Lecture 6: Diseases of Cardiovascular System Flashcards
1
Q
Structure of CV system
A
composed of
1) pulmonary circulation
2) systemic circulation
2
Q
Pericardium
A
fibrous covering of heart
3
Q
endocardium
A
innermost layer of heart, most susceptible for microbial infection
*blood supposed to be sterile with no microbiota
4
Q
lymphatic system function
A
absorbs, transports, filsters lymph and initiates immune response
5
Q
lymphatic system points(2)
A
- 4L fluid a day leaks from capillaries into tissue and is reabsorbed by lymph system
- filtrate can contain pathogens which are screened by immune cells
- immune cells in nodes, tonsils, spleen, adenoids
- removal of lymph nodes causes backup and accumulation of fluid in tissues - fluid eventually drains back into blood
6
Q
Speticemia
A
bacterial infection of bloodstream, systemic infection
-more bacteria in blood stream than can be *effectively removed by WBS
7
Q
lymphangitis
A
infection of lymphatic system
-lymphangitis vessel infection can cause an inflammation seen as a red streak on skin
8
Q
Sepsis/septic shock
A
can trigger state of pysiological collapse, sudden drop in blood pressure and physiological collapse due to multiple organ failure
9
Q
Bacteremia
A
bacteria in bloodstream
10
Q
Septicemia clinical signs (4)
proceeded by? risk factor? sx (3) Septic shock Most common cause (pathogen)?
A
- Often secondary infection preceded by respiratory or urinary tract infections
- sx on infected tissue can introduce microbes into bloostream
- change in mental status, SBP < 100 (spontaneous bacterial peritonitis), RR >22 (respiratory rate)
- Septic shock: medication to maintain SBP > 65, high lactic acid
**most commonly causes by gram + species
11
Q
Chain of events leading to sepsis and septic shock
A
- localized infection
- Septicemia
- endo/exo toxin accumulation
- blood clotting, tissue damage, hemorrhage-> death
- complement activation, lung damage, rapid breathing ->death
- macrophage and circulating leukocytes instate inflammatory cascade -> fever, increased heart rate, vasodilation.
- septic shock -> death
12
Q
infective endocarditis
3 types
A
- affects endocardium and heart valves
A. acute
B. subacute
C. prosthetic valve disease
13
Q
acute endocarditis
5 common pathogens
4 common symptoms
can cause what?
A
5 common pathogens
- Staph aureus
- streptococcus pneumonia
- neisseria gonorhheae
- streptococcus progenies
- enterococcus faecalis
4 common sx
- high fever
- fast heart rate
- fatigue
- signs of infections at other sites
can cause heart failures
14
Q
Subacute endocarditis
definiton
2 pathogen
A
underlying heart vale disease
streptococcus, haemophilus
15
Q
Prosthetic endocarditis
A
- acute or subacute onsent
2. sugery
16
Q
Peuperal fever
2 pathogens
can develop into..?
A
childbed fever caused by
- streptococcus pyogenies
- streptococcus agalactiae
can develop in puerperal sepsis
-infective condition in mother following childbirth, can be fatal
*strep affected CV system
17
Q
Neonatal spesis
caused by 2 pathogens
A
caused by
- streptococcus agalactiae
- E. coli
*strep affected CV infections
18
Q
Rhuematic Fever
A
streptococcus pyogenes
-inflammatory response to throat infection and primarily affects joint and heart
19
Q
Schistosomiasis
cause damage to (3) organs
A
causes by several species of blood flukes (phylum schistosoma)
eggs can cause damage in liver, intestines, bladder
*worms causing schistosomiasis not found in U.S.
20
Q
Trematode S. mansoni life cycle
A
- miracida in snails convert to cercariae, leave snail and attach to human skin
- infect the blood and mature, caring fever and chills
- major effects are due to eggs in the liver or blaster. Substantial tissue damage
- egg infection in bladder causes urine pain and bloody urine
21
Q
Schistoma in US
A
causes minor infection, swimmer’s itch
-mild since immune system eliminated before they get into blood.
22
Q
Lymphatic Filariasis
pathogen
transmisstion
MOA
A
causes by wuchereria bancrofti- filarial nematode
-transmitted by mosquitos
-larvae infect lymphatic system and damage vessels and glands
-after years of infestation, arms legs, and scrotum swell and distort
AKA: elephantiasis, lymphedema
23
Q
Black death (3 facts, incl. organism)
A
black plaque
- 14th c. europe
- millions dies
- caused by yersinia pests, organism found on rats and their fleas
24
Q
Yersinia Pestis
- characteristics/staining
- transmission
A
causes black plaque
- facultative, gram negative rod.
- stains heavily at pole of cell (bi polar staining)
- transmitted between hosts by oriental rat flea
- picked up from rodents by flea
- biofilm formed in flea gut
- flea starved and tried to bite human, transmitting infection
25
3 forms of plague
1. bubonic
2. Septicemic
3. Pnuemonic
26
Bubonic plague
1. pathogenesis
2. complications
3. transmission
1. bacteria localize in lymph nodes, hemorrhaging can occur
2. causes painful and substantial swelling (buboes)
- dark splotches on skin from bleeding "black death"
- 60 % mortality if untreated
3. transmitted through bite if infected flea or exposure to infected material through a break in the skin
27
Septicemic plague
1. pathogeneis
2. sx (3)
3. complication
1. bacilli spread to bloodstream
2. high fever, diarrhea, abdominal pain
3. can lead to meningitis and nearly 100% fatal if untreated
28
Pneumonic plague
transmitted from person to person
buboes not present
29
Tularemia
cause
transmission (2)
sx
tx
"rabbit fever"
caused by francisella tularensis
-common in rabbits, rodents and animals
t: via arthropod bite (ticks) or inhalation
sx from bite: swollen glands, flu-like symptoms, skin ulceration
sx from inhalation: respiratory disease, swollen nodes, coughing, pain under breastbone, not communicable among humans
tx: streptomycin or oral cirpoflaxacin or DCN
30
Lyme Disease overview
cause
characteristics pathogen
4 sx
-major emerging infectious disease in US
- caused by borrelia burdgorferi
- gram-negative spirochete
- usually transmitted by ticks
- sx: fever, HA, fatigue, erythema migrans rash
31
3 stages lyme disese
1. early, localized stage
2. early disseminated stage
3. late stage
32
early stage lyme disease
sx
tx
1. involves slow expanding red rash: erythema migrans at bite site
- bulls-eye rash
2. rash acompanied by flu like symptoms
tx: 10 days DCN
33
early disseminated stage of lyme disease
sx
tx
* weeks to months later
1. bacteria disseminate to skin, heart, nervous system
tx: 10 days DCN
34
late stage lyme disease
sx
tx
* months to years later
1. chronic arthritis, swelling in larger joins
tx: 28 days DCN
35
Endemic relapsing fever
2 pathogens causing
caused by borrelia hermisii and borrelia turcatae
-transmitted by ticks and rodents
36
louseborne (epidemic) relapsing fever
cause
sx
tx (2 kinds)
caused by borrelia recurrentis carried by body lice
- chills, fever, HA peak with high numbers of microorganisms in bloos
- tx w/o CNS involvement: DCN
- tx w/ cns involvement: penicillin or ceftrioxone
37
Rickettsial infections
transmission
diseases assoc. (2)
1. transmitted by arthropods (ticks, lice, fleas)
- usually hard ticks/dog ticks
- painless bite
- 8-10 hrs for tick to transmit infection to host
2. Diseases Associated
A. rocky mountain spotted fever (RMSF)
B. spotted fever rickettsiosis (SFR)
38
Rickettsisae
1. small, gram (-) obligate intracellular parasites
39
Rickettsial infections
sx
tx
1. classic sx: fever, HA, skin rash reflecting damage to small blood vessles
- malaise, myalgias, arthralgia,
2. the rash progresses to a macropapular rash in 90% patents
- begins in palm and soles of feet and spreads to trunk
tx: DCN
40
Ehrlichial infection
1. sx
2. complications
3. tx
sx: similar to lyme disease, come and go more quickly
c: cause leukopenia (decreased WBC) which leads to susceptibility fo other infections
lives in leukocytes (monocytes)
tx: DCN
41
Human monocytes ehrlichiosis (HME)
cause by what pathogen
transmission
clinical presentation (4)
tx
caused by Ehrlichia Cheaffeensis
-transmitted by lone star tick
clinical presentation: acute febrile illness, myalgia, arthralgias, sometimes 1/3 cases result in maculopapuler rash
-sometimes confused with rocky mountain spotted fever
Drug of choice: DCN
42
Human Granulytic Anaplasmosios (HGA)
```
cause
infects what cells
transmitted
sx
dx
tx
```
c: anaplasma phagocytophilum
g(-) bacterium
i: leukocytes- neutrophils
t: backlogged tick (same one that transmits lyme disease)
sx: similar to HME, rash is rare
dx: antibody tests distinguish from RMSF and ehrlichiosis
tx: DCN
43
Brucellosis
caused by what pathogens
characteristic of pathogen
serous systemic disease
p: brucella species
rx: affects people who work with large, ruminant animals
C; gram negative rod, b. abortus
44
Brucellosis
transmission
incubation
MOA
tx
t: infection can occur through eyes, abrasion, or consumption of contaminated dairy
i: 2-10 week incubation
bacteria transported to spleen, and lymph glands upon infection, causing flu-like symptoms
-chronic infection in one organ or systemically
tx: DCN 6 weeks, gentamicin 7-10 days
45
Infectious mononucleosis
pathogen
affects what organs
transmisstion
sx: special populations?
1. systemic viral disease
c: epstein-barr virus
- member herpesviridae
a; affects b lymphocyte in lymph nodes and spleen
t: spread yay contact with saliva, kissing disease
- children don't show symptoms
- adolescents or young adults who are infected may develop more severe symptoms that include fever, sore throat and enlarged nodes
46
EBV complications (6)
1. heart problems (myocarditis)
2. facial paralysis (guillan-barre)
3. rupture of spleen
4. Janice (hepatitis)
5. Burkitt lymphona, tumor of the jaw prevalent in africa
- malaria parasite might help stimulate tumor development
6. t-cell malignancies, b-cell carcinoma, hodgkin disease, M.S.
47
aftermath EBV
dx:
vax,tv?
indefinite carrier once infected
dx: elevated lymphocyte levels
- presence of downy cells (damaged b cells)
- ab detected via mono spot test
- novax or tx
48
Burtkitt lymphoma
tumor of jaw, prevalent in africa
-malaria parasite might help stimulate
49
Cytomegalovirus overview (4 pts.)
1. can produce serious birth defects
2. largest member herpesviridae
3. produces infectious mononucleosis-like sx
4. can pass to fetus to cause mental impairment
50
CMV
member of TORCH microbes that cross placenta to cause severe congenital defects
51
TORCH
microbes that cross placenta to cause severe birth defects
52
TORCH pathogens
1. Toxoplasma
2. Rubells
3. Cytomeglavirus
4. Herpes simplex II
5. Other- coxsackievirus, syphillis, varicella zoster virus, HIV, parvovirus, B 19 and lsiteria
53
Flavivirus
causes what disease
transmission
1. also calles arboviruses
- arhtropodborne
3. yellow fever 1st human disease assoc. with virus
t: person to person via mosquitoes
- can also infect non human primates
*severe hemorrhagic ilness
54
Yellow fever
sx
prevention
sx: abrupt HA, fever, muscle pain
* most patients recover after symptoms abate in 3-5 days
lines can re-appear as: nausea, hiccups, black vomit, jaundice, derlium, hemorrhaging of gums/mouth/nose, 50% of patients enter a coma and die from internal hemmorghaging
*2 vaccines, no therapuetic drugs
55
Dengue virus Overview (4)
Dengue fever occurs in 4 types
1. serotypes: DEN-1 -> DEN-4
2. recovery from one types does not confer immunity to others
3. transmitted by 2 species of mosquitos
4. 2.5% mortality, 20% if left untreated
56
Dengue fever
sx
complications
sx; high fever, HA, prostration, muscle pain, maculopapular rash, scar pains and sensations
c: unusual, unless of the the 3 other types enter body later
- hemmorrhagic fever: rash from skin hemorrhages appear-> severe vomiting,sschok, decreases BP
57
Lassa fever
where does it occur in world
transmission
sx
tx
1. occurs in w. Africa
t: rodents that cary- humans in contact with urine or droppings
sx: fever, exhaustion, patchy blood-filled lesions on throat
*fever can last weeks
-internal hemorrhaging common
-
tx: ribarvirin effective
58
Ebola hemorrhaic fever (EHS)
reservoir
transmission
MOA
sx
filoviridiae family member
50-90% mortality
- zoonitc, fruit bats possible recevoir
t: with contact of blood or secretions from infected person or contaminated objects
M: damages endothelial cells, causing massive internal bleeding and hemorrhaging
sx: fever, HA, joint/muscle pain, weakness, n/v/d, sometimes visible bleeding but can be internal
59
CV effects COVID-19
1. ind. w pre-excisting CV disease at increased with for morbid and mortal complications due to COVID-19
- hypertension and coronary artery disease
2. clinical: asymptomatic heart disease, ECG, imaging or lab findings, myocardial infarction, heart failure, pulmonary or venous clot (thromboembolismO
60
Systemic protozoal Disease
what parasite
causes what diseases
speciel population
1. plasmodium parasite infects blood
malaria affects 300-500 people
- trans. by infected mosquitoes
* control mosquito population can help
children most susceptible
61
4 species plasmodium that cause malaria
1. p. vivax
2. p. ovale
3. p. malariae
4. p. falciparum
62
pathogenesis malaria
1. enter host
2. go to liver, undergo transformation into merozoites
3. merozites from to RBCs
4. thousands RBCs disrupted, merozoites emerge causing cycles of fevers and chills. some merozoites eventually develop into gametocytes that continue in cycle
5. anopheles mosquito bites infected individual and aq. plasmodium
63
Malaria complications
tx
RBC become infected and lyse, producing more parasites and toxins.
death can occur due to lack of RBCs or clustering in small vessel, causing clots
tx: chloroquin or artemisinin-based (if resistant)
64
Babesiosis
contracted where in world
transmission
complications in host
parasitic diseases contracted in northeaster US
1. malaria-like disease
2. caused by babes microti
3. transmitted by ticks
parasite invades RBC:
-anemia, HA, meningitis
65
Tyrpanosomiasis
what 2 diseases?
transmission?
moa?
name for diseases caused by tyrypanosoma
1. african sleeping sickness
2. Chagas disease
- caused by t. Cruzi
- transmitted by reduviid bug (insecT)
- infected feces contaminate and tier sites where buds bite host
- 20-30% individuals develop chronic disease that develops 10-3 years after infection
- damaes intestinal tract, cardia nerves (sudden heart failure)
66
Epidemic Typhus
pathogen
transmission
sx
caused by rickettsia prowazekii
t: feces of body lice (not head lice) that flourish when sanitation and hygiene is poor
sx: maculopapular rash starts on trunk and progresses to extremities
- high fever, hallucinations, delerium
- permamnet damage to blood vessels, heart, kidney, lungs
67
Brill-Zinsser disease
appears to be a relapse of epidemic typhus
68
Endemic typhus
pathogen
transmission
sx
(mexican typhus, murine typhus)
cause by rickettsia typhus
- carried by oriental rat fleas
sx: fever, HA, maculopapular rash spreading from trunks to limbs
69
SBP
Spontaneous Bacterial Peritonitis
infection of ascitic fluid in the absence of any intra-abdominal, surgically treatable source of infection
