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Microbiology 18
| Question | Answer |
|---|---|
| stds are transmitted by | mixing and matching of mucus membranes |
| which microbes cause stds | bacteria, viruses, fungi, parasites |
| ex of std w/ bacteria | chlamydia, gonorrhea, syphillis |
| ex of viral std | herpes simplex type II, HIV, papilloma virus |
| ex of fungal std | candida albicans |
| ex of parasitic std | trichomonas vaginalis |
| generally stds are not | lethal and have more morbidity than mortality (except for hiv) |
| stds are transmitted via | direct sexual contact |
| transmission of stds depends on | type and frequency of intercourse and number of partners |
| ...are silent transmitters of stds | asymptomatic carriers |
| std infection occurs in | packs so an individual may have multiple infections |
| sites of primary infection for females includes | vulvovaginitis, vagina, cervic, uterus, fallopian tubes, peritoneal cavity |
| vulvovaginitis is | inflammation of all or part of the external vulva |
| vagina | vaginitis |
| cervix | cervicitis |
| uterus | endometritis, pid |
| fallopian tubes | salpingitis |
| peritoneal cavity | peritonitis |
| male sites of infection | external genitalia and urethra (urethritis) |
| seauelae at other sites: there is concern for | spreading from primary site to other organs such as heart, brain, eye and joints |
| stds that can spread to other sites include | gonorrhea and syphilis |
| stds are | worldwide pandemics or epidemics |
| why are stds so much higher in women | women with stds are more symptomatic so more are reported |
| neisseria gonorrheae biology | g- bean shaped diplococci |
| neisseria gonorrheae grow in | chocolate agar |
| neisseria gonorrheae are | oxidase + |
| virulence factors for neisseria gonorrheae include | fimbriae(pili), outer membrane proteins, lps, iga protease, serological diversity |
| neisseria gon. fimbriae or pili mediate | attachment and is antiphagocytic |
| outer membrane proteins of neisseria help | invade mucosal epithelial cells |
| lps of neisseria induces | overt inflammation and tissue damage |
| iga protease of neisseria protects | microorganism from mucosal antibody iga |
| serological diversity of neisseria: there are more than | a million types in nature |
| there is no | vaccine for neissiera gonorrheae |
| neisseria gon is diff from neisseria meningitides bec it | attaches to diff tissues |
| once neisseria invades the tissues, it actually | goes through the cells to hide from the immune system |
| gonorrrhea is called..and what is the host for it | clap...humans are the only natural host |
| gonorrhea is the...reported infectious disease in the use with...cases per year in the world | second most common...150 million |
| neisseria gonorrheae starts with | superficial infection and then goes deeper |
| surface infections caused by neisseria gonorrheae include | urethritis, cervicitis, pharyngitis and proctitis and conjuctivitis |
| urethritis or...is mostly... | ngu..symptomatic in men |
| urethritis has a..incubation period and symptoms include | 2-8 day...dysuria and purulent discharge (drip) |
| cervicitis is | 50% asymptomatic |
| pharyngitis caused from...and proctitis is from... | oral sex...rectal gonorrhea |
| conjuncitivits is in...of.. | newborns...infected mother |
| conjuncivitis involves...and may lead to... | ophthalmia neonatorium..blindness |
| you can treat conjunctivitis with | silver nitrate or erythromycin drop in the eyes at birth |
| neisseria gonorrhea can become an...that hapens in.. | invasive/systemic disase..10% of infected women who do not get treatment |
| invasive systemic diseases caused by neisseria include | pelvic inflammatory disease |
| pid is an infection of the | female reproductive organs |
| pid affects more than | one million women per year and the rate is highest among teenagers |
| yearly, about...women become...because of pid | 50,000...infertile |
| pid may be | asymptomatic 2/3rds of the time |
| pid can cause | scarring inside the reproductive organs leadig to infertility |
| pid complications include | salpingitis and peritonitits |
| salpingitis is | inflammation of the fallopian tubes |
| salpingitis symptoms include | fever, flank pain, painful sex, discharge, abnormal bleeding |
| ...cause about...of salpingitis cases | gonococci...40-60% |
| peritonitis infection spreads | beyond fallopian tube into the peritoneal cavity |
| another invasive/systemic disease associated with neisseria gono is | disseminated gonococcal infection (DGI) |
| dgi occurs following | gonococcal bacteremia |
| dgi results in | arthritis, dermatitis and conjunctivitis |
| most reported cases of arhtritis is in the | sexually active young individuals |
| dermatitis is | skin lesions |
| conjuncitivitis is | inflammation of conjunctiva |
| symptoms of n gonorrheae that travels in the blood include | rash, joing pain which may lead to deformity, and conjunctivitis |
| diagnosis of n gonorrhoeae is based on | symptoms (discharge) |
| you diagnose the symptoms of n gono. by taking a | gram stain of the dischargd |
| diagnosis of n gono is more difficult in | females bec you need additional tests like the oxidase test |
| for the treatment of uncomplicated urogenital and anorectal gonorrhea, the cdc now recommends | a single intramuscular dose of ceftriaxone (cephalosporin) or oral doses of other types of cephalosporins |
| persons w/ gonorrhea should be | tested for possible coinfection with chlamydia trachomatis |
| if person w/ gonorrhea is chlamydia trachomatis positive, you treat with a | single dose of azithromycin(1 g) by mouth or with doxycycline 100 mg twice a day by mouth for 7 days |
| gonorrhea was an...however, the estimaed cost of treating gonorrhea in the us is.. | easily treatable disease..56 million$ each year |
| samll amounts of...and later on..was the standard treatment for gonorrhea since the emergence of... | penicillin..tetracycline...antibiotics in the 1940s |
| during the..the use of...was used to treat.. | vietnam war...penicillin and tetracycline...uncomplicated gonorrhea became more and more resistant as new strains mutated |
| in 2000, the cdc recommended | fluoroquinolone (ciprofloxacin) to treat uncomplicated gonorrhea |
| n gono's resistance to...was documented in... | fluoroquinolones..canda, australia, united kingdom, hong kong, and the us starting in 2000 |
| since n gono is resistant to fluoro it is not | treatment of choice anymore |
| on...the cdc announced that it no longer recommends treating gono with... | april 12, 2007...fluroro antibiotics such as ciprofloxacin and levaquin |
| bec the fluoroquinolones are no longer recommended, the options for treating gonococcal infections in the us are | limited |
| instead, the cdc recommends only one class of drugs, the...which are...for gonorrhea treatment | cephalosporines..antibiotics such as rocephin |
| the vaccine was...for n gonorrhea since there are more than... | unsuccessful...a million types of pili antigen |
| prevention of n gonorrhea: | long term mutually faithful relationship w/ a partner who has been tested and is known to be uninfected, condoms and contact tracing |
| contact tracing is | notifying all recent sex partners so they can see a health care provider and be treated |
| chlamydia trachomatis is an | obligate intracellular pathogen (energy parasite) |
| chlamydia trachomatis has to grow in | cell cultures, it can't grow on agar |
| chlamydia trachomatis has a....but it does not have a... | gram-negative structure...cell wall (pg) |
| chlamydia trachomatis has a..which are... | complex developmental life cycle with two stages...elementary body and reticulate body |
| elementary body is not...and is... | biologicallly active...resistant to environmental stresses |
| the elementary body of chlamydia trachomatis can survive | outside of a host |
| the elementary body is the..which converts to... | infectious form...reticulate body once in the cell |
| the elementary body is sort of like | a spore but not a real one |
| the reticulate body is the...form | biologically active and dividing (binary fisison) |
| the reticulate body is also the..which converts... | noninfectious form..back to elemtnary body |
| chlamydia trachomatis preveents...and grows... | phagolysosome fusion during intracellular growth...within phagosomes of host cells |
| phagosomes are sometimes called | inclusion bodies |
| chlamydia is thhe | most frequently reported bacterial sexually transmitted disease in the usa |
| an estimated...are infect w/ chlamydia /year | 2.8 million americans |
| what percents of women/men are asymptomatic carriers of chlamydia | 70/50% |
| what percent of women w/ chlamydia will develop...? | 40%..pid |
| of the 40% of women w/ chlamydai who will develop pid, ...will become...and...will have a... | 20%..infertile ...9%...potentially fatal ectopic pregnancy |
| c trachomatis can be transmitted at | birth which may cause eye infection or pneumonia in new borns |
| the pathology of chlamydia trachomtis is either | surface infection or invasive disease |
| surface infections w/ c trachomatis in males it causes....and ...of males are... | ngu (nongonococcal urethritis)...50%...asymptomatic and may lead to infertility |
| surface infections w/ c trachomatis in females causes...and ..of woemn are... | cervicitis..70%..asymptomatic and may lead to infertility |
| both male and females get...because of c trachomatis | trachoma |
| trachoma is the leading cause of | blindness in the world |
| trachoma mainly happens in | underdeveloped countries |
| c trachomatis surfae infection in the new born leads to | inclusion conjunctivitis |
| invasive disease w/ c trachomatis in males leads to | prostatitis and epididymitis (may lead to infertility) |
| invasive disease w/ c trachomatis in females leads to | salpingitis, pid, sterility, lymphogranuloma venereum |
| salpingitis is | inflammation of the fallopian tubes similar to gonococci |
| pid is similar to...as a result of... | gonococci...ascending infection of reproductive organs |
| sterility for females w/ c trachomatis | chances increase with repeated episodes of pid |
| lymphogranuloma venereum is an..which may lead to.. | infection of the inguinal lymph nodes...swelling of buboes, elephantiasis of genital organs |
| invasive disease of c trachomatis in new borns is..which is the most common newborn... | infantile pneumonia...lung infection in the world |
| infantile pneumonia is usually | not fatal |
| you can't do a..with chlamydia trachomatis | gram stain bec it doesn't grow on agar |
| you have to grow c trachomatis in | cell culture |
| you can do...with c trachomatis though | fluorescent antibody staining (FAS) and dna hybridization |
| therapy for c trachomatis involves either | azithromycin (z pack) 1 g orally in a single dose or doxycycline 100 mg orally twice a day for 7 days |
| for neonatal conjunctivitis you treat with | erythromycin orally for 2 weeks |
| risk factors for developing pid include | having an std (gono or chlamydia), under 25 sexually active, multiple sex partners, douche, intrauterine device |
| douching can | push germs into the womb, ovaries, and tubes causing infection |
| douching can also | hide the signs of an infection |
| intrauterine devices: you need to | get tested and treated for any infections before getting an iud |
| treponema pallidum causes...and is an... | syphilis...historical std (15th century epidemic) |
| treponema pallidum bugs are | spirochete, long spiral shaped organisms |
| treponema pallidum are..with.. | very motile..axcial filaments |
| treponema pallidum have an | atypical cell wall (pg) |
| trep pallidum is visualized by | dark field microscopy |
| t pallidum can not be | grown in culture |
| t pallidum virulence: | axial filament allows penetration into tissues |
| pathology of t pallidum involves the...which are... | three stages of syphilis..primary, secondary and tertiary |
| primary syphilis causes...which appear.. | primary cutaneous lesions (chancres) as the first sign...10 days - 30 months after exposure on the part of the body where the infection was transmitted |
| untreated primary syphilis results in the | chancre healing spontaneously in 4-6 weeks |
| around the time that the chancre heals... | the symptoms of secondary syphilis may occur |
| chancre characteristics | indolent, punched out apperance, indurated, painless, raised border, red, smooth base, scant serous secretions |
| indurated means | raised edges |
| secondary syphilis begins | 2-8 weeks after the chancre heals |
| secondary syphilis happens when the bacteria...cuasing... | spread throughout the body..fever, fatigue and aching and many types of rash |
| rashes w/ secondary syphilis happen especially on the | palms of hands and soles of the feet |
| signs and symptoms of secondary syphilis may | disappear within 4-6 weeks or repeatedly come and go for as long as a year |
| after secondary syphilis comes...which only happens... | latent syphilis...in some people |
| latent syphilis does not have any...and the... | symptoms or signs...signs and symptoms may never return or the disease may progress to the tertiary stage |
| without treatment...of infected syphilis pateitns progress to...within... | 40%...tertiary syphilis...5-20 years |
| signs and symptoms of tertiary syphilis include | neurlogical problems and cardiovascular proglems |
| neurlogical problems w/ tertiary syphilis may include | stroke, meningitis, poor nmuscle coordination, numbness, paralysis, deafness or visual problems, personality changes, dementia |
| cardiovascular problems w/ tertiary syphilis may include | bulging (aneurysm) and inflammation of the aorta and of other blood vessels |
| pockets of damage accumulate in...such as the..are called... | various tissues...bones, skin, nervous tissue, heart and arteries..gummas (very destructive) |
| t pallidum can be | passed from mother to child during fetal development or at birth |
| newborns with congenital syphilis may be | asymptomatic and are only identified on routine prenatal screening |
| by definition, earlly congenital syphilis occurs in | children between 0 and 2 years old |
| after early congenital syphilis, they can develoope | late congenital syphilis |
| diagnosis of syphilis is with...or by... | dark field microscopy of lesions...serological techniques for detecting antibody response to t pallidum |
| therapy for syphilis: it is | easy to cure in its early stages |
| therapy for syphilis involves giving a | single intramuscular injection of penicillin (benzathine) for all stages |
| in a pregnant mother is identified as being infected with syphilis, treatment can | effectively prevent congenital syphilis from developing in the unborn child, espeiclaly if she is treated before the sixteenth week of pregnancy |
| prevention of syphilis: there is no...so we rely on.. | vaccine...early diagnosis |
| stds often | occur together in the same individual |
| it is important to | test for other stds if you see one |
| all bacterial stds are | treatable |
| the prevalence of...in the us and abroad, especially in...has... | gonorrhea...under developed and developing...decreased in the last two decades |
| as of recently, though,....have been reported due to the... | higher rates of infection w/ gonorrhea...increase of antimicrobial resistant gonococci |
| atypical bacterial diseases include | chronic pulmonary disease, vector-borne disease, infectious cause of peptic ulcers |
| chronic pulmonary disease is caused by | mycobacterium tuberculosis |
| vector-born disease caused by..transfered on... | borrelia burgdorferi..ticks |
| infectious cause of peptic ulcuers is from | helicobacter pylori |
| atypical bacterial diseases are...and cause.. | human pathogens only...chronic infectionis that can go unnoticed |
| it is important to...and they are... | diagnose atypical bacterial diseases quickly...curable w/ antibiotics |
| mycobacterium tubuerculosis does not | have normal g+/- glassification |
| m tuberculosis bugs are | nonmotile, aerobic bacilli with a very lipid rich cell wall |
| m tuberculosis are stained by | acid fast stain(acid fast bacilli) |
| cell wall structure of m tuberculosis: the pg layer is | bound to arabinogalactose-mycolic acid |
| arabinogalactose-mycolic acid is a | characteristic to bacterium |
| m tuberculosis cell wall is | overlaid with waxy lipid (waxD) |
| waxD of m tuberculosis protects from..and allows the bacterium to... | desiccation (drying out)...survive in dried aerosol droplets for up to 8 months |
| thre cell wall lipids of m tuberculosis can withstand | phagocytic killing and cause necrosis of tissue |
| m tuberculosis'...can induce... | lipoarabinomannan(LAM)...inflammation |
| the...of m tuberculosis are very... | surface proteins...immunogenic |
| surface proteins of m tuberculosis induce | cell mediated immune response (CTL response) |
| ..is an important virulence factor for m tuberculosis | cord factor |
| m tuberculosis is highly...you only need... | highly infectious...5-200 organisms to start disease |
| there are...of m tuberculosis, which are... | three forms...primary, secondary and disseminated |
| primary tb is an infection of | respiratory tract via inhalation of droplets from infected individuals |
| primary tb's...allow... | pili..attachment to lung epitheial cells |
| alveolar macrophages...the m tuberuclosis bacteria but.. | phagocytize...cannot destroy them |
| alveolar macrophages can't destroy m tubuerculosis because the bacteria | prevent fusion of lysosomes and phagosomes |
| m tubuerlosis bacteria replicatewithin | host cells(alveolar macs), gradually killing them |
| the..which also... | inflammatory process attracts more macrophages ...become infected with tb |
| infected macrophages trigger...which form a.. | ctl response, recruiting t cells...granuloma (tubercle) |
| granulomas happen when... | tightly packed macrophages and t cells wall off infected area |
| a..is deposited around the tubercle, which causes... | collagen layer..latent infection (stalemate) |
| secondary tb hapens when the bacteria...which does what.. | break stalemate and rupture thre tubercle...reestablishes the infection |
| disseminated tb happens when the...including... | macrophages carry the bacteria throughout the body to various sites..bone marrow, spleen, kidneys, spinal cord and brain |
| complications with disseminated tb occur at the | lungs and other sites |
| when disseminated tb complications occur in the lungs and other sites it contributes to | wasting disease or consumption |
| wasting disease or consumption is associated wit | bloody sputum, malaise and weight loss |
| epidemiology of tb: worldwide, ...is infected with this organism | a third of the worlds population |
| fewer than...in... | 15000 new cases of tb in the us...2003 (mostly aids patients) |
| populations at greatest risk for disease with tb are... | immunocompromised patients (HIV), drug or alcohol abusers, homeless persons, and invidivuals exposed to diseased patients |
| humans are the | only natural reservoir for tb |
| person to eprson spread of tb is through | infectious aerosol |
| diagnosis of tb is via | skin testing (mantoux test) |
| skin tests for the | reactivity of intadermal injection of mycobacterial antigen ppd |
| ppd is | purified protein derivative of bacterial wall |
| skin test reaction is measured | after 48 hours (delayed reaction) |
| if an...of more than..occurs then... | induration...15 mm...it is considered a positive skin test for tb |
| positive skin test is followd up with | chest x ray |
| the skin test is basically looking for a | type 4 hypersensitivity |
| treatment of tb is by using a | cocktail of antibacterial drugs over long time courses ( > 6 months due to slow growing nature of bacteria) |
| the cases of tb are..however there is an... | declining the in us..increase in the multidrug resistant tb in third world countries |
| m tubuerculois correlates with an | increase in incidence of tb in us residents of foreign origin |
| concerns of...are taking hold in the.. | mdr strains of tb...us population |
| tb immunization is with a | live attenuated mycobacterium bovis vaccine |
| mycobacterium bovis is | bacillus of calmette-guerin (BCG vaccine) |
| mycobacterium bovis is a...which causes... | cattle pathogen..disease in zoo keepers |
| m bovis can cauase | pulmonary disease by consumption of contaminated milk but is destroyed by milk pasteurization |
| tb vaccine is not for | immunocompromised patients |
| recipients of tb vaccine become | skin test positive for tb |
| reports of efficacy of tb vaccine | varry widely from 80% to 0 |
| in the us, bcg vaccine is | not used bec of relatively low prevalence, coupled w/ testing and treatment |
| vector born borelia burgdorferi causes | lyme borelliosis (lyme disease) |
| genus borrelia are | g- bacilli that are spirochetes |
| borrelia burgdorferi is the leading cause of | vector borne disease in the us |
| lyme disease is transmitted by | hard shelled ticks that live on rodents, deer and domestic pets |
| hard shelled ticks are called | ixodes |
| lyme disease has been shown in | 49 states of us |
| virulence factors for borrelia burgdorferi: bacteria can | escape from blood and penetrate tissues (simnilar to pmn) |
| virulence factors for borrelia burgdorferi: the..is very..and triggers... | outer surface protein (ops)...immunogenic...inflammatory responses w/ tissues and causes damage |
| stages of lyme disease include | early manifestation stage and late manifestation stage |
| early manifestation of lyme disease involves an | incubation period of 3-30 days |
| early manifestation of lyme involves a...at the site of.. | rash..tick bite |
| the rash at the tick bite is called...and shows up in... | erythema migrans..80% of cases |
| systemic symptoms of early stages of lyme disease include | fatigue, headache, fever, chills, muscle pain, lymphadenopathy |
| early manifestation of lyme dissease resolves in | 4 weeks due to humoral immunitity |
| late manifestation of lyme disease occurs in..and is... | 80% of patients..hard to treat |
| late manifestation of lyme disease occurs whe bacteria | escape from blood to tissues and survive there but stimulate immune system which causes the damage |
| late manifestation of lyme disease occurs within | few weeks to 2 years following the onset of disease |
| late stage of lyme disease has two phages that include...and it happens in..of patients | neurlogical and cardiac symptoms and arhtralgias and arthritis...10-15% |
| two phases of late stage ofl yme disease can last for | days to months |
| neurlogical and cardica symptoms of late stage of lyme disease include | meningitis, encephalitis, peripheral nerve neuropathy, heart block, myopericarditis, congestive heart failure |
| arhralgias and arthritis persist for | months to years |
| autoimmune arthritis occurs in | 89% of people with hla-dr2+ and hla-dr4+ |
| definition of lyme disease for clincal cases | erythema migrans (5 cm in diamter) and at least one late manifestation |
| late manifestation for clincal definition of lyme disease can be | musculoskeletal, nervous sytem, cardiovascular involvement |
| last part of clinical definition of lyme disease is | lab confimration of infection |
| lab criteria for diagnosis is a...and ther emust be at least one of the following.. | challenge...isolation of borrelia burgdorferi, demonstration of diagnostic levels of immunoglobulin (IgM or IgG) antibodies to the spirochetes, significant increase in antibody titer between acute and convalescent serum samples |
| helicobacter pylori was discovered in...as the | 1993...cause of peptic ulcer |
| helicobacter pylori bugs are | g- curved bacilli w/ polar flagella |
| helicobacter pylori are present in the | stomach of many mammals including humans |
| helicobacter pylori bacteria are highly | motile and have several virulence factors |
| virulence factors of h pylori include | urease, adhesins and tissue damaging toxins |
| urease of h pylori is an..which.. | enzyme..catalyzes the hydrolysis of urea into carbon dioxide and ammonia |
| urease also | locally raises the ph from -2 to a more biocompatible rainge of 6-7 |
| adhesins of h pylori mediate | binding to host cells |
| tissue damagining toxins of h pylori cause | damage and inflammation of the lining of sotmach which leads to peptic ulcer |
| mode of transmission of h pylori is by | fecal oral route |
| there is no..for h pylori | animal reservoir |
| what percent of adults in the us are colonized with h pylori | 45% |
| what percent of patients with...are infect with h pylori | 70-100%...gastritis, gastric ulcers or duodenal ulcers |
| h pylori is associated with | gastritis, gastric ulcers, gastric adenocarcinoma and gastric malt lymphoma |
| h pylori is an...of.. | etiological agent..type b gastritis |
| diagnosis of h pylori is confirmed by | histological microscopic examination of gastric biopsy with upper endoscopy |
| h pylori will cause | urea breath test to be positive (relatively sensitive) |
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handrzej
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