micro- spirochetes, mycobacterium, mycoplasma Flashcards Preview

LAST EXAMMMMMM Year I > micro- spirochetes, mycobacterium, mycoplasma > Flashcards

Flashcards in micro- spirochetes, mycobacterium, mycoplasma Deck (82):
1

what are the unique additions to spirochetes besides that LPS outer layer

additional phospholipid rich outer membrane with few exposed proteins
axial flagella that come out of the ends of spirochete cell wall rather thatn from outer membrane and the flagella runs under the outer membrane sheath
"periplasmic flagella"

2

how do we visualize apirochetes

dark field microscopy, immunofluorescence and silver stains

3

What are the 3 genera of spirochetes

Treponema
Borrelia
Leptospira

4

Describe primary syphilis

painless chancre erupts 3-6 weeks after contact
chancre is firm, ulcerated painless lesion with punched out base and rolled edges
resolves 4-6 weeks without scar
regional nontender lymph node swelling

5

Describe secondary syphilis

6 weeks after original chancre healed
systemic widespread rash with lymphadenopathy
fever, weight loss

6

paatiend presens with small red macular (flat) lesions symmetrically over body, palms and soles and mucous membranes of oral cavity
become bumpy and pustular

syphilis

7

What is condyloma latum and what infection is it manifested in

painless wartlike lesion in warm moist areas like vulva or scrotum
ulcerates
syphilis
resolves over 6 weeks and enters latent phase

8

Describe latent syphilis

asymptomatic usually
sometimes more lesions
most will remain asymptomatic but some may progress to tertiary syphilis (1/3 unTx)

9

When does tertiary syphilis develop and what are the 3 categories

6-40 years
gummatous
cardiovascular
neurosyphilis

10

What is Gummatous syphilis

3-10 yrs after infection
granulomatous lesions Gummas necrose and become fibrotic in skin and bones
skin-painless with sharp borders
bone- deep pain

11

What is CV syphilis

10 yrs after infection
aneurysm in ascending aorta or aortic arch
from chronic inflammation

12

What are the 5 common presentations or neurosyphilis

asymptomatic- CSF is +
subacute meningitis
meningovascular syphilis
tabes dorsalis
general paresis

13

presentation subacute meningitis from syphilis

fever, stiff neck, HA
high lymphocyte, high protein, low glucose + syphilis

14

describe process behind meningovascular syphilis

spirochetes attack blood vessels in brain and meninges causing infarction and neurologica impairments

15

describe tabes doralis from syphilsi

affects post column spinal cord
loss os vibration and proprioception
ataxia
loss of reflexes and pain and temp from DRG

16

What form of syphilis leads to progeressive nerve cell death in brain and mental deterioration

general paresis

17

What is the argyll-robertson pupil

no reactive pupil to light from midbrain lesion
seen in syphilis

18

what is early congenital syphilis

within 2 yrs
widespread rash and condyloma latum
runny nose
lymph node, HSM and bone infection are common

19

patient has saddle nose(sunken in nose) and saver shins(bowing of tibias)
widely spaced incisors with central notch and the molars have too many cusps(mulberry)
what is this assoc with

congenital syphilis

20

when is the window to treat pregnant mother with antibiotic therapy for syphilis

before the 4th month of gestation

21

What is the best way to Dx syphilis active and latent

active is through visualization of spirochetes
serologic for latent

22

what titers do we pull for syphilis

anti-lecithin and cardiolipin which are Ag from cell damage
also used on CSF detection for neurosyphilis

23

What are the two most common nonspecific treponemal tests

VDRL and RPR

24

what are the specific treponemal tests and what are they detecting

Ab againts spirochetes
Indirect Imunofleurescent Trepnemal Ab-Absorptions FTA-ABS

25

If a patient after contracting syphilis has a drop in VDRL or RPR while FTA-ABS is still +, was tx successful?

yes

26

Immediately after Tx with syphilis patient has mild fever, chills, malaise and HA with muscle aches
what is going on

Jarisch-Herxheimer phenomenon

27

What treponema does not cause gummas

treponema carateum

28

patient from desert zone in Africa or Middle east
has skin lesions in oral mucosa ang gummas in skin and bone
Dx?

treponema endemicum

29

patient is from tropical area with disfigured face and open ulcers
Dx?

yaws
treponema pertenue

30

if a hispanic patient comes in and has red skin lesions that become blue in the sun
Dx?

treponema carateum

31

What diseases are caused by the Borrelia spp

lymes and relapsing fever

32

What are the 3 stages of lymes

early localized stage, early disseminated stage and late stage

33

what is the time period for early localized stage lymes and what occurs

10 days after tick bite lasts 4 weeks
skin lesion at site- erythema chronicum migrans with flulike symptoms

34

What does the skin lesion erythema chronicum migrans look like

starts red round rash then spreads and the outer border stays red and the center is clear, blue or necrose

35

What occurs in the early disseminated stage of lymes

skin, nervous system, heart and joints
many lesions
cranial nerve and motor sensory nn involved0 cranial nn palsies especially Bells and peripheral neuropathies
AV nodal block and sometimes myocarditis and L ventricular dysfunction
arthritis that is hot swollen and painful

36

describe late stage lymes

10% untreated have chronic arthritis assoc with HLA DRB1*0401, HLA-DRB1*0101
chronic neurologic damage, encephalopathy

37

What part of the lymes rash is biopsied

the leading edge

38

What techniques are used to Dx lymes

ELISA and western immunoblotting of CSF

39

Describe symptoms of Borrelia recurrentis

high fever, chills, HA muscle aches
rash with drenching sweats that last 3-6 days then relapse 8 days later
progressive shorter and milder each relapse

40

What causes the relapsing symptoms of Borrelia

antigenic variation

41

When ust you pull blood cultures in someone with Borrelia recurrentis

during active febrile period. negative when afebrile

42

what are the phases from leptospirosis

leptospiremic phase- high temp, HA, malaise and muscle aches
immune phase- IgM Ab, meningismus and elevated WBC count in CSF

43

What is Weils disease and what causes it

renal failure, hepatitis with jaundice, mental status changes and hemorrhages
Leptospirs interrogans

44

What lab results lead towards leptospirosis

elevated liver function tests, protein in urine and clinical history of animal contact or swimming in areas shared by animals

45

What are the 2 species of Mycobacterium

TB
leprae

46

What are mycosides

mycolic acid- large fatty acid
mycoside- mycolic acid bound to a carb
cord factor- mycoside formed by union of 2 mycolic acids and disaccharide
sulfatides- sulfate attached to disaccharide inhibiting phagolysosomal fusion
wax D- activates protective cellular immune system

47

What component of mycosides is only found in virulent Mycobacterium TB

cord factor

48

What is the pneumonic for remembering mycosides for mycobacterium TB

Mike(mycosides) waxes (Wax D) his SUrfboard (sulfatides) and has a surfboard cord (cord factor)

49

What type of organism is mycobacterium TB

acid fast
facultative intracellular growth

50

What cells does M TB infect first

macrophages

51

What causes the caseous necrosis seen in M TB

the cell mediated immunity of the macrophages eating everything

52

what type of DTH is ppd test for M TB

IV

53

what diseases could lead to a false negative ppd

steroid use, malnutrition, AIDS
because do not have normal immune response

54

What is the best Dx screening for M TB

new IGRAS from whole blood

55

presentation of primary TB

asymptomatic lung infection
middle and lower lobes- neutrophils and edema

56

presentation of symptomatic TB

children usually
enlargement of mediastinal lymph nodes and lower/middle lung infiltrates

57

What is ghon focus and complex

focus is calcified tubercle in middleor lower lung zone
complex is ghon focus plus perihilar lymph node calcified granulomas

58

what is presentation of reactive pulmonary TB

infection in apices around clavicles
fever, night sweats, weight loss and productive cough sometimes with blood

59

What other organ sysmtems can be affected by secondary TB

pleural and pericardial spaces
lymph node infections
kidney- sterile pyuria
skeletal- invertebral discs
joints- chronic arthritis of 1 joint
CNS-subacute meningitis and granulomas in brain
Miliary TB- tubercles all over body

60

What is sterile pyuria and what infection does it occur in

RBC and WBC in urine but no bacteria
M TB

61

What is the best Dx tool for M TB active infection

sputum culture

62

M leprae is common where

India, Brazil, Burma, Indonesia, MAdagascar and Nepal

63

Why does M leprae like the skin

likes cooler areas of the body
also attacks superficial nn, eyes nose and testes

64

What is Lepromatous Leprosy

severest leprosy form
no cell mediated immune response
defective T CD8 cells

65

What is presentation of lepromatous leprosy

thickened face- leonine facies
saddle nose deformity
internal testicular damage- infertility
blindness
loss of sensation

66

What is presenation of Tuberculois leprosy

localized superficial unilateral skin and nerve involvement
1-2 hypopigmented skin lesions
enlarged nerves

67

what is a common cause of Fever of unknown origin in AIDS patients

M avium complex
MAC

68

What form of leprosy will have a negative lepromin skin test

the lepromatous leprosy because cannot mount DTH

69

What is the presentation of AIDS patient with MAC

unexplained fevers, weight loss, diarrhea and general malaise
elevated alkaline phosphatase

70

What is confirmatory Dx for MAC

growth in mycobacterial blood cultures

71

Describe structure of mycoplasma organisms

no peptidoglycan cell wall
just cell membrane with sterols to help shield organelles

72

What are the pathogenic spp of mycoplasma

pneumoniae and Ureaplasma urealyticum

73

What is the number one cause of bacterial bronchitis and pneumonia in teenagers

mycoplasma pneumoniae

74

What are the virulence factors of mycoplasma pneumoniae

Protein P1 an adhesin

75

What is walking pneumonia

gradual onset, fever sore throat, malaise and peristent dry hacking cough

76

what is presentation of CXR walking pneumonia

streaky infiltrate

77

What is erythema multiforme or Stevens-johnson syndrome

severe skin run with erythematous vesicles and bullae over mouth eyes and skin
caused with mycoplasma pneumonia sometimes

78

What is a rapid way to test someone for Mycoplasma pneumoniae

put their blood in test tube then on ice and if the blood clumps then has cold agglutinins which are in mycoplasma pneumoniae

79

what does a mycoplasma culture look like

tiny dome fried egg appearance
like a mulberry

80

what bacteria cause atypical pneumoniae

Mycoplasma, legionella and chlamydia

81

What is T strain mycoplasma

Ureaplasma urealyticum

82

What could cause a young sexually active woman to have burning while peeing and yellow mucoid discharge

N gonorrhea, Chlaymydia
Ureaplasma urealyticum!