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Semester 3 > General Pathology 300 (Infections, cont.) > Flashcards

General Pathology 300 (Infections, cont.) Flashcards

1
Q

mycobacterial infections

A

..

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2
Q

what are mycobacteria

A

Mycobacteria are small, slow-growing aerobic bacteria

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3
Q

what are mycobacteria distinguished by

A

distinguished by a complex, lipid-rich cell envelope

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4
Q

what are TWO examples of diseases caused by mycobacteria

A

Diseases caused by mycobacteria include TUBERCULOSIS and LEPROSY.

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5
Q

mycobacteria etymology

A

myco = “mushroom, fungus,”

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6
Q

Tuberculosis

A

An infectious, inflammatory systemic disease that affects the lungs

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7
Q

TB, dissemination

A

may disseminate to involve lymph nodes and other organs.

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8
Q

Tuberculosis, (PATHOGEN?)

A

Caused by Mycobacterium tuberculosis

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9
Q

tuberculosis, TRANSMISSION and MODE OF ENTRY

A

Infection most commonly occurs through INHALED DROPLETS

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10
Q

TB, pathogenesis

A

Once a susceptible person inhales an infected droplet, the bacteria become established in the lungs

and a proliferation of epithelial cells surrounds and encapsulates the multiplying organisms in an attempt to wall them off.

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11
Q

TB, pathogenesis 2

A

The granulomas eventually become necrotic in the center leading to fibrosis and calcification of tissues.

In later stages of the disease, the bacteria is able to enter the blood and lymph circulation and ultimately colonize distant sites.

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12
Q

granuloma

A

A granuloma is a tiny cluster of white blood cells and other tissue.

It can appear in your lungs, skin or other parts of your body.

Granulomas aren’t cancerous.

They form as a reaction to infections, inflammation, irritants or foreign objects.

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13
Q

TB mortality

A

TB kills 3 million people per year (worldwide)

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14
Q

which infectious disease causes the most deaths?

A

TB

Leading infectious disease cause of death

Represents 1/3 of world’s preventable deaths

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15
Q

TB, SSx

A

Fever

Night-time sweating

Loss of weight

Persistent cough

Constant tiredness

Loss of appetite

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16
Q

why loss of appetite during infection?

A

“When you are seriously ill, your body may not be able to use food to build itself up. Because the body recognises that it can no longer use as much food as before, your appetite becomes smaller.”

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17
Q

TB, Dx

A

culture sputum;

tuberculin skin test

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18
Q

tuberculin define

A

a sterile protein extract from cultures of tubercle bacillus, used in a test by hypodermic injection for infection with or immunity to tuberculosis, and also formerly in the treatment of the disease.

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19
Q

tuberculin skin test

A

The test is done by putting a small amount of TB protein (antigens) under the top layer of skin on your inner forearm.

If you have ever been exposed to the TB bacteria (Mycobacterium tuberculosis), your skin will react to the antigens by developing a firm red bump at the site within 2 or 3 days.

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20
Q

sputum culture

A

You will be asked to cough deeply and spit any phlegm that comes up from your lungs into a special container.

The sample is sent to a lab. There, part of it is placed in a special dish (culture). It is then watched for two to three days or longer to see if bacteria or other disease-causing germs grow.

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21
Q

TB, tx

A

antibiotic cocktail

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22
Q

TB, prevention

A

vaccination

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23
Q

VIRAL INFECITONS

A

Viruses are the smallest microorganismS.

They are always pathogens.

They depend completely on cells to reproduce. (OBLIGATE PATHOGENS)

For infection to occur, the virus first attaches to the host cell.

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24
Q

virus, structure

A

They have an outer cover of protein, and sometimes lipid, and an RNA or DNA core.

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25
Q

what does the virus DNA/RNA do when it finds host cell?

A

The viral DNA or RNA then separates from the outer cover (uncoating) and replicates inside the host cell in a process that requires specific enzymes.

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26
Q

what happens to the host cell after it is affected by the virus DNA/RNA?

A

The host cell typically dies, releasing new viruses that infect other host cells.

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27
Q

viral infections, E.g.

A

Rubella – caused by rubella virus

AIDS – caused by HIV

Flu – caused by influenza virus

Cold – caused by rhinovirus

Pneumonia

Measles

Hepatitis

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28
Q

Herpesvirus

A

Family of DNA viruses that cause active or latent infections

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29
Q

herpes virus types

A

Herpes simplex 1 (HSV-1)

Herpes simplex 2 (HSV-2)

Varicella-zoster virus (VZV)

Epstein-Barr virus (EBV)

Cytomegalovirus (CMV)

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30
Q

Herpes Simplex

A

Causes oral herpes – cold sores (most common)
—> usually via HSV1

Causes genital herpes (second most common)
—> usually via HSV2

Easily transmitted via direct contact, but can also be transmitted via indirect contact

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31
Q

indirect contact?

A

(objects with viruses on surface, surviving for variable periods depending on environment and depening on virus)

(?)

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32
Q

HSV1 vs 2 (mouth vs genitals?)

A

note that HSV1 can still affect genitals, and HSV2 can still affect mouth

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33
Q

HSV1 vs 2 severity

A

HSV1:

“substantially less severe both in terms of recurrences and shedding”

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34
Q

HSV transmission

A

Can be transmitted through contact with lesion or with contact of bodily fluids

Can also be transmitted during asymptomatic periods (asymptomatic viral shedding)

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35
Q

how can HSV be transmitted from mother to child?

A

Can be transmitted from mother to child via birth canal

(during birth)

(?)

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36
Q

HSV symptomatic vs asymptomatic phase

A

Symptomatic phase includes sores on face, mouth, genitals, hands

Symptomatic phase alternates with periods of remission

Virus tends to burn out over time

No treatment or vaccine

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37
Q

HSV, treating symptoms – and prevention

A

Symptoms -antiviral meds

Prevention - condoms

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38
Q

Varicella-Zoster Virus

A

Causes chicken pox

Can persist in peripheral nervous system as latent infection

Reactivated as shingles in adults

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39
Q

chicken pox characteristics

A

Chicken pox characterized by small, itchy vesicles all over body

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40
Q

chicken pox, children vs adults

A

In children, usually benign self-limiting disease

Chicken pox in adults generally more painful, more scarring

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41
Q

VZV, complications

A

Can develop into life threatening ENCEPHALITIS or pneumonia

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42
Q

VZV, immunity after infection

A

Infection generally confers life long immunity

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43
Q

VZV, prevention

A

Prevention – vaccination

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44
Q

Shingles

A

Shingles aka herpes zoster

Characterized by UNILATERAL painful blisters

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45
Q

shingles, treatment (SSx)

A

Treatment – antiviral meds, painkillers

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46
Q

shingles, prognosis

A

Prognosis – usually self-limiting within 5 weeks

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47
Q

EBV

A

Epstein-Barr virus

Cause infectious mononucleosis (“mono” or the “kissing disease”)

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48
Q

EBV/mono, characteristic SSx

A

Characterized by fatigue, malaise, sore throat

Mild except for in Immunocompromised people, elderly, newborns

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49
Q

CMV

A

Cytomegalovirus

Very common

Causes symptoms similar to IM

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50
Q

CMV and TORCH (exogenous (microbial) teratogens)

A

Can cause congenital defects in developing embryo if maternal infection (TORCH)

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51
Q

Enterovirus

A

Members of the PICORNAVIRUS family (small RNA viruses)

Affects millions of people per year

Symptoms can range from mild to severe

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52
Q

picornavirus

A

any of a group of very small RNA viruses which includes enteroviruses, rhinoviruses, and the virus of foot-and-mouth disease.

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53
Q

picornavirus etymology

A

pico

RNA

virus

The name “picornavirus” has a dual etymology.

The name derives from picorna- which is an acronym for “poliovirus, insensitivity to ether, coxsackievirus, orphan virus, rhinovirus, and ribonucleic acid”

Secondly, the name derives from pico-, which designates a very small unit of measurement (equivalent to 10−12), combined with rna to describe this group of very small RNA viruses.[8]

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54
Q

enterovirus, viral shedding (?)

A

Shed in oral secretions, stool, blood, CSF, nasal secretions

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55
Q

enterovirus, conditions/diseases

A

aseptic meningitis,

acute paralysis,

hand, foot and mouth disease,

myocarditis,

mild respiratory illness,

conjunctivitis

and polio (?)

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56
Q

entervirus, pathogenesis

A

Enters the mouth via the fecal-oral route, multiplies in tissues, reaches the CNS

Example includes polio

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57
Q

poliovirus

(part of larger category of enteroviruses, which is part of larger category of Picornaviruses)

A

Enterovirus, a genus within the family Picornaviridae, comprises enteroviruses, coxsackieviruses, rhinoviruses, polioviruses, and echoviruses.

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58
Q

E.g. Poliovirus

A

Causes poliomyelitis (“polio”)

Highly contagious via fecal-oral route or direct contact

Symptoms can range from mild/asymptomatic to severe paralysis in children

Routine vaccination (1950s)

(note Iron Lung)

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59
Q

Influenza Virus

A

Causes an acute febrile upper respiratory infection; “the flu”.

Highly contagious airborne disease

Incubation period of 1 – 4 days

—> Can be contagagious 5 -10 days after symptoms start

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60
Q

febrile

A

having or showing the symptoms of a fever.

“a febrile illness”

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61
Q

incubation period

A

the period between exposure to an infection and the appearance of the first symptoms.
“hepatitis B has an incubation period of 30 to 180 days”

62
Q

influenza, symptoms

A

Symptoms include fever, cough, headache, nasal discharge and malaise.

Can range from mild symptoms to respiratory failure/death

63
Q

which patients are at risk for severe symptoms & mortality during influenza infection?

A

Mortality is common in high risk patients.

—> Elderly, infants, immunocomprimised

64
Q

influenza virus, Tx

A

Antivirals

Prevention
-> Vaccine
—> Has 2 strains of Influenza A and 1 strain of Influenza B

65
Q

influenza virus structure

A

Single stranded RNA virus.

66
Q

3 types of influenza virus

A

3 types of influenza virus

—> Types A, B, and C

67
Q

which type of influenza is most often responsible for human infection?

A

Type A is responsible for most human infections.

68
Q

4th type of influenza virus (???) —> (Not on notes)

A

Influenza D viruses primarily affect cattle with spillover to other animals but are not known to infect people to cause illness.

69
Q

how are influenza types identified?

A

Identification can be from surface proteins (Type A)
—> Hemaglutinin and Neuraminidase proteins
—-> Example: H1N1, H5N1

70
Q

which influenza virus type has very high mutation rate?

A

Influenza A has a very high mutation rate

—> Approx 300x higher than other microbes.

—> Occurs via antigenic drift and antigenic shift

71
Q

antigenic drift

A

takes longer to occur

small mutations over time

minor structural changes

72
Q

antigenic shift

A

occurs in shorter period of time compared to drift

combination of viruses producing new sub-type

larger structural changes

73
Q

shift, define 2

A

“Antigenic shift is the process by which two or more different strains of a virus, or strains of two or more different viruses, combine to form a new subtype having a mixture of the surface antigens of the two or more original strains”

74
Q

example of antigenic shift

A

flu of bird and flu of human infect pig, and viruses combine to create new strain (ANTIGENIC SHIFT)

“If a pig catches both a human influenza A virus and an avian influenza A virus at the same time, it can spark a process known as viral reassortment — a genetic exchange in which flu viruses swap gene segments.”

75
Q

Rhinovirus

A

RNA virus

Causes upper respiratory tract infection (URTI)

Most common cause of the “common cold”

76
Q

rhinovirus, URTI, common cold – features, SSx

A

Acute, afebrile, mild, self-limiting infection

Symptoms include rhinorrhea, sneezing, nasal obstruction and coughing.

77
Q

rhinovirus, transmission, mode of entry

A

Transmission is usually by direct contact or aerosol particles

78
Q

Fungal infections

A

Mycosis - any disease induced by a fungus

Fungi include yeasts and molds

79
Q

are fungi generally pathogenic in healthy individuals?

A

Many fungi are opportunists and are not usually pathogenic except in a compromised host.

80
Q

superficial fungal infections

A

Superficial – limited to outermost layers of skin and hair

81
Q

systemic fungal infections

A

Systemic - affect severely immunocompromised patients

Often have acute presentations with rapidly progressive pneumonia, fungemia, etc.

82
Q

pneumonia

A

Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.

83
Q

fungemia

A

Fungemia is the presence of fungi or yeast in the blood.

The most common type, also known as candidemia, candedemia, or systemic candidiasis, is caused by Candida species.

Candidemia is also among the most common bloodstream infections of any kind.

84
Q

FUNGAL PNEUMONIA, pathogen

mortality (?)

A

Caused by…
Pneumocystis carinii / pneumocystis jirovecii

Extremely serious form of pneumonia

Causes significant mortality in IMMUNOCOMPRIMISED patients

85
Q

carinii and jirovecii etymology

A

carinii:
proposed the species name P. carinii in honor of Antonio Carini

jirovecii:
named in honor of Czech parasitologist Otto Jirovec

86
Q

YEAST INFECTION

A

via Candida albicans

Normally populates GI tract, mouth, genitals

Overgrowth causes candidiasis (genitals) or thrush (mouth)

87
Q

Candida albicans

A

Candida albicans is a naturally occurring fungus that lives on your body

88
Q

candidiasis

A

infection with candida, especially as causing oral or vaginal thrush.

“Candidiasis is an opportunistic infection due to Candida, which can affect the oral cavity, vagina, penis, or other parts of the body.”

“Untreated Candida infection carries the risk of leading to a systemic infection in which other organs can become involved and may lead to sepsis.”

89
Q

thrush

A

infection of the mouth and throat by a yeastlike fungus, causing whitish patches.

“a disease that is caused by a fungus (Candida albicans), occurs especially in infants and children, and is marked by white patches in the oral cavity.”

“Another name for thrush in your mouth or throat is oropharyngeal candidiasis.”

90
Q

candidiasis and thrush

A

“candidiasis (genitals) or thrush (mouth)”

91
Q

note again, candidiases vs thrush

A

Candidiasis (sometimes called moniliasis or a yeast infection) is an infection caused by yeast on the skin and mucous membranes.

When the infection occurs in the mouth, it is called thrush.

92
Q

Sexually transmitted infections (most common)

A

Herpes

Warts

Chlamydia

Gonorrhea

Hepatitis

Syphilis

93
Q

Genital Warts

A

Human Papilloma Virus

More than 100 different types of HPV
—> Approx 35 have an affinity for genitals

94
Q

WHICH CANCERS IS HPV INFECTION LINKED TO ?

A

linked to a higher incidence of CERVICAL, ANORECTAL and BLADDER cancers

95
Q

genital warts, incidence

A

Incidence: 5.5 million new cases/yr;

incidence rapidly escalating

96
Q

genital warts, transmission

A

unprotected sexual contact

Infection of newborn through delivery

97
Q

where do warts appear (around genitals), and after how long (?)

A

Warts on genitals, anal region, cervix etc.

1-6 months after sexual contact with infected person

98
Q

genital warts, treatment

A

Warts can be removed using chemical, ablative or surgical therapies.

—> Recurrence is common (when removed this way?)

99
Q

genital warts, if untreated

A

Spontaneous resolution
—> 75% after 2 years

in others there is possibility for…
—> Increase in size or numbers
—> or remain unchanged

100
Q

genital warts and CERVICAL cancer in women

A

In women abnormal pap smear can indicate possible cervical cancer

101
Q

pap smear define

A

a test carried out on a sample of cells from the cervix to check for abnormalities that may be indicative of cervical cancer.

102
Q

why called pap smear (?)

A

It is named after Georgios Papanikolaou, the doctor who determined its use in detecting early signs that could lead to cervical cancer.

103
Q

Chlamydia

A

Caused by bacteria: Chlamydia trachomatus

Incidence: 3 million new cases/yr

104
Q

what is the MOST COMMON STI caused by bacteria

A

CHLAMYDIA

105
Q

chlamydia, transmission

A

unprotected sexual contact

infection of newborn during delivery
—> Conjunctivitis
—> Pneumonia

106
Q

Chlamydia, clinical manifestations (SSx) in MEN

A

Asymptomatic in 50% of cases

urethritis with discharge

Pain with urination (dysuria)

Unilateral pain and swelling of scrotum (epididymitis)

Fever

107
Q

Chlamydia, clinical manifestations (SSx) in WOMEN

A

Asymptomatic in 80% of cases

Endocervicitis with discharge

Pain during urination (dysuria)

Abdominal/pelvic pain
Intermenstrual bleeding

Painful intercourse (dyspareunia)

Fever

108
Q

dyspareunia etymology

A

dys – difficult, bad

pareunos – lying with

109
Q

-ia suffix

A

“Suffix meaning condition, esp. an abnormal state, and taxonomic names of genera classes or orders.”

note also -osis:
“Osis is a suffix meaning ‘disease or condition of’”

110
Q

Chlamydia, COMPLICATIONS

A

PELVIC INFLAMMATORY DISEASE
—> Inflammation and scarring through fallopian tubes resulting in infertility

REACTIVE ARTHRITIS (Reiter Syndrome)
—> not same as psoriatic “, and septic (infective) “

111
Q

Chlamydia treatment

A

Treatment - antibiotics

112
Q

Gonorrhea

A

Caused by bacteria - Neisseria gonorrhoeae

Incidence: 650,000 new cases/yr

113
Q

Neisseria etymology

A

“Neisseria is named after Albert Ludwig Sigesmund Neisser, a German physician who discovered Neisseria gonorrhoeae in 1879.”

“Neisseria is a large genus of bacteria that colonize the mucosal surfaces of many animals. Of the 11 species that colonize humans, only two are pathogens.”

114
Q

gonorrhea etymology

A

gonos = semen

rrhea = discharge; flow.

115
Q

gonorrhea typically affects…

A

Typically infects lower genital tract but can infect almost any mucus membrane

116
Q

gonorrhea, tranmission

A

Unprotected sexual contact

Infection of newborn via delivery

117
Q

gonorrhea, clinical manifestations (SSx) in MEN

A

urethritis with discharge

increased urge to urinate

pain during urination

118
Q

gonorrhea, clinical manifestations (SSx) in WOMEN

A

Endocervicitis with discharge

pain during urination (dysuria)

Abdominal/pelvic pain

Intermenstrual bleeding

Painful intercourse (dyspareunia)

119
Q

gonorrhea, asympomatic?

A

Can be asymptomatic in males and females

120
Q

gonorrhea, COMPLICATIONS (if untreated?)

A

PELVIC INFLAMMATORY DISEASE
—> Inflammation and scarring through fallopian tubes leading to infertility

DISSEMINATED GONOCOCCAL INFECTION
—> Infection moves into blood and spreads.
—> Causes widespread tenosynovitis, arthralgias and dermatitis

121
Q

gonorrhea, aka

A

gonococcal infection

122
Q

which organs can DISSEMINATED GONOCOCCAL INFECTION affect?

A

Causes widespread tenosynovitis, arthralgias and dermatitis

123
Q

Gonococcemia (aka disseminated gonococcal infection)

A

“Gonococcemia is a rare complication of mucosal Neisseria gonorrhoeae infection, or Gonorrhea, that occurs when the bacteria invade the bloodstream. It is characterized by fever, tender hemorrhagic pustules on the extremities or the trunk, migratory polyarthritis, and tenosynovitis”

124
Q

Gonorrhea – what can happen if it is UNTREATED?

A

If left untreated, it may progress to
-> septic (INFECTIVE) arthritis,
-> MENINGITIS
-> or ENDOCARDITIS.

125
Q

gonorrhea, tx

A

Antibiotics

Prevention through safe sex practices

126
Q

Hepatitis B

A

Caused by HBV (Hepatitis B virus)

Incidence: 77,000 new cases/yr

127
Q

HBV, structure

A

DNA virus

128
Q

Hepatitis B virus, transmission

A

infected blood: needles/drug use

sexual contact

delivery

129
Q

horizontal vs vertical transmission

A

vertical = from mother to newborn/child

(perinatal tranmission)

130
Q

Hepatitis B, SSx

A

jaundice,

arthralgias,

rash,

dark urine,

anorexia,

nausea,

painful abdominal bloating,

clay-coloured stools,

fever

131
Q

hepatitis, why clay-coloured stools?

A

You may have clay-colored stools if you have a liver infection that reduces bile production, or if the flow of bile out of the liver is blocked.

132
Q

hepatitis B, why “anorexia” ?

A

Because your liver plays a role in digestion, you may experience a loss of appetite, feel a little nauseous, or experience pain in the upper right quadrant of your abdomen

133
Q

hepatitis B, acute infection vs chronic/asymptomatic/inactive infection

A

After acute infection, they may progress to an inactive/asymptomatic chronic infection

—> 5%-10% progress to an active chronic infection

134
Q

Hepatitis B, Tx

A

Vaccination

Antiviral meds

Liver transplant

135
Q

Hepatitis B, prognosis

A

Inactive and active chronic infection can progress to liver CIRRHOSIS, liver failure and HEPATOCELLULAR CARCINOMA.

136
Q

cirrhosis

A

a chronic disease of the liver marked by degeneration of cells, inflammation, and fibrous thickening of tissue.

It is typically a result of alcoholism or hepatitis.

137
Q

hepatocellular carcinoma define

A

Primary liver cancer—cancer that starts in the liver—is called hepatocellular carcinoma (HCC).

It is the sixth most-common form of cancer worldwide, but the third leading cause of death from cancer.

HCC almost always occurs in people who have had liver disease for many years.

138
Q

Syphilis

A

STI caused by bacteria - Treponema pallidum (SPIROCHETE)

Incidence: 70,000 new cases/yr

139
Q

syphilis, transmission

A

Transmission:

unprotected sexual contact,

contact with skin and mucous membranes,

TRANSPLACENTAL,

blood transfusions

140
Q

syphilis, pathogenesis

A

The bacteria enter through the mucous membranes or skin, reach the lymph notes and rapidly disseminate through the body.

141
Q

Primary syphilis

A

painless lesion (chancre) at the site of inoculation (?) 3-8 weeks after infection

142
Q

Secondary syphilis

A

flu-like symptoms and rash 6wks to 2 years after infection

143
Q

syphilis – latent period

A

Latent Period – Can last years to decades.

Asymptomatic and non-contagious.

144
Q

Tertiary syphilis

A

About 1/3 of untreated individuals will develop tertiary syphilis.

Not contagious at this stage.

145
Q

tertiary syphilis, classification

A

cardiovascular syphilis,

neurosyphilis

or gummatous syphilis

146
Q

gumma

A

a tumor of gummy or rubbery consistency that is characteristic of the tertiary stage of syphilis

“a small soft swelling which is characteristic of the late stages of syphilis and occurs in the connective tissue of the liver, brain, testes, and heart.”

147
Q

gummatous syphilis

A

Gummatous syphilis is a rare form of tertiary disease manifested by gummas (granulomatous nodules with a somewhat rubbery texture and necrotic centers)

that typically affect the skin and are most often found internally in the liver as well as the testes, brain, heart, and bone but can also develop in any organ.

148
Q

which stages of syphilis can be cured/treated?

A

Primary, secondary and latent syphilis can be cured with antibiotics

149
Q

which stage of syphilis can create irreversible damage?

A

Tertiary syphilis can occur up to 20 yrs after initial infection and may cause irreversible cardiovascular neurological damage

150
Q

VACCINATION

A

A vaccine is any suspension containing antigenic molecules derived from a microorganism, given to stimulate an immune response to infectious disease.

Vaccines can be administered intramuscularly, subcutaneously, intradermally, orally or intranasally.

151
Q

what are ways that vaccines can be made?

A

Vaccines may be made from weakened or killed microorganisms inactivated toxins or immunologically active surface markers extracted or copied from microorganisms.

152
Q
A

Semester 3 (32 decks)

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