What type of tissue response is associated with bacterial infection?
Which microbes are associated with lymphocyte proliferation?
Name 2 disorders associated with granulomatous response.
What type of microbial infections are associated with a mixed acute/chronic inflammation?
*central neutrophils surrounded by lymphocytes and macrophages (some histiocytes present)
Which microbes are associated with eosinophils?
Which parasites are associated with fibrosis?
What is the tissue response to Clostridia?
necrosis (gas gangrene)
List 2 disorders associated with pseudomembranous inflammation.
clostridium dificile colitis
List 2 locations in the body where Schistosoma reside?
List 2 Schistosoma species that reside in the GIT.
Which Schistosoma species causes carcinoma bladder?
How does Schistosoma morphologically affect the spleen and liver?
hepatosplenomegaly with ascites causes huge abdomens
Describe the development of portal hypertension due to Schistosoma infection.
Eggs discharged into portal triad leads to granuloma formation.
Fibrosis of portal vein causes narrowing and increase in back pressure.
Increased back pressure leads to portal hypertension
What type of gram-stained bacteria is Clostridia perfringens?
What types of wounds are susceptible to Clostridia perfringens?
traumatic & surgical wounds
Name the most important toxin secreted by Clostridia perfringens.
alpha toxin (lecithinase)
Name 3 targets of lecithinase.
What process of cell death causes gas release after infection with Clostridia perfringens?
Diphtheria has affinity for what type of mucosa?
Describe the formation of the pseudomembrane in infection by Diphtheria.
Inflammation is rich in fibrin.
Fibrin binds necrotic mucosal cells and inflammatory cells to form pseudomembrane.
What is the normal WBC number per microliter?
4,000 - 11,000
What is the WBC number per microliter in leukocytosis?
15,000 - 20,000
Review the steps in diagnosis of infectious diseases.
Clinical features (classical history, physical examination)
Knowledge of epidemiology (common infections in the geographic area)
Isolate the organism (pus, blood, tissue, fluids)
Antibody response (rising titers)
Biopsy (type of tissue response, special stains, immunological techniques, PCR)
Identify the gram-staining properties and bacterial arrangement of Neisseria meningitides.
How is Neisseria meningitides transmitted?
In what part of the pharynx does Neisseria meningitides reside?
Describe symptoms of infection by Neisseria meningitides in carriers.
Invasion of bloodstream by Neisseria meningitides.
Invasion of the meninges by Neisseria meningitides.
Which "space" of the brain is infected by meningitis?
Describe the gross structure of the meninges in meningitis in reference to color and vasculature.
dull & congested
What type of exudate is associated with meningitis?
Name the immune cells and proteins apparent in meningitis.
DISORDER: fever, headache, cloudy consciousness, neck stiffness.
What causes headaches in meningitis?
increased intracranial pressure due to inflammation of subarachnoid space
What causes neck stiffness in meningitis?
inflammatory exudate in subarachnoid space produces muscle spasms
Describe CSF of a patient with meningitis.
How can one diagnose meningitis?
spinal tap (CSF)
List 3 causes of meningitis (other than Neisseria meningitidis).
DISORDER: fever, tachycardia, hypotension, shock, toxemia, purpura.
DISORDER: bilateral adrenal hemorrhages due to meningococcemia.
Waterhouse Friderichsen Syndrome
List 3 organisms that cause meningitis in neonates up to 2 months.
List 3 organisms that cause meningitis in infancy and childhood.
List an organism that causes meningitis in adolescents.
Name 4 organisms that cause meningitis in people between the ages of 20 and 60.
Describe the gram-staining property and arrangement of Nisseria gonorrhea?
DISORDER: urethritis, epididymitis, urethral discharge and dysuria.
gonorrhea in males
DISORDER: oropharyngitis and proctitis (inflammation of the rectum).
gonorrhea in homosexual males
DISORDER: cervicitis, salpingitis, peritonitis, vaginal discharge, inter-menstrual bleeding.
gonorrhea in women
What inflammatory disease can result in females from gonorrhea?
pelvic inflammatory disease
List 5 secondary effects of gonorrhea (HEART).
Hemorrhagic skin lesions
What organism causes typhoid fever?
Identify the gram-staining property and shape of Salmonella typhi.
What is the usual route of transmission for Salmonella typhi?
ingestion (contaminated food and water)
Describe the development of enteric fever by Salmonella typhi.
Organism enters ileal wall (Peyer's patches) to gain access to the blood stream.
Bacteremia lasts for 1 week.
Enters the lymph node to the mesenteric group and eventually the thoracic duct.
Once in the bloodstream, the organism is taken up by monocytes and phagocytes in the liver, bone marrow and spleen.
Organism proliferates in these organs, where they are lysed and killed by monocytes and macrophages.
They are released once again and produce enlargement of lymphoid follicles and ulcers.
How is the size of the liver affected by Salmonella typhi?
Which immune cells are associated with enteric fever?
macrophages (no PMNs)
List 3 components of typhoid nodules.
Kupffer cell hyperplasia
minute foci of hemorrhagic necrosis
collections of macrophages
How does gonorrhea present in the newborn?
purulent conjunctivitis (ophthalmia neonatorum)
What type of eye drops are used to prevent gonorrhea in the newborn?
erythromycin/silver nitrate eye drops
Identify the gram-staining property and arrangement of Neisseria gonorrhoeae.
Which disorder is associated with erythrophagocytosis (macrophages engulfment of RBCs)?
DISORDER: fever, toxic appearance, leucopenia, bradycardia.
What type of toxin produced by Salmonella typhi causes depression of the heart and bone marrow?
Review diagnosis of enteric fever.
1st week: blood culture (lysis of macrophages releasing large numbers of bacilli into the circulation)
2nd week: organisms in feces and urine
3rd week: antibodies (Widal test)