Spirochetes

Question 1

What does Treponema pallidum gram stain and shape?

Answer 1

-Gram−spirochete

Question 2

Does Treponema pallidum have LPS?

Answer 2

No

Question 3

• Gram−spirochete but no LPS
• flagella (3/pole) in an axial filament (between inner &outer membrane)
• fragile (only survive transmission without exposure):sexual and congenital (placental)transmission in body fluids and mucous membranes

Answer 3

Treponema pallidum

Question 4

What is the main virulence factor of Treponema pallidum?

Answer 4

host response causes disease symptoms

Question 5

Which sexually tansmitted diease was passed from native american people to settlers? (a new world —> old world disease)

Answer 5

Syphilis

Question 6

• sexual (human reservoir)

• congenital (spirochete
crosses placenta: late lethality

Answer 6

Transmission of Syphilis

Question 7

1. local: hard chancre/ulcer at
site of infection; infectious
2. disseminated: rash, aches;
mucous membrane lesions
(“the great imitator”);
infectious
3. gummas; damage to blood
vessels, eyes, CNS;
insanity; not infectious

Answer 7

Stages of Transmission of Syphilis

Question 8

2-6 weeks; chancre, which heals

spontaneously, giving false sense of relief.

Answer 8

Primary Syphilis

Question 9

2-24 weeks

Answer 9

Asymptomatic period:

Question 10

2-6 weeks; 50% of primary
infections go on to secondary; symptoms typically
resolve spontaneously (but recurrence in 25% with 1 yr)

Answer 10

Secondary syphilis

Question 11

Microbe persists for 2/3 of secondary infections, with 1/2 exhibiting tertiary syphilis

diffuse, chronic inflammation

Answer 11

Tertiary syphillis

Question 12

These form in tertiary syphilis

granuloma lesion = inflammatory mass which can perforate, e.g. roof of mouth or any other tissues.

Answer 12

gummas

Question 13

T/f: congenital syphilis is completely preventable by penicillin treatment early in pregnancy!

Answer 13

true

Question 14

_______ has high lethality in-utero OR when initially born without symptoms: high lethality typical of young children (e.g. 2 yrs old) with facial and dental abnormalities like “Hutchinson’s incisors” and “mulberry molars”.

Answer 14

Syphilis

Question 15

______ for 1º and 2º syphillis infections, which contain actively growing spirochetes

Answer 15

penicillin

Question 16

T/F: there is no vaccine for syphillis

Answer 16

true

Question 17

t/f: borrelia is a gram negative spirochete

Answer 17

true

Question 18

Lyme disease is caused by _____ ______.

Answer 18

Borrelia burgdorferi

Question 19

______ ______ ______ life cycle can be traced showing the tranmission of Borrelia burgdorferi.

Answer 19

Ixodes scapularis tick

Question 20

The tick transmission cycle sustains the bacteria _. _______, that cause lyme disease. Lyme disease risk is greatest in the spring and summer, but can occur during all four seasons. nymphs, which feed in the later spring and the early summer, are responsible for tranmitting the majority of infections to humans.

Answer 20

b. Burgdoferi

Question 21

_______ _____ is tranmitted through ticks and reservoir (deer/ rodents)

Answer 21

Lyme Disease: Borrelia burgdorferi

Question 22

Disease:
1. acute, local: fever

2. disseminated: nerve
   paralysis (with heart
   arrhythmia)(2-8 wks)
3. chronic: arthritis,
   CNS paralysis (due
   to persistent immune
   response)(>6 months)

Answer 22

Lyme Disease: Borrelia burgdorferi

Question 23

What skin symptom is characteristic of lyme disease?

Answer 23

erythema migrans rash

Question 24

Is there an effectice vaccine for lyme disease?

Answer 24

no

Question 25

Virulence Factor: Relapsing fever due to effective immune response to antigenic variation

Answer 25

Relapsing Fever: Borrelia spp.

Question 26

Infection: Relasping fever epidemic (louse-bourne) Reservoir: human Vector: body louse

Answer 26

b. recurrentis

Question 27

Infection: relasping fever endemic Reservoir: rodents, soft shelled ticks Vector: soft shelled ticks

Answer 27

b. miyamotoi

Question 28

Gram - obligate intracellular parasite entry into endothelial cells, escape vascular hemorrhages (no laboratory culture) Transmission of this zoonosis: • wood tick (including transovarian transmission from adult ticks into tick eggs) • reservoir: wild rodents

Answer 28

Rickettsia

Question 29

Disease: • rash of extremities, then trunk • hemorrhagic lesions (with disseminated vascular CTL lysis of endothelial cells) ► spots ``` • dissemination to heart, kidneys, etc ► shock, death No vaccination (mortality = 20-40% if no treatment) ```

Answer 29

Rocky Mountain spotted fever

Question 30

Agent of chlamydia

Answer 30

Chlamydia trachomatis

Question 31

The most frequent sexually transmitted infection (followed by gonorrhea, AIDS and syphilis)

Answer 31

Chlamydia

Question 32

Obligate intracellular parasite (no laboratory culture; “AT P ”-parasite)

Answer 32

Chlamydia

Question 33

No “peptidoglycan” synthesis (although the bacterial cell wall looks ‘normal G−’ Inflammatory cytokines released from infected cells cause disease manifestations: damaging cell-mediated immune response in various tissues.

Answer 33

Chlamydia trachomatis

Question 34

EB: epithelial cell adhesion to microvilli ► RB in phagosomes (no fusion with lysosomes) ► replication and division ► EB ► cell lysis / exocytosis

Answer 34

Tranmission of Chlamydia trachomatis

Question 35

EB = elementary body | stable, infectious

Answer 35

Chlamydia trachomatis

Question 36

RB = reticulate body (replicating, fragile, non-infectious)

Answer 36

Chlamydia trachomatis

Question 37

8 serotypes: gonorrheal-like sexual disease • Mucopurulent urethritis, cervicitis, salpingitis (fallopian tube infection) • mobility by adhesion to sperm (► epididymitis prostatitis in men) • PID (pelvic inflammatory disease) ► scarring ► ectopic pregnancy + decreased fertility 3 serotypes: lymphogranuloma venereum 4 serotypes: trachoma (endemic chronic eye infection: blindness) ophthalmia neonatorum with conjunctivitis and pneumonia

Answer 37

Chlamydial diseases caused by CMI responses

Question 38

- no immune protection -reinfection: stronger CMI C.pneumoniae strain causes “walking pneumonia”

Answer 38

Chlamydial diseases caused by CMI responses

Question 39

non-Gram staining (no rigid cell wall: no effect of penicillin or lysozyme); strong membrane (due to sterols) no sterilization by filtration (0.45μm) Mycoplasma species are smallest prokaryote (M. genitalium 580,070 bp – 475 genes) strict aerobe (preference for bronchial mucosa) Disease: no vaccination; fading protective immunity after recovery • atypical, mild pneumonia, the leading cause in schools, students, and military: aerosol transmission in crowded conditions

Answer 39

Mycoplasma pneumoniae

Question 40

capsular vaccine is available

Answer 40

pneumococcal pneumonia

Question 41

no vaccine available

Answer 41

klbsiella pneumonia mycoplasmal pneumonia

Question 42

t/f: Mycoplasma pneumonia is also known as “walking pneumonia” because it is typically mild and without the need for hospitalization.

Answer 42

true