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Urinary tract Inf Di
Med Micro T3
| Question | Answer |
|---|---|
| Risk factors | female, sexual activity, types of birth control(diaphram, spermicidal jelly), age(menopause), catherized(NF skin on tube), blockage(kidney stones), immune illnesses(diabetes) |
| Complications | acute kidney infections(kidney damage-pregnant,children&elderly[reduced immune system]) chronic kidney infections(sepsis), pelvic inflammatory disease(devastating impacts[sterility leading cause]) |
| Resistance,host mechanisms | urine(mechanical flushing away bacteria, inhibits micro growth[cidal compounds,ammonia(block complement)]) |
| Exception | preggers & diabetics nutrients in urine actually support growth of some microbes,length of urethra(chk this), increase of osmolality decrease leukocytes |
| VFactors | pili,fimbri(adherence),compounds(cidal),urease(urea into NH3 and CO2), hemolysis, sythesize essential Amino acids (ARG & GLY) |
| Diagnosis | increase freq & persistence, burning, may or may not have blood or pain, change in mental statue(elderly),fill the cup(pus,RBCs,WBCs,bacteria, urinanalysis |
| Rx | drink H2O(lots),heating pad,cranberry |
| E. coli | wiping the wrong direction cross cont. (VF flagella,capsule) community acquired |
| Klebsiella | hospital, foley catherters, hospital acquired |
| Proteus mirabilis | motile, produces ureas |
| Staph aureus | antibiotic resistant cat + coagulase pos |
| Staph saprophyticus | particually bladder Gram + cocci community acquired coagulase neg cat + |
| Staph epidermidis | penicilli treatment |
| Pseudomonas | only bug that is more resistant that Staph aureus (hospitals and nursing homes, catheters) |
| Candida | NSkinF, yeast inf. self-limiting, |
| Cystitis | bladder inf. due to:reactions to drugs, radiation therapy, feminine hygene products,catheters (Women 30-50, Men 50 & above) |
| Pyelonephritis | kidney inf. (IC-elderly,HIV) acute or chronic, any case of backflow due to obstruction(kidney stones,neopathies,renal papillary neucrosis [Treatment-14day dose long term antibiotics] |
| Iga1 | |
| Immunoglobulin | |
| LPS androgen | |
| gonococcal uretritus | |
| endometritus | uterus |
| sepiritis | fellopian tubes |
| oophoritis | ovaries |
| sterility | ectopic pregancies,abcesses,liver |
| opthalmia neonatorium (conjunctivities) | erthromycin eyedrops babies |
| NGU chlamydia trachomatis 23-55% sti's human only GramNeg (lacks petidogylcan layer) VF: resistance to lysozyme; | |
| NGUureoplasmaureolytic no cell wall, pleomorphic, urease urea->NH3 & CH2, | |
| NGUmycoplasma genitalium no cell wall pleomorphic | |
| NGUHaemophilus vaginalisa | |
| Trichonmonas vaginalis (protozoan) | |
| HSV | Herpes Simplex Virus |
| Genital Warts | Condylomas, STD, human papillona virus (HPV)Type 6 & 11 cause 90% of genital warts cervical cancer Vaccine |
| Guardical skin to skin contact 3/4 of sexual active age groups have had some exposure to this tiny clusters in genital region, internal or external, microscopic abrasions, months to years latency | not internal, no cervical cancer risk, smaller in size have central demple or depression associated with Cox Viriday family human 4 different serotypes, NC2 is the STI |
| Molluscum contagiosum (MC) | not internal, no cervical cancer risk, smaller in size have central demple or depression associated with Cox Viriday family human 4 different serotypes, NC2 is the STI |
| Latency 3rd Stage of Syphilus=serology is positive, still carrying bug 25% of people will have relapses to 2ndary Syphilus; | |
| avg 4+ yrs of latency and 2/3rds of individuals are asymptomatic and the remainder will proceed to tertiary syphilis can occur 6-40 yrs later | |
| Gummas=granuloars skin Painless & bones painful | |
| Cardiovascular -> aneuryisims | |
| CNS=neural syphilis 8% | |
| subacute menygitis | |
| menigo vascular problemsr | |
| tapes dorsalis=syphilis sets up in the spinal cord loose reflex ability | |
| Progressive nerve cell degenertion = insanity paeresis | |
| Congenital syphilis=passed from mother to fetus | |
| Skin | 1.5~2m^2 largest organ of the body protective barrier against microbes sensation, heat regulation, storage site lipid and water, synth vitamin D, absorption in 1in^2 650 sweat glands 20 blood v 60k melanocytes 1k nerve ends 50m bact. 1k species 19 phyla |
| Treponema pallidum | syphilis disease with three states 1, 2, 3 (CNS Cardiovascular) |
| T.p.endemicum | Bejel mucosa nose mouth area (skin infections Africa and dessert Middle East) genetically identical to that causes sypilis |
| T.p. pertenue | Yaws signifcant facial damage(skin infections moist tropical pacific islands in Carribean) |
| T.p. carateum | Pinta least problematic rash reddish bluish color |
| Cellulitis | skin infection inpetigo, ;erysipeles, ;folliculitis, St. Anthonny's fire propional bacterium acnes |
| furmculosis | basal layer |
| hidranetitis | sweat glands |
| facciatis | disseminated skin infections |
| NF skin | staph aureus, infections at any level; streptococcus progenes, strep throat, pharyngitis VF streptokinase, hyaluromdase, DNAases, pyrogenic extoxius; |
| pyrogenic exotoxin | rash (redness swelling tenderness warm fever ) -> toxic shock Risk Factor (kids, IC, diabetics, chicken pox/shingles, IV dosing) |
| necrotizing faciatis discoloration of skin & necrosis on day 5 sudden drop in blood pressure leading to unconciousness and toxic shock, exotoxin, and they are dead | infection of the facial basement layer working along the fat layer near the muscles and as it goes it is killing tissue "flesh-eating bacteria" 1.5k cases/yr 20% die 24 hours skin trauma flu dehydrated 2-4 pain becomes less specific and more generalized |
| Clostridum | gramPos rods anaerobic (live in soil) step on rusty nail injects endospores hatches open and kick out more bugs, severe car crashes, gunshot wounds, battlefield wounds, |
| C. tetani AB / hyperbaric O2 | tetanus (VF:tetanuspasmin toxin inhibits release of GABA (NT) sustained muscle retraction "lock jaw" respirator muscle paralysis (resp. death) 11 enzymes DPT-vaccine (antitoxin binds up to reduce damage) supportive care->ventilator |
| C. perfringeus hyperbaric O2 | gangrene (battlefield) serious trauma for it to occur anaerobic inf spreads via facia alpha toxin->destroy tissue & septic shock (11 enzymes) produces gas that fills cavity Sonargram will show; discoloration leak-black fluid radical surgery |
| Bite infections | pets or wild animals, Pasturella (VF capsule non-motile->bones & joints, easily cultured AB; can be people, Bacteroides anaerobes & Eikenella |
| Superficial Fungal Infections Skin Scraping KOH test | patch of discoloration tinea versicolor(malasecia), whitening of the skin;tinea nigra(exophilia), blackening of the skin; Rx dandrug shampoo contains selenium kills fungi |
| Cutaneous skin infection Microsporium & Trichophytum | t. capis, ringwork(fungal infection);t. curis, jock itch; t. pedis, athlete's foot; t. capitatis, scalp itch; t. vaguirm(VF:keratinase), nail rot; Diaper rash - Candida albicans |
| Subcutaneous AB | sporothrix schenkii, fungi on rose thorns; phialosposa & cladosprium (rotten wood) Wart-like lesions sort of violet color and spreads by lymph Flu-like symptoms; Rhizopus oryzae, nucor mycosis (flesh-eating fungi) |
| Osteomyelitis | cells become puss after WBCs attack infectious cells |
| restricts blood flow to the site bone becomes demineralized Risk: young boys, IC, catherized IV drug abusers NF Staph aureus 90% (poor cirulation:sickle cell <-Pseudomonas aeruginosa) Trauma | |
| Det bugs for osteomyelitis | bacteria & fungi tests blood tests->culture, Xrays (5-7 days post infection), bone biopsys-culture, CT/MRI's |
| Rx for ostemyelitis | surgery (amputate) drain site, remove damaged tissue, restore blood flow children newborns 4 mo - 4 yrs - adult, Staph aureus Strepo coccus Enterobacter Haemophilus influenza; |
| adults | staph sutero strep, mixed microbe mycohesertum tuberculosis 1-3% Fungi blastomyces coccidiodes |
| Septic arthritis | synovial fluid superative arthritis (producing puss) bacteria fungi viruses (Borrelia burgdorfea Lyme disease; arthritis caused by an infectious agent that isn't septic) |
| Blood or abscess carries an infectious agent to the joints possible originating from skin lesion | local translocation ->osteomyelitis to joint or local soft tissue penetrating trauma iatrogenic (we caused it) -> |
| #1 Staph aureus common cause of septic arthritis in adults and Streptococci 2nd most Haemolophilos influenzae Neisseria gonorrhrea E coli- ELDERLY / IV IC M tuberserelosis Salmonella Brucella | fever/shaking chills localized joint pain tenderness, very specific to the site of infection (knees are most common can be unilateral) swelling redness heat |
| Symptoms | fever/shaking chills localized joint pain tenderness, very specific to the site of infection (knees are most common can be unilateral) swelling redness heat |
| Risk factors | existing joint problem, IC, rheumatoid arthritis (immune response related disease); complications 5-7 days - degeneration perm damage |
| Diagnosis | fluid biopsy, culture, blood test, imaging (CT/MRI) |
| Treatment | AB, surgical, drain joint multiple times to dryness (removing bacteria) |
| Plasmodium | P. falciparum:36-48(cont. F&C) P. malariae:72hr F&C [P. vivax P. Ovale]>48hr F&C {P. knowlesi} vector:female anopheles mosquito feeds during dusk 5-7pm |
| Life cycle of malaria | inf f. mosq bite(sporozoites salavary glands) blood stream to liver {exo-erythrocytic cycle} cells and infect them:larval stages: trophozoite, merozoite, schizont |
| Schizont ruptures | migrates to RBCs erythrocylic cycle that occurs withing RBCs and some gametocytes can travel as sporozoans into the stomach of the mosquito |
| Definitive host | mosquito, where sexual reproduction of the invader Sporogonic cycle occurs |
| Symptoms from malaria | periodic F&C {hatch times and species plasmodium} anemia, hepatomegaly (liver enlargement), spleenomegaly, COUGH, NAUSEA/Vomiting, back pain, myalgia/arthalgia, headache (no headache -> Dengue) |
| Intermediate host | human, asexual reproduction of the invader |
| Diagnosis | blood smear (ring phase), antibody test/PCR |
| P. falciporum | Organ disfunction:CNS, kidney failure, respiratory failure, Complications: tropism (drawn to pregnant women & cause stillbirths) Rx chloroquine |
| Rx for malaria | Asia, Artemethes; US, mefloquin/larium, doxycycline (prophylactic for travelers 1-2 wks prior & 4 wks after) |
| P. vivax & P. ovale | hypnozoites, reinfect the liver and hideout w/o releasing, latent protozoans as much as 30 yrs Rx primequine targets the liver |
| Resistance to malaria | co-evolution sickle cell anemia (RBCs elongated & crescent shaped in response to plasmodium), Duffy antigen, chemokine receptor site is absent, G6P |
| Babesi microti | sporozoan NE-coastalUS vector-tick lxodes & reservoir-white footed mouse *"malaria"-> no liver stage |
| Flagellates | leishmania, tropica (S.&C.America), chagesii (Africa), major & brazillienzia (S. America) donavania (Mid East) vector-sandfly promastigote reservoir-dogs, rodents |
| Flagellates forms disease takes | Cutaneous (single lesion-oriental scar,1yr & diffuse lesion-nodules,20yrs block blood flow cause organ failure), mucocutaneous (necrotic 2ndary infections w/bacteria), & visceral (occurs over course of mo. after initial bite anorexia anemia death |
| Trypanosoma bruceii | rhodiesiants (E.Africa wks) & gambiense(w.Africa mo.) {causes African Sleeping Sickness} vector-tsetse fly:1st hand-rash painful ulcer at bite site 2wks, fever headache lymph swell, fever subside/relapse mo., CNS sym |
| CNA symptoms trypanosoma b. | drowsiness,behavioral changes, slurred speech, gait, coma & death |
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