelitis
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infects long bone

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Helicobacter Pylori
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  • gram negative, comma shaped bacteria
  • produces urease, which breaks down urea, producing ammonia that neutralizes stomach acid
  • responsible for 90% of peptic ulcers
  • dogs and cats carry H. Pylori
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Salmonella
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  • gram negative, facultatively anaerobic rods
  • zoonotic- lives in intestinal tract of animals without making them sick
  • Most infected with samonella develop diarrhea, fever, abdominal cramps 12-72 hours after infection
  • most recover without treatment
  • during infection, populations of host bacteria decrease, sugars become abundat, and host inflammation abounts
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Escherichia Coli
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  • gram negative facultative anaerobic rods
  • cause 70% travelers diarrhea
  • causes 50-80% urinary tract infection
  • E.coli is in indicator organism for human fecal contamination
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STEC E. Coli

(Shiga Toxin Producing E Coli)

0157H7

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  • can cause people to suffer from severe cramps, bloody diarrhea, vomiting, and a low grade fever for 5-7 days
  • symptoms show up 3-4 days after ingesting bacteria
  • self limited disease in most people
  • can be serious and cause hemolytic uremic syndrome, which casues permanent kidney damage and death if left untreated
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Norovirus
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  • presents as acute-onset vomiting, watery non-bloody diarrhea with abdominal cramps, and nausea
  • occasionally a low grade fever occurs
  • dehydration most common complication
  • lasts 24-48 hours
  • an infected person can spread the virus for 3 days or more ater diarrhea or vomiting stops
  • immunity may be strain specific
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Functions of Liver
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  • removes and destroys toxins
  • stores vitamins, minerals, and sugars
  • manufactures proteins involved in clotting, immunity, etc
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Viral Hepatitis
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  • inflammation of the liver, producing swelling, tenderness, and sometimes permanent damage
  • caused by at least 6 diff viruses:  HAV, HBV, HCV, HDV, HEV, AGV
  • non-viral hepatitis may be caused by chemicals, drugs, or alcohol
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HAV
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  • fecal-oral transmission
  • non-enveloped RNA virus
  • classified as an enterovirus
  • milder, shorter term disease
  • treatment with immune globulin
  • vaccine both inactivated and attenuated available
  • is not chronic
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HBV
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  • transmission through contact with blood, sexual partners, and perinatally
  • 7 week incubation period
  • can lead to the development of hepatocellular carcinoma
  • treatment through interferon and reverse transcriptase inhibitors
  • recombinant vaccine produced by yeast available for prevention
  • Member of the hepadnavirus, a groupe of enveloped DNA virus
  • 50% cases are asymptomatic
  • virus cannot be grown in tissue culture
  • 10% become chronic carriers
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HCV
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  • Transmission is primarily through contact with blood and blood products
  • estimated that more than 3 million americans are infected by this RNA virus
  • treated through interferon and ribavirin (old) and protease inhibitors (new)
  • no vaccine available
  • Can be chronic in about 80%
  • 1/3 rd of all liver transplants for HCV damaged livers
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HAV PREVENTION
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  1. handwashing
  2. inactivated&attenuated vaccine available
  3. immune globulin
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Staph Aureus Virulence Factors
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  • coagulase enzyme causes blood plasma to clot
  • penicillinase enzyme allows s. aureus to grow in the presence of penicillin
  • hyalauronidase enzyme promotes invasion of host tissues
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Tetanus Infection Cycle
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  1. necrotic tissue causes anaerboic conditions
  2. germination of spores
  3. production of tetanospasmin toxin
  4. excess skeletal muscle contraction
  5. respiratory muscles go into spastic, sustained contractions
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Clostridium Botulinum
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  • gram positive, endospore forming rods
  • food poisoning
  • found in soil, may contaminate vegetables
  • improper canning does not kill spores and can produce botulinum neurotoxin
    • neurotoxin blocks release of acetylchole and causes flaccid paralysis (muscles cannot contract).
    • die from respiratory or cardiac failure
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Botox Cosmetic
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  • Blocks nerve impulses, temporarily paralyzing the muscle that cause wrinkles while giving the skin a smoother appearance.
  • relieves migraines, excessive sweating and muscle spasms in the neck and eyes

 

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Infant Botulism
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  • Babies don't have well established normal flora
  • babies my ingest endospores, which germinate and produce toxin in the body
  • c. botulinum does not grow in adult intestines
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Clostridium Tetani
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  • Gram positive bacilli, endospore forming rod
  • common resident of soild and GI tracts of animals
  • causes tetanus or lockjaw, a neuromuscular disease
  • endospores usually enter through accidental puncture wounds, burns, umbilical stumps, frostbie, and crushed body parts
  • bacteria grows and tetanospasmin - a neurotoxin that causes spastic paralysis
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Tetanus Toxin
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  • blocks muscle relaxation
  • death occurs from spasms of respiratory muscles
  • Vaccine - DPT is a toxoid, inactivated toxin (td or Tdap)
  • Vaccine booster needed every 10 years
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Neisseria Meningitidis
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  • gram negative diplococci; meningococcus
  • carried in nasopharynx, invades when resistance is lowered; enters bloodstream & meninges
  • Symptoms are high fever, chills, lethargy, and a rash
  • if meningitis is present, the symptoms will aslo include headache and neck stiffness (which may not be present in infants); seizures may also occur
  • in overwhelming meningococcal infections (septicemia), shock, coman, and death can follow within several hours even with appropriate medical treatment
  • about 9-12% of persons with meningococcal disease die.  Of those that recover, up to 20% suffer from serious after-effect, such as hearling loss, limb loss, or brain damage
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Neisseria Mengingitidis

Types and Vaccines

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  • 5 types:  A, B, C, W135, and Y
  • the MCV vaccine contains Neisseria meningitidis serogrop A, C, Y, and W-135 capsular polysaccharide antigens individually conjugated to diptheria toxoid protein
  • vaccine does not contain live bacteria
  • new vaccine portects against subtype B which casues about 1/3 of all the meningococcus cases in the US
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Varicella Zoster Virus (VZV)

 

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  • member of the Herpes virus family, which all cause chronic infections for life & recurrence disease
  • 95% US population infected
  • causes chickenpox and shingles
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Varicella Zoster Virus (VZV)

Primary Infection

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  • Chickenpox - vesicles virus enters neurons and remains latent
  • live chickenpox vaccine
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Varicella Zoster Virus (VZV)

Reactivation

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  • Shingles with vesicles localized to a dermatone on one side of trunk or face
  • live virus shinges vaccine (14X stronger than chickenpox)
  • most commonly occurs in people 50 or older or people who are immunosupressed
  • shingles vaccine recommended at 60 years
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Smallpox vs Chickenpox
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  • smallpox is most easily confused with chickenpox
  • a single case of smallpox would be considered an act of bioterrorism
  • chickenpox lesions at different stages- new lesions appear in crops every few days
  • All smallpox lesions should be at the same stage of development
  • centrifugal pattern of smallpox lesions
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Smallpox History
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  • smallpox was worldwide
  • 15M people infected annually
  • 2M died with millions more left disfigured and sometimes blind
  • 1796-Jenner used cowpox to vaccinate against smallpox
  • 1977-last natural cause of smallpox, occurred in Somalia
  • 1980-smallpox was declared eradicated
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Smallpox
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  • Largest and most complex virus known
  • transmission does not occur until onset of rash, by then most are in bed with high fevers & malaise
  • mortality rate 20%-30%
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Smallpox Diagnosis
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  • most easily confused with chickenpox
  • all smallpox lesions should be at the same stage of development
  • chickenpox lesions at different stages - new lesions appear in crops every few days
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Smallpox as a biological weapon
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  • smallpox is stable in aerosol form
  • stable on surfaces ~24 hours if not exposed to UV light
  • stable on linens, clothes for extended periods
  • spreads from person to person by
    • aerosol expelled from the respiratory system
    • direct contact
    • fomites- contaminated clothing
  • No known animal or insect reservoir
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Measles Virus
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  • Causes Rubeola or red measles
  • 8th most frequent death worldwide
  • VERY contagious through respiratory aersols
  • sore throat, headache, Koplik's spots in mouth then rash, ear infections, pneumonia, ecephalitis, even death
  • most serious complication is subacute sclerosing panecephalitis (SSPE) progressive neurological degeneration of the cerebral cortex - 1 in 1M cases
  • less than 100 cases/year in US.  Cases have been increasing due to rise of anit-vaxers
  • life attenuated measles vaccine, MMR, given 12-15 months
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HIV/AIDS History
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  • 1981- CDC first reported new disease.  5 cases of PCP pneumonia in homosexual men
  • 1983-Montagnier discovered the cause, a virus, HIV
  • 1985- HIV blood test available
  • 1996- effective treatment, protease inhibitors and combinations became available
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How is HIV Transmitted?
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  • Sex - anal, vaginal, and oral
  • Parenteral - IV drug use, needlesticks, transfusions, transplants
  • Perinatal - mother to fetus
    • only 25-33% of untreated HIV pass infection to babies
    • less than 1% with treatment
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HIV
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  • 1.1 M HIV infected people in the US
  • 12.5% are unaware of their infection (1 in 8)
  • ~50,000 Americans become infected with HIV each year since 1995
  • 15,000 Americans die of AIDS each year
  • Worldwide, over 33M are infected with HIV
    • 30.8 million are adults
      • 15.4 million are men
      • 15.4 million are women
    • 2.5 million are children under 15
    • 95% are in developing nations that have 10% of the world's wealth
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How does HIV virus enter in female or male body?
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  • semen
  • blood
  • vaginal secretions
  • breast milk
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What type of virus is HIV?
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  • ssRNA virus, enveloped
  • Virion contains 3 enzymes
    • reverse transcriptase
    • protease
    • integrase
  • HIV changes rapidly because it lacks correction mechanisms - every time the virus makes a copy there is at least one genetic mistake in the new virus
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Origin of HIV
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  • 1900s benign simian virus - SIVcpz mutated into HIV1
  • stayed in remote Africa until large population settlements established, trade routes, travel and the sexual revolution spread it worldwide
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HIV
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  • MUST bind to CD4 and a co-receptor (CCR5 or CXRCR4)
  • infects two types of cells
    • T4 cells
    • Phagocytes - macrophages, and dendritic cells
  • infected macrophages travel to brain, lungs, bone marrow
  • replicates rapidly and generates lots of mutant strains
  • B cells produce antibodies to each new variant
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HIV binding
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  • Binds to CD4 and a co-receptor (CCR5 or CXRCR4) and fuses to host cell surface
  • HIV RNA, reverse transciptase, integrase, and other viral proteins enter the host cell
  • viral DNA is formed by reverse transcription
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Course of HIV infection
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  • varies substantially among people
  • Window period - time before seroconversion (anti-HIV antibodies are not detectable); false neg HIV tests; high viral replication, dangerous time when people might infect others
  • usually anti-HIV antibodies are detected between 6 and 18 weeks after exposure to HIV
  • Antiretroviral drugs recommended when HIV is diagnosed
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HIV progression
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  • HIV destroys T cells, the body replaces them until body is overwhelmed
  • Antiretroviral drugs slow replication
  • Without medication, asymptomatic period may last 1-20 years, average is 10 years
  • AIDS = less than 200 T4 cells/microliter, presence of HIV, opportunistic infections, and cancers
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HIV Testing
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  • blood test for antibodies reactive to HIV
  • antibodies are detectable between 6-18 weeks
  • window period- people don't produce detectable antibodies for 6 weeks to 1 year after infection.  False negative HIV tests, dangerous time when people may infect others
  •  
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OraSure HIV-1 Oral Specimen Collection Device
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  • does not collect saliva, but a sample called oral mucosal transudate (OMT)
  • NOT a saliva test
  • OMT contain high levels of IgG antibodies
  • tests for antibodies - not virus
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Opportunistic Infections
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  • diseases caused by microbes that normally live in or on the body without causing disease in people with normal immune systems
  • suppression of the immune system allows the harmless to become harmful
  • casued by viruses, bacteria, fungi, and protozoa that are kept in check by an intact immune system
  • caused by over 100 microbes
  • cam become disseminated (systemic)
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HIV Prevention
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  • abstinence or fidelity-most effective measure of prevention
  • comprehensive sex education
  • male circumcision reduces infection by 60%
  • tests and get positive people into treatment
  • antiviral medication reduces transmission by infected person to unifected person
  • PrEP (Pre-Exposure Prophylaxis)-treatment of high risk individuals to prevent infection
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Condoms
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  • latex - use water based lubricant only
  • polyurethane (plastic)- use any lubricant, more expensive, higher frequency of breakage, slippage
  • lamb skin- porous, prevent pregnancy, NOT STDS!
  • reduces but not eliminate HIV transmission
  • Don't use male and female condoms at same time
  • 1 in 140 condoms break
  • must be used consistently and correctly
  • Do not prevent HPV
question
HIV Universal Precautions
answer
  • gloves
  • gowns, masks, and goggles
  • careful handling of needles
  • disinfection with 1:100 bleach dilution
  • preventive treatment after exposure
question
Defense Mechanisms of the genitourinary system
answer
  • valves of bladder prevent backflow of urine to kidneys
  • Secretory IgA
  • acidity of urine
  • urine has lysozyme and lactoferrin
  • flushing action of urine
  • acidity and normal flora of vagina - microbial antagonism
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