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From Flashcardlet > Micro/Immuno Eye > Flashcards

Micro/Immuno Eye Flashcards

1
Q

What are three defenses of the eye?

A

Tears
Blinking
Lysozyme

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2
Q

What is conjunctivitis?

A

Infection and inflammation of the conjunctiva - Pink eye

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3
Q

What is a sty?

A

Infection of the eyelid

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4
Q

What is the etiology of conjunctivitis?

A

Viruses - rhinovirus, adenovirus, Herpes Simplex I

Bacteria - Haemophlius influenza, Strep pneumoniae, Staph aureus, Neisseria gonorrhea, Chlamidia trachomatis

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5
Q

What are the characteristics of Chlamidia trachomatis?

A

Small
Gram negative
Bacillus
Obligate intracellular

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6
Q

What is an obligate intracellular pathogen?

A

Can only replicate within certain host cells

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7
Q

Are obligate intracellular pathogens usually viral or bacterial?

A

Usually viral, chlamidia trachomatis is an example of bacterial

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8
Q

What is the reservoir for conjunctivitis?

A

Human

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9
Q

What is the transmission method for conjunctivitis?

A

Respiratory droplets
Secretions from eye to hand to fomites in eye
Contaminated contact lens
During birthing

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10
Q

What is the viral pathogenesis of conjunctivitis?

A
  • Viruses attach to cells of conjunctiva
  • Virus induce endocytosis and enter cells
  • Replicates in cell
  • Cell damage/lysis
  • Release of cytokines and inflammatory mediators
  • Inflammation of conjunctiva
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11
Q

What is the bacterial pathogenesis of conjunctivitis with the Chlamydia bacteria?

A
  • Binds to host cells
  • Induces endocytosis
  • Differentiates and replicates inside host cell
  • Leaves cell by exocytosis or lysis
  • Release of cytokines and inflammatory mediators
  • Inflammation of conjunctiva
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12
Q

How does the infection in conjunctivitis end?

A

Usually self limiting - no severe or permanent damage to conjunctiva or eye

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13
Q

Are the most severe symptoms of conjunctivitis bacterial or viral?

A

Bacterial

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14
Q

What are the signs and symptoms of conjunctivitis?

A
  • Dilated blood vessels
  • Redness of conjunctiva, one or both eyes
  • Excessive tears
  • Yellow exudate
  • Itchiness, irritation
  • Swelling of eyelids
  • Stickiness of eyelids
  • Photophobia
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15
Q

Is there pain associated with conjunctivitis?

A

NO PAIN - if pain, disease is more serious than conjunctivitis

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16
Q

What does exudate with a virus in conjunctivitis look like?

A

Little

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17
Q

What does exudate with a Chlamydia in conjunctivitis look like?

A

Medium

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18
Q

What does exudate with a bacteria in conjunctivitis look like?

A

Very sticky

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19
Q

What is the amount of stickiness of eyelids in the morning with viral conjunctivitis?

A

Not much or none

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20
Q

What is the amount of stickiness of eyelids in the morning with Chlamydia conjunctivitis?

A

Medium sticky

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21
Q

What is the amount of stickiness of eyelids in the morning with bacterial conjunctivitis?

A

Very sticky

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22
Q

What does inflammation with a viral in conjunctivitis look like?

A

Mild

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23
Q

What does inflammation with Chlamydia in conjunctivitis look like?

A

Medium

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24
Q

What does inflammation with a bacteria in conjunctivitis look like?

A

Severe

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25
Q

How do we diagnose conjunctivitis?

A

Signs and symptoms, lab culture of bacteria

Fluorescent antibodies against pathogens from eye scrapings

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26
Q

What is the treatment of conjunctivitis?

A

Antibiotic eye drops, only for bacterial

No treatment for viral

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27
Q

What is the epidemiology of conjunctivitis?

A

Most common eye infection in world

Most prevalent in tropics and subtropics

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28
Q

What is keratitis?

A

Infection and inflammation of the cornea

29
Q

What can keratitis lead to?

A

Damage to cornea and vision impairment - much more serious than conjunctivitis

30
Q

What is the etiology of keratitis?

A 
Viruses - common in developed world
- Herpes simplex type I
Bacteria - less common
- common among contact lens wearers
Fungi
Amoeba
- Acanthamoeba keratitis
- common in developing world or contact lens wearers
31
Q

What is the reservoir for keratitis?

A

Viruses and bacteria - Human
Fungi - Soil
Amoeba - Water

32
Q

What is the transmission method for keratitis?

A

Depends on pathogen:
Virus - direct or fomites
Fungi, bacteria, amoeba - contaminated contact fluids or hot tubs, some ponds/lakes

33
Q

What is the pathogenesis of viruses in keratitis?

A
  • Infection promoted by trauma (scratch)
  • Virus gets into cells of cornea invading by endocytosis
  • Replicate
  • Lysis
34
Q

What is the pathogenesis of bacteria, fungi, and amoeba in keratitis?

A
  • Corneal damage due to toxic products
35
Q

What does severe damage to the cornea due to inflammation cause?

A

Leads to ulceration of cornea

36
Q

Is keratitis usually unilateral or bilateral?

A

Usually just one eye

37
Q

What happens if deeper layers of cornea are damaged in keratitis?

A

Scarring, can lead to opacification and vision loss

38
Q

What are the signs and symptoms of keratitis?

A
  • Eye pain (might feel like something is in your eye)
  • Dilated blod vessels causing redness
  • Excessive tearing, discharge
  • Usually only one eye
  • Blurred vision
  • Itchiness in eye
  • Photophobia
  • Edema around eye
  • Difficulty opening eyelid due to pain/swelling
39
Q

How do we diagnose keratitis?

A
  • Signs and symptoms
  • History - hot tub use, eye trauma, etc.
  • Sometimes corneal scrapings to identify presence of pathogen via fluorescent antibodies
40
Q

What is the treatment of keratitis?

A
  • Anti herpatic antiviral drugs
  • Antibiotics if bacterial
  • Antiprotozoals although there are some resistant strains
  • Corticosteroids - bacterial
  • Corneal transplant if damage is severe
41
Q

What is the epidemiology of keratitis?

A

10,000-25,000 cases each year in US

Amoebic keratitis associated with home made contact solutions and hot tubs

42
Q

What is the single greatest cause of blindness due to pathogenic microorganisms?

A

Trachoma

43
Q

What is the etiology of trachoma?

A

Certain strains of C trachomatis

44
Q

What are the characteristics of C trachomatis?

A

Obligate intracellular parasite

Cell wall similar to gram negative

45
Q

What is the reservoir of trachoma?

A

Human

46
Q

What is the transmission method of trachoma?

A

Direct con act with infected eye, nose, throat secretions
Fomites
Flies in Africa and tropics

47
Q

What is the pathogenesis of trachoma?

A
  • Due to chronic repeated infections

- Subsequent infections lead to scarring

48
Q

What does inflammation in trachoma lead to?

A

Bumps in normally smooth conjunctiva

49
Q

What does contraction of scar tissue in trachoma lead to?

A

Results in turning of the eyelid

50
Q

What do certain strains of C trachomatis cause in addition to trachoma?

A

Conjunctivitis

51
Q

What does blindness result from in trachoma?

A

Repeated infections cause scarring, which overtime can cause visual impairment and blindness due to long term mechanical abrasions of cornea

52
Q

What mechanical abrasions of the cornea can cause scarring in trachoma?

A

Eyelashes cause scratches

53
Q

What are the signs and symptoms of trachoma?

A
  • Conjunctivitis
  • Swollen, pebbled eyelid
  • Turned in eyelids
  • Scarring of cornea
54
Q

How do we diagnose trachoma?

A
  • Signs and symptoms
  • Travel history
  • Corneal scrapings
  • Identify pathogen
55
Q

What is the treatment of trachoma?

A

Antibiotics

Prevention in better hygiene and fly control, access to clean water

56
Q

What is the epidemiology of trachoma?

A

Rare in developed world

Common in Africa

57
Q

What is onchocerciasis?

A

River blindness

58
Q

What is the etiology of onchocerciasis?

A

Onchocerca volvulus - nematode worm

59
Q

What is the reservoir for onchocerciasis?

A

Humans

60
Q

What is the transmission method for onchocerciasis?

A

Vector - larvae form from infected human to new host by bite of black flies (Simulium genus)

61
Q

When do Simulium flies bite?

A

Bite by day

62
Q

Where do Simulium flies live?

A

Only along certain rivers in Africa and S. and C. America

63
Q

What is the pathogenesis of onchocerciasis?

A
  • Larvae form enters skin at bite
  • Larvae grow to mature nematodes in subq nodules
  • Adults mate and produce million of motile microfilariae
  • Microfilariae migrate through subq, lymphatics, and circulation; some to cornea
  • Inflammation and damage to cornea and elsewhere in eye
  • Promote secondary bacterial infections
64
Q

How long do larvae live in the body after a bite?

A

About one year

65
Q

What are the signs and symptoms of onchocerciasis?

A
  • Skin nodules
  • Inflammation of eye
  • Opacification
  • Microfilariae in cornea
  • Blindness
66
Q

How do we diagnose onchocerciasis?

A

Difficult in non endemic areas
Signs and symptoms
Travel history

67
Q

What is the treatment of onchocerciasis?

A

Prevention is best - avoid flies, vector control

Anti-helminthes

68
Q

What is the epidemiology of onchocerciasis?

A

99% in Sub Saharan Africa
1% in C. and S. America
250-300,000 people irreversibly blinded currently

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