Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
117 Cards in this Set
- Front
- Back
|
Cardiovascular Barriers to infection
|
Blood low in Fe
Bacteria don't grow Phagocytic cells clear bacteria |
|
|
Normal Flora in cardio system
|
None
|
|
|
Lymphatic system
|
very permeable
fixed macrophages clear baxter both types lymphs T cells and b cells RES |
|
|
Bacteremia
-where? -gets in how? |
presence of bacteria in blood
-gets in through invasive procedures and wounds |
|
|
2 types of bacteremia?
|
1. absence of identifiable source
2. spread from 1 source of infection -many bacteria can lead to sepsis under right circumstance |
|
|
Symptoms of bacteremia
|
self-limiting
no symptoms |
|
|
Lymphangitis
-inflammation of lymph vessel |
APC go to present to lymph nodes and cause inflammation they travel in lymphatic system and vessels become inflamed and cause streaking
|
|
|
Septicemia
|
Uncontrolled proliferation in blood
sepsis |
|
|
Signs and symptoms of septicemia
|
-bacterial siderophores steal Fe
-increase bacterial growth -fever, chills, increased hr, breathing |
|
|
Severe Sepsis
|
-inflammatory response causes decrease bp
-hypotension earmark with sepsis -must be treated with fluids -cause must be identified -body wide inflammation and blood not getting to organs |
|
|
Septic shock (worst)
-mortality rate? -leads to? |
BP can be controlled by fluids
vessel constriction decreased blood flow leads to organ failure 20-40% mortality rate |
|
|
Endocarditis
-what is it? |
Inflammation of inner layer of heart and valves
|
|
|
Predisposition for endocarditis
|
-altered or abnormal heart architecture
1. trauma (MI, surgery, prosthetic valves) 2. Congenial heart disease 3. Rheumatic fever (immune response to GAS) |
|
|
Exposure to bacteria for Endocarditis
|
-major dental surgery
-open heart surgery/genitourinary procedure -body piercing (susceptibility) -IV drug use (adherence strong, in mouth so not washed away) |
|
|
2 types of endocarditis
|
Acute- outside sudden high fever and high fatality
Subacute- inside, slower onset, daily mild fever for months with heart murmur |
|
|
Endocarditis symptoms
|
fatigue, general discomfort (malaise), headache, night sweats, heart murmur
splinter hemorrhages appear under fingernails |
|
|
Diagnosis for sepsis and endocarditis
|
-blood culture
-broth culture (aerobic and anaerobe) -# of cells present in septic blood often <100ml |
|
|
Treatment for endocarditis and septicimia
|
Antibiotic and then something more specific
|
|
|
causes of sepsis and endocarditis
Staph aureus and Strep epi -gram stain? |
found of skin
-gram + cocci in clusters |
|
|
Epidemiology of S. Aureus
|
-normal flora so opportunistic nosocomial
-tooth extractions -MRSA -Pos op. surgical sepsis |
|
|
Epidemiology of S. Epidermidis
|
-40% nosocomial sepsis, linked to iv catheters
- make biofilm, adherence and grow on needle |
|
|
Diagnosis of S. aureus
|
culture
staph aureus -beta hemo, cat + coat + S. Epi -gamma, cat +, coag- (STREP cat-) |
|
|
Treatment of S. Aureus
|
penicillin with tooth extractions
MRSA treat with vancomycin |
|
|
Cause of endocarditis
-viridans streptococci (oral) -gram stain? |
-gram + cocci in chains
- alpha hemolytic -one of leading cause of endocarditis -normal flora in mouth, infected during dental procedures -CAT - -optichin resistant vs sensitive |
|
|
Cause of endocarditis enterococci
-gram stain? Catalase? -2 main species |
gram + cocci, D carb
Cat - aerotolerant E. faecalis (80-90%) (gut flora) E faecium (5-10%) |
|
|
epidemiology of enterococci
|
-3rd leading cause of endocarditis
-prothetic valve endocarditis mainly -naturally drug resistant HARD to TREAT |
|
|
Cause of sepsis streptococcus pyogenes
|
Group a Strep
Gram + cocci |
|
|
Virulence factors of Strep Pyogenes
|
Capsule
Hyaluronidase DnAse leukocidins m protein streptolysins |
|
|
Puerperal Sepsis
|
childbed fever
-nosocomial infection of uterus -transmitted by hands and instruments of dr -prevent with hand washing -rare now |
|
|
Lemierre's syndrom
|
abscess secondary to GAS strep throat infection (eats holes through throat)
VF: streptolysin, Hyaluronidase allow invasiveness -cause infected clot in jugular and travel to lung or heart and be fatal -reemergence |
|
|
Rheumatic fever
|
original pharyngitis infection
-autoimmune complication of strep throat GAS infection and then antibodies to M protein Type II hypersensitivity |
|
|
Symptoms of rheumatic fever
|
arthritis
misdirected immune response fever M protein is self like and leads to heart damage |
|
|
Epidemiology of rheumatic fever
|
early century killed children
declining due to loss of virulence reemergence of virulent serotypes in Us reinfection renews immune attack and worsens heart each time |
|
|
Diagnosis of S. pyogenes
|
B-hemolytic on blood agar
Bacitracin senseitive Cat - A carb |
|
|
Treatment for rheumatic fever
|
high rid patients get Benzathin Penicillin G and anyone with a history of rheumatic fever
|
|
|
Prevention of rheumatic fever
|
hand washing
treat strep throat |
|
|
Cause of sepsis Group B strep Agalactiae
|
Sepsis of newborns
-moms vaginal infection spread during delivery -baby septic within day and mom has no symptoms |
|
|
Diagnosis of Group B strep
|
Culture
-B hemo -Cat - Lancefield group b |
|
|
Treatment of group B strep
|
Antibiotics during delivery
|
|
|
Prevention of group b strep
|
Check pregnant women for group b at 35-37 weeks
rectal and vaginal |
|
|
Endotoxic shock
|
Cause of sepsis
Gram- rods LPS most likely cause of septic shock (20%) |
|
|
Symptoms of shock
|
increase heart rate and respiration
weak pulse dehydration, cold DIC |
|
|
Treatment for shock
|
Maybe antibiotics, maybe not, dead cell better than non-dead cell if LPS available
Vasopressors to control blood pressure |
|
|
Protein C in septic shock treatment
|
is an important player in the body's response to inflammation and systemic sepsis
-reduce production of thrombin -inhibits influence of tissue factor on clotting system, shuts down clotting |
|
|
Gram + endotoxic shock
|
less common and less severe
LTA |
|
|
Plague
|
Uncommon cause of sepsis (zoonotic)
-yersinia pestis -facultative intracellular -gram - bacilli Black death |
|
|
Plague disease
-symptoms -how do you get it? -mortality rate? |
Bubonic -flea bite-buboes in armpits and groin (inflammation) mortality 50-75% -death w/in week if septic Pneumonic -infects lungs -mortality 100% -person to person |
|
|
Epidemiolog of plague
|
Bubonic
Reservoir-rat Vector -rat flea Due to over-crowding Pneumonic Human to human aerosol Slvatic plague-flea associated with told rodent or bite by flea touched by wild rodent |
|
|
Virulence factors of plague
|
1. YOP gene necessary for attachment to host cells
2. Plasminogen activator 3. Capsule-inhibit phagocytosis Last 2 needed to cause disease in mice and survive in flea |
|
|
History of plague
|
-oldest recoded infection disease
|
|
|
Diagnosis of plague
|
Fluorescent antibody
culture PCR |
|
|
Treatment for plague
|
antibiotics
|
|
|
Prevention for plague
|
Live attenuated vaccine
Get rid of flea and rat recovery offers immunity |
|
|
Brucellosis
|
Uncommon causes of sepsis associated with animals
- 3 species -gram - bacilli undulant fever (up and down) |
|
|
Epidemiology of Brucellosis
|
Foodborne infections
-unpast. goat cheese -exposure to disease animal tissue so someone comes in contact with raw meat -no person to person -farmers and vets |
|
|
Symptoms of brucellosis
|
-septicemia: muscular pain and sweating.
Duration varies from a few weeks to many months/years |
|
|
Treatment for brucellosis
|
prolonged antibiotics
|
|
|
Prevention
|
Vaccine animals
|
|
|
Tularemia GNR
|
uncommon cause of sepsis related to animals
-francisella tularensis (rabbits and rodents) -potential agent of bioterrorism Gram -- rod -due to skinning water ticks dust and mowing |
|
|
Symptoms of tularemia
|
headache
backache ulcerative lesion conjunctivitis Pulmonary |
|
|
Anthrax
|
uncommon causes of sepsis zoonotic
-bacillus anthracis Gram + bacilli spore former -herbivorous animals ingest soil in water or on vegetation |
|
|
1.Cutaneous antrax (wool sorters disease)
2.GAstrointestinal antrax |
1. most cases
skin lesion-ruptures scabs sheered sheep and dusty wool 2. undercooked food with spores bloody diarrhea |
|
|
Inhalation anthrax
|
breath in spores
mortality very high septic shock LTA gram + |
|
|
Epidemiology of anthrax
|
-imported disease associated with animals
-bio warfare |
|
|
Antrax virulence factors
|
capsule
anthrax toxin -edema factor -lethal factor -protective antigen |
|
|
A-B subunit toxin for anthrax
|
PA protective antigen
EF edema factor LF lethal factor |
|
|
Diagnosis of anthrax
|
Culture
-protect against airborne spores PCR |
|
|
Treatment for anthrax
|
antibiotics
|
|
|
Prevention for anthrax
|
1. vaccine for animals (live attenuated)
2. Vaccine for humans military inactivated form of protective antigen |
|
|
Q fever
|
uncommon cause of sepsis zoonotic
-coxiella burnetti in domestic animals |
|
|
Cat scratch
|
uncommon causes of sepsis zoonotic
bartonella sp cat bite or scratch |
|
|
Lyme disease
|
borrelia burgdorferi
Spirochete |
|
|
Lyme disease
-rash? -symptoms? |
75% rash target rash
-flu like symptoms -if untreated 75% will develop later manifestations |
|
|
Complications of lyme disease
|
due to immune response
-arthritis (primary) -heart disease -neurological |
|
|
Epidemiology of lyme disease
|
reservoir is field mice
vector is deer tick (tick wants the deer, we get it from tick) |
|
|
Diagnosis of Lyme disease
|
sign and symptoms Rash
ELISA PCR Not done clinically culture Bacterial |
|
|
Treatment of lyme disease
|
antibiotics
|
|
|
Prevention of lyme disease
|
control tick population
|
|
|
Typhus fever 1
|
Aka louse borne typus
from body lice so rare -rickettsia prowazekii -obligate intracellular bacteria -arthropod vector -human body louse lice Too tiny for gram stain |
|
|
Typhus fever cause 2
|
Tick borne typhus or rocky mountian spotted fever (rickettsia rickettsii)
-rash on palms and soles of feet -vector is wood tick -delayed diagnosis but rarely fatal -serology only late in disease -no vacc -control tick polulationE |
|
|
epidemiology of rocky mountain spotted fever
|
-every louse has to feed on somebody who has typhus to give it to someone else
-A tick with rocky mountain will have babies who are already infected |
|
|
Human Immunodeficiency Virus
|
Retrovirus so has reverse transcriptase
-similar to SIV STD primarily -infection of t cells which are circulation in blood |
|
|
HIV Primary infection
-symptoms |
Acute Retroviral syndrome
-flu or mono-like symptoms -viral infection of T lymphocytes, CD4 helper cells and macrophages |
|
|
HIV secondary infection
|
Latency
-meidan time 10-11 year few have rapid progression 2-3 years really persistence bc active virus production |
|
|
AIDs disease
|
immune systems ability to control infectious or malignant disorders is destroyed
relentless production of HIV proteins elimination of host cells destruction of immune system Death |
|
|
ARC (AIDS related complex)
|
Die from infection bc of lack of Cd4 T cells
immunocompromised Kaposi's sarcoma Mycobacteria pneumocystis herpes zoster toxoplasma histoplasmosis |
|
|
Epidemiology of HiV
|
STD.
IV drug use contaminated needles transfusions organ transplants |
|
|
Diagnosis of HIV
|
Indirect ELISA (detect 20 days after infection)
Confirmation with PCR or western blot |
|
|
Treatment of AIDs
|
cocktail combination of 3
|
|
|
Prevention of HIV
|
Condoms
Education |
|
|
Epstein barr virus HHV 4
|
AKa burkitts' lymphoma
-most common cancer of african children -in areas with endemic malaria -malaria impairs immune response of EBV |
|
|
Infectious mononucleosis
|
Disease 4-7 week incubation
lymphocytosis fever sore throat |
|
|
Epidemiology of inectious mononucleosis
|
Young adults 15-25
saliva transmitted kissing disease |
|
|
Diagnosis of mononucleosis
|
mono spot tests for heterophile antibodies (antibodies produced during EBV infection)
|
|
|
Treatment for mononucleosis
|
self limiting/none
|
|
|
Prevention of mononucleosis
|
permanent immunity of you have gotten mono through E barr
|
|
|
Yellow fever
|
Disruption of clotting factors, supportive treatment
accompanied by jaundice mosquito |
|
|
Dengue fever
|
breakbone fever, sever pain
mostquito |
|
|
Ebola
|
massive hemorrhage rash
vector unknown |
|
|
Lassa Fever
|
chest pain and deafness as long as term sequelae
|
|
|
Hanta virus
|
human exposure to dried rodent urin
pulmonary syndrome SE when people sweeping warehouse and breath drown in your own fluid |
|
|
West Nile Virus
|
Carried by virus
Arbovirus Mostquito |
|
|
Symptoms of West Nile Virus
|
asymptomatic or mild illness sometimes with headache
-encephalitis in rare cases Not seen in US before 1999 |
|
|
Toxoplasmosis
|
Tocoplasma gonii
parasitic Associated with AIDS Pregnant women ingest cyst of parasite due to liter box, can cross placenta and infect baby None to few symptoms |
|
|
Toxoplasmosis
|
-majority of world population infected
mostly with no symptoms and normal immune system keeps away illness -AIDS immune suppressed have severe neurological impairment -Congenital infection (stillborn, brain and vision problems) |
|
|
Epidemiology of toxoplasmosis
|
outdoor cats, sandboxes, and children
-accidentally ingest cat feces rat or undercooked meat -pork lamb venison contaminated water fomites organs or blood |
|
|
Diagnosis of Toxoplasmosis
|
TORCH panel
Toxoplasma specific antibodies |
|
|
Treatment for toxoplasmosis
|
Treat only immune suppressed, pregnant, and congenitally infected
-antiparisitic treatment |
|
|
Malaria
|
Apicomplexa protozoan
-caused by plasmodium species -intracellular in RBS |
|
|
Symptoms of malarial disease
|
malaise, fatigue, vague aches, and nausea with diarrhea or not
next symptoms have bouts of chills, fever, and sweating, -occur at 48-72 hour intervals RBC lysis leading to anemia RBC stick clog tissue damage |
|
|
Epidemiology of malaria
|
10 million cases/yr
2 million death/yr mosquito US rare, tropical arease |
|
|
Diagnosis of Malaria
|
identify parts of life cycle in peripheral blood smear
|
|
|
Treatment for malaria
|
Drug resistance is big problem
Quinine Chloroquine Artemisinin as last line of defense |
|
|
Prevention of malaria
|
control mosquito population
netting enriched pesticide |
|
|
Lymphatic filariasis
|
worms transmitted by bite of mosquito
invade and reproduce in lymphatic system often asymptomatic can cause blockage of lymphatic vessel and lymphadema and elephantiasis |
|
|
Diagnosis of filariasis
|
detection of worms in blood
microfilariae specific antibodies |
|
|
Treatment of Filariasis
|
Anti-filarial drugs will not resolve lymphedema and elephantiasis
surgery |
