Infectious Disease pt. 2 Flashcards by sophie rosen

Bacteria Pathogens
(7)

• Transient bacterial infections
• Localized infections
• Systemic infections
• Extracellular pathogens
• Intracellular pathogens
• Toxins
• Grow on media

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Tuberculosis
(4)

• Mycobacterium tuberculosis
• Pulmonary infection most common
• Intracellular pathogen
• Granulomatous disease

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Tuberculosis
• — of world population infected

One-third

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Tuberculosis
Leading infectious cause of death after —

AIDS

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Tuberculosis
• Disadvantaged populations
(3)

– Homeless
– Malnourished
– Overcrowded

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• Active tuberculosis cases increasing
(2)

– HIV infection
– Immigration

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Infection -

growth of the organism in a
patient

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Active disease -

destructive,
symptomatic disease

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Transmission of Tuberculosis
(3)

• Droplet nuclei (1 - 5 microns)
• Stay airborne for long periods of time
• Reach the pulmonary alveol

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Primary Pulmonary Tuberculosis
(6)

• Previously unexposed (unsensitized) person
• Gohn complex (parenchymal lung lesion and hilar nodal lesion)
• Cell-mediated immunity controls infection
• Fibrosis and calcification
• Viable organisms dormant in lesions (latent disease)
• May reactivate if immune defenses lowered

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Secondary Pulmonary Tuberculosis
(2)

• Reactivation of dormant primary lesions in a
previously sensitized host
• Cavitation leads to erosion into airway and
production of contaminated sputum

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Tuberculosis
Diagnosis
(3)

• Chest radiograph
• Sputum culture
• Molecular biologic tools

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Tuberculosis
Treatment
• Multi-drug regimens
(6)

– Isoniazid
– Rifampin
– Ethambutol
– Streptomycin
– Pyrazinimide
– Rifabutin

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Symptoms of Active
Tuberculosis
(5)

• Chronic cough
• Hemoptysis
• Weight loss
• Night sweats
• Fever

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Mantoux Tuberculin Skin Test:
PPD Test
(4)

• Type IV delayed hypersensitivity reaction to
protein from M. tuberculosis
• Intracutaneous tuberculin injection
• T-cells sensitized by prior infection recruited
to area
• Produces an area of induration

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Positive Tuberculin Skin Test:
(3)

• Individual has been infected
• Cell-mediated hypersensitivity exists
• Does not indicate active disease

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Bacillus Calmette-Guerin (BCG)
Vaccination
(4)

• Live, attenuated strain of Mycobacterium bovis
• Causes positive PPD reaction
• Effectiveness uncertain
• Not used in United States

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Scrofula
(4)

• Tuberculous lymphadenitis of neck
• Mycobacterium bovis infection from infected milk
• Pasteurization of milk
• Tuberculosis control for cattle

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SYPHILLIS
(4)

• Treponema pallidum
• Sexually-transmitted systemic disease
• Sequential clinical stages
• Years of latency

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2 FORMS OF SYPHILLIS

• Acquired syphilis -
sexual transmission
• Congenital syphilis - in
utero transmission

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Clinical Stages of Untreated Acquired
Syphilis
(3)

• Primary - 1 week to 3 months
• Secondary - 1 to 12 months
• Tertiary (Late) - 1 to 30 years

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Lesions of Secondary Syphilis
(3)

Study These Flashcards

• Skin rash
• Mucous patch
• Condyloma lata

Tertiary Syphilis
(5)

Study These Flashcards

• Most destructive stage
• Gumma
• Syphilitic glossitis
• Nervous system –neurosyphilis
– Tabes dorsalis
• Cardiovascular system
– Aneurysm of ascending aorta

Stage: Primary
Lesion:
Infectious:

Study These Flashcards

Chancre
yes

Stage: Secondary Lesion: Infectious:

Mucous Patch yes

Stage: Tertiary Lesion: Infectious:

Gumma no

Lesion of Congenital Syphilis (5)

• Snuffles • Saddle nose • Rhagades • Hutchinson’s incisors • Mulberry molars

Congenital Syphilis - Depressed Nasal Bridge “---”

Saddle Nose

Dental Stigmata of Congenital Syphilis (2)

• Hutchinson’s incisors • Mulberry molars

Hutchinson’s Triad of Congenital Syphilis

1. Blind - intersitital keratitis 2. Deaf 3. Dental anomalies

Laboratory Tests for Syphilis • Culture – • Microscopy –

cannot culture dark field or fluorescence microscopy

Serologic tests for Syphilis: • Non -Treponemal Tests - reagin - antibody to cardiolipin (2)

– VDRL –Venereal Disease Research Laboratory – RPR –Rapid Plasma Reagin

Serologic tests for Syphilis: • Treponemal Tests –specific for T. pallidum (2)

– FTA-ABS –Fluorescent Treponemal Antigen Absorption – MHA-TP –Microhemagglutinin –Treponema pallidum

Diseases Caused by Fungi • Superficial

- skin, hair, nails – Dermatophytes

Diseases Caused by Fungi • Subcutaneous

- dermis and subcutaneous tissue – Sporotricosis

Diseases Caused by Fungi • Systemic

- deep infections of internal organs – Histoplasmosis

Diseases Caused by Fungi • Opportunistic

–immunocompromised host – Candidiasis

Histoplasmosis • Endemic to • Transmission by • --- infection usual • ---like syndrome

Mississippi River Valley inhalation of spores – Bird droppings, dust particles Sub-clinical Flu

Mississippi Valley Fever

Histoplasmosis

Histoplasmosis - Deep Fungal Infection of the Lungs (5)

• Inhalation of spores • Phagocytosis • Specific immunity • Killing of organism • Dystrophic calcification

Histoplasma Capsulatum (2)

• Dimorphic fungus - yeast at body temperature, mold in nature • 80% - 90% population infected

Most common systemic fungal infection in USA

Histoplasma Capsulatum

Disseminated Histoplasmosis (4)

• Elderly, debilitated, immunosupressed , AIDS • Spreads to extra- pulmonary sites • Adrenal lesions - Addison’sdisease • Oral lesions

Coccidioidomycosis (3)

• Deep fungal infection of the lungs • 40% develop respiratory symptoms • Disseminated disease may occur

Sarcoidosis (4)

• Multi-system granulomatousdisorder • Unknown cause • Young adults • African-Americans - 10:1

Sarcoidosis • Common findings (2)

– Hilar lymphadenopathy – Skin and eye lesions

Hilar Lymphadenopathy in Sarcoidosis

Non-caseating granulomas

Sarcoidosis is a Diagnosis of Exclusion (5)

• Clinical • Radiographic • Laboratory –elevated Angiotensin Converting Enzyme (sACE), serum Calcium • Biopsy – Bronchoscopic biopsy – Salivary gland biopsy • Histopathologic –non-caseating granulomas – Special stains negative – Cultures negative

Sarcoidosis –Non-Caseating Granulomas (2)

Asteroid Bodies Schaumann Bodies

Oral Lesions of Sarcoidosis (2)

• Uncommon • A non-specific submucosal papule affecting any site

Salivary Gland Involvement in Sarcoidosis (3)

• Parotid enlargement • Xerostomia • Facial nerve weakness

Treatment of Sarcoidosis • Mild disease – • Severe disease –

observation, no treatment, may resolve spontaneously systemic corticosteroids

Clinical Forms of Oral Candidiasis (5)

• Pseudomembraneous (Thrush) • Erythematous (Atrophic) • Hyperplastic • Angular Cheilitis (Perleche) • Central Papillary Atrophy

Infectious Disease pt. 2 Flashcards

(53 cards)