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metha 2010 chp20
Infectious Diseases Affecting the Cardiovascular and Lymphatic Systems
| Question | Answer |
|---|---|
| Structure and Function of the Cardiovascular and Lymphatic Systems | Both systems circulate various substances throughout the body and can serve as vehicles for the spread of infection. |
| Cardiovascular System | - heart - blood vessels - and blood |
| Heart | a. the muscular hollow organ that pumps blood throughout the body by coordinated nerve impulses and muscular contractions; b. arteries take blood away from the heart and veins take blood to the heart; capillary beds c. encased in a fibrous covering calle |
| Blood vessels | – any one of the network of muscular tubes that carry blood - e.g. arteries |
| Cardiovascular Defenses | a. Highly protected by leukocytes; no normal flora b. Infections that do occur are dangerous gaining access to the whole body – systemic; denoted by the ending -emia |
| Lymphatic System | – lymph - lymph capillaries - lymph nodes and the lymphoid organs: tonsils - appendix - spleen - and thymus |
| Plasma leaves blood and enters spaces between tissue cells | = interstitial spaces; the plasma is now called interstitial fluid |
| The interstitial fluid is taken up by lymph capillaries and now called | lymph |
| The lymph capillaries will also pick up | microbes or their products |
| Phagocytes help clear the lymph of | microbes; maturation of macrophages and an increase in lymphocytes is responsible for lymph node swelling |
| The lymph returns to the heart passing at least through | one lymph node and eventually all the lymph is returned to the blood |
| Endocarditis | – endocardium lines the heart muscle and covers the heart valves; endocarditis is usually caused by an infection of the valves of the heart |
| Acute bacterial endocarditis | a. Usually caused by Staphylococcus aureus that has entered the body through a wound or IV b. Infection of normal and abnormal heart valves - which can be fatal within days if not treated |
| Subacute bacterial endocarditis | a. Condition arises from bacteria entering the bloodstream from other sites - e.g. tooth extractions and tonsillectomies; b/c heart valves are abnormal (usually from Rheumatic Fever); bacteria get entrapped in blood clots and the clot can break off and b |
| Rheumatic Fever | – Damages the heart valves 1) An autoimmune complication following strep throat primarily in children and teenagers (4-18) 2) Antibodies to strep cross react with heart proteins damaging the valves; re-infection with strep renews the immune attack 3) Ass |
| Septicemia | – uncontrolled proliferation of microbes in the blood; chills and fever inflamed lymph vessels = lymphangitis: red streaks under the skin sometimes incorrectly called blood poisoning |
| Sepsis | – the condition resulting from septicemia; usually caused by gram (-) rods from either an injury - or in the hospital from a catheter or feeding tube |
| As the bacteria die - endotoxins are released and blood pressure drops resulting in | septic shock. |
| Antibiotics can | worsen the condition by increasing the rate of bacterial death. Mortality rate is about 50% with 500 -000 cases/year in the US |
| Plague | – Yersinia pestis |
| Plague Transmitted by | fleas (can jump about 8 cm) - although vector is not always needed; infected fleas feed aggressively b/c growth of bacteria block the digestive tract and the blood ingested is quickly regurgitated |
| Plague In the US | - 50% of the cases have been in New Mexico - with 2 deaths in 2006 |
| Plague Once bacteria enter the body they | enter the bloodstream and grow in the blood and lymph; the pathogen grows inside phagocytic cells |
| Bubonic plague | – swelling of lymph nodes - buboes - in groin or neck; prognosis good if treated - but untreated up to 75% will die |
| Septicemic plague | – bacterium moves from the nodes to the blood; virulence factors cause darkening of skin Black Death; 100% death rate is untreated |
| Pneumonic plague | – bacterium moves to the lungs; if not treated within 12-15 hours of the onset of fever - people will die within 3 days; mortality rate near 100%; highly contagious through airborne droplets (like influenza) |
| Infectious Mononucleosis Epstein-Barr Virus | = Human Herpes Virus 4 |
| Epstein-Barr Virus Fever | - swollen lymph nodes in the neck - and general weakness; rare but death may be associated with the rupture of the spleen during vigorous activity; sometimes a rash on the back; recovery time is a few weeks and immunity is permanent |
| Epstein-Barr Virus In | developing countries before the age of 4 usually asymptomatic unless infection delayed until young adulthood; US – incidence of disease occurs from 15-25; College populations - high incidence of the disease. Up to 95% of middle-age adults have been infec |
| Epstein-Barr Virus Transmission | – by saliva; Incubation period is 4-7 weeks |
| Epstein-Barr Virus Symptoms | are associated with B-cell proliferation and the immune response; the name mononucleosis refers to the production of lymphocytes with unusual lobed nuclei |
| Infectious Mononucleosis Cytomegalovirus | = Human Herpes Virus 5 |
| Cytomegalovirus during pregnancy can cause | long-term neurological and sensory deficiencies; also a problem in AIDS patients |
| Cytomegalovirus Virus can cause | cells to fuse. |
| Lyme Disease | - Borrelia burgdorferi |
| Lyme Disease Caused by | a bacterium that is a spirochete; vectored by the deer tick; greatest threat in areas that have high mouse and deer populations; the mouse is the reservoir for the spirochete; most cases concentrated in the northeast US in summer/early fall |
| Lyme Disease Early | - bull's eye rash and flu-like symptoms |
| Lyme Disease Nonfatal but | often causes a syndrome that mimics neuromuscular and rheumatoid conditions - burrows into the cartilage; heart may be affected as well; may also cause memory loss |
| Lyme Disease Early treatment with | tetracycline or amoxicillin; vaccine for dogs; human vaccine was available in 2002 but was withdrawn b/c of possible side effects |
| Hemorrhagic Fever Diseases Extreme fevers often | accompanied by internal hemorrhaging by the disruption of clotting factors; caused by RNA enveloped viruses |
| Yellow fever | – Transmitted by the mosquito; vaccine available; Africa and South America; jaundice Hemorrhagic Fever Diseases |
| Dengue fever | – Transmitted by the mosquito; vaccine available; Southeast Asia and India; breakbone fever – b/c of severe pain in the muscles and joints (bones don’t break) Hemorrhagic Fever Diseases |
| Marburg and Ebola | -– probably zoonotic diseases but associated with transmission by contact with blood from human to human; no vaccine; massive hemorrhaging Hemorrhagic Fever Diseases |
| Lassa fever | – Reservoir is rats; ribavirin treatment; deafness in many that survive Hemorrhagic Fever Diseases |
| Q Fever | – Coxiella burnetii Nonhemorrhagic Fever Diseases Q stands for query – the search to find a cause - which is a tiny - intracellular bacterium that produces endospores within the infected cell. People at greatest risk are those working with animals; can b |
| Cat-scratch disease | Nonhemorrhagic Fever Diseases More cases than Lyme disease; caused by Bartonella henselaeScratch or bite produces a papule at site 3-10 days after initial contact; swelling of lymph nodes - sickness and fever follow; usually the body will fight the infec |
| Rocky Mountain spotted fever | – Rickettsia rickettsii Nonhemorrhagic Fever Diseases Obligate intracellular bacterium that is vectored by ticks - especially dog tick; SE United States and eastern seaboard; Bacterium induces apoptosis in cells lining blood vessels; symptoms are mild to |
| H. Malaria | – Plasmodium spp.(cycles between humans and mosquitoes); |
| Malaria Four protozoan species responsible | - Plasmodium falciparum - P. vivax - P. ovale and P. malariae; vectored by 78 species of the female Anopheles mosquito |
| Malaria Obligate | intracellular parasites; |
| Malaria Control of | mosquitoes in temperate areas had restricted it to around the equator; most cases in Africa - but upward trend in the US b/c of travel and immigration |
| Malaria Most frequent victims are | children & young adults |
| Malaria Life Cycle | a. asexual stage: human; sexual stage: mosquito b. the parasite infects the RBC’s; symptoms - violent fever/chill cycles capable of breaking bones; enlargement of the liver - spleen - anemiac. R - Some form of quinine; preventative -regular adult diet |
| Anthrax – Bacillus anthracis | 1. A skin and lung infection of domestic animals humans; if organism moves into the bloodstream - resulting septicemia leads rapidly to death.2. Endospores used in biological warfare. |
| HIV: | Human Immunodeficiency Virus |
| HIV AIDS: | Acquired Immune Deficiency Syndrome |
| HIV Symptoms | determined by the levels of 1) virus and 2) T-cells. |
| HIV Enveloped RNA retrovirus | - a group of RNA viruses w/ mechanisms for converting their genome to dsDNA using reverse transcriptase lysogenic |
| HIV Virulence | - Infects human immunity cells: primarily destroying T4 lymphocytes with lysogenic-lytic action |
| HIV gp120 of the virus binds with | the CD4 receptor site on the T-cell. CCR5 co-receptor is also needed for HIV to dock. A few individuals lack CCR5 and cannot be infected with HIV. |
| HIV Origin: Mutated version of the simian immunodeficiency virus | - a virus that infects African monkeys and transferred to humans when captured; world-wide spread within the past 20 years; epidemic; #2 killer of American males 25-44 |
| HIV TORCH | - transmitted transplacentally - in the birth canal - in colostrum |
| HIV Confections with other STDs: | transmission by increase in the shedding of cells |
| HIV Signs/symptoms | - Initial infection produces mono-like symptoms that disappear in response to antibody production; incubation 2-15 years; (+) titer with or without symptoms; chronic lymph node swelling; sudden weight loss; reduced resistance - opportunistic infections |
| Mycobacterium tuberculosis | caused by a bacterium |
| Vascular cancer called Kaposi’s sarcoma | - purple lesions; caused by HHV-8 |
| HIV Clinical | - Blood - secretion precautions |
| HIV Prevention | - Safe sex? No cure - R & vaccines limited success b/c rapid viral changes in the envelope |
| HIV Enzyme Inhibitors: | HAART = Highly Active Anti-Retroviral Treatment |
| Reverse transcriptase (RT) inhibitors interfere with the critical step during | the HIV infection cycle known as reverse transcription. During this step reverse transcriptase converts HIV RNA to HIV DNA. |
| Nucleoside/nucleotide RT inhibitors are | faulty DNA building blocks. When these faulty pieces are incorporated into the HIV DNA (during the process when the HIV RNA is converted into HIV DNA) - the DNA chain cannot be completed - thereby blocking HIV from replicating in the cell. (AZT - ddl - E |
| Non-nucleoside RT inhibitors bind to | reverse transcriptase - interfering with its ability to convert the HIV RNA into HIV DNA. (Nevirapine - Sustiva) |
| Protease inhibitors (PI) block the HIV | enzyme involved in cutting capsid proteins to functional unit size. (Crixivan - Norvir - Agenerase) |
| Fusion inhibitors prevent entry of the | virus into the cell by preventing the fusion of the viral envelope and cell membrane (Fuseon) |
| Integrase inhibitors are a new class of experimental drugs that attach to the enzyme required to | splice the dsDNA from HIV into the host genome. This will prevent formation of the provirus and block future virus multiplication in that cell. |
| HIV The most common treatment approach is to | combine two reverse transcriptase inhibitors and one protease inhibitor in a “cocktail -” interrupting the virus in two different phases of its reproductive cycle. This therapy has been successful in reducing viral loads to undetectable levels and facili |
| Rapid changes in the envelope | billions of strains. Combining the different types of inhibitors has given the best results |
| ever increasing problem exists with | the development of HIV drug-resistant strains. |
| Leukemia | – many causes - but two types thought to be caused by retroviruses |
| HTLV-1: Adult T-cell Leukemia; | possibly some forms of non-Hodgkin’s lymphoma |
| HTLVII: Hairy T-cell Leukemia. | Hairy b/c of the appearance of infected lymphocytes |
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