A-Std's

Front 1

Chlamydia is an obligate intercellular bacteria, what does that mean?

Back 1

It means it needs the cell host to cell ATP from; can't survive on their own.

Front 2

Describe the morphonlogy of Chlamydia: (4)

Back 2

1. small rounded
2. have envelop
3. NO peptidoglycans in cell membrane (so beta lactams are ineffective)
4. Have PBP's but penicllin is not effective

Front 3

What do you use to treat Chlamydia?

Back 3

Erythromycin

Front 4

Does Chlamydia contain DNA or RNA?

Back 4

BOTH!

Front 5

What is Chlamydia's virulence factor?

Back 5

Heat shock proteins that cause a potent inflammatory response.

Front 6

Describe the two forms in the reproductive cycle of Chlamydia:

Back 6

1. Elementary body - infectious form

2. Reticulate body - replicates through binary fission

Front 7

What are the three types of Chlamydia?

Back 7

C. Trachomatis
C. Pneumoniae
C. Psittaci

Front 8

What are the clinical manifestations of each of the three types of Chlamydia?

Back 8

C. Trachomatis-
Eye trachoma (ABC), Inclusion Conjuctivtis (DK), Genital tract infection (DK), Lymphogranuloma verereum (L1-L3), neonatal pneumo

C. Pneumoniae - atypical pneumo in young adults (20% of community acquired pneum)

C. Psittaci - severe and fatal pneumonia after presentation of severe headache.

Front 9

How are the three types of Chlamydia Dx-ed?

Back 9

C. Trachomatis - DNA probes of rRNA and PCR (combo with Gonorrhea) - using epithelial cells

C. Pneumoniae - serology IgG/M
C. Psittaci - clinical (serology takes too long)

Front 10

What bacteria that causes pneumonia lacks cells walls?

Back 10

Mycoplasma - but has a triple layer membrane

Front 11

What is the pathogenesis of Mycoplasma?

Back 11

It attaches to cilia and microvillia lining bronchial epithelium mediated by a cell adhesion protein P1 --> binding with P1 interferes with ciliary action and causes an INFLAMMATORY RESPONSE (like a superantigen) --> thickened bronchial tree walls!

Front 12

What is the mneumonic for Mycoplasma?

Back 12

Myco-P1-lasma (only child -myne, myne, mine)

If I don't get an inverted fried egg for breakfast --> give you thickened bronchial tree from my inflammatory response!!

Front 13

Who are mainly effected by mycoplasma induced pneumonia?

Back 13

Young individuals (just like C. Pneumoniae)

Front 14

What is the treatment of Mycoplasma?

Back 14

Eythromycin (NOT TREAT WITH MACROLIDES)

Front 15

SQ:

What is responsible for the unique mobility of Treponema Pallidum and the other spirocetes?

Back 15

They are helical shaped and have axial fibrils which wind around the cell wall of the organism!

Front 16

SQ
What is the mechanism of transmission of Treponema Pallidum?

Back 16

Sexual contact

Front 17

Is Treponema Pallidum visible by light microscope?

What else shares the same?
What two are opposite?

Back 17

Treponema Pallidum = not visible
Leptospira Interrogans isn't either

Both Borrelia recurrentis and burgdorferi are visible by light microscope.

Front 18

SQ
Widespread dissemination of Treponema Pallidum first occurs during what stage?

Back 18

Secondary stage

Front 19

Persons with syphilis are infectious for sex partners during which stages of the disease?

Back 19

Primary and Secondary

Front 20

What is the pathogenesis of Treponema Pallidum?

Back 20

Passes through intact mucus membrane or abraded skin and multiplies locally in subepithelial tissue --> disseminates to lymph nodes and other organs.

Front 21

What is the pathologic lesion of Treponema Pallidum?

Back 21

Obliterative endarteritis

Front 22

What stages of syphilis are self-limiting?

Back 22

Primary and secondary

Front 23

If immunity to reinfection after treatment for syphilis enough to prevent reinfection?

Back 23

NO!

Front 24

Mainfestations of primary syphilis?

Back 24

Red ulcerative lesions (chancre that has a crusted dry base) at site of incoulation.

Front 25

Mainfestations of secondary syphilis

Back 25

Mucocutaneous rash with generalized lymphadenopathy & Papulosquamous rash over entir body (including palms and soles)

Front 26

How is latent syphilis diagnosed?

Back 26

With the presence of a positive treponemal serologic test in the absence of clinical manifestiations and a normal CSF examination.

Front 27

What are the Manifestations of late syphilis?

Back 27

1. Neurosyphilis
2. Cardiovascular - aneurysms in proximal aorta
3. Benign "gummatous" - granulomatous lesion in skin and bones.

Front 28

What is congenital syphilis?

Back 28

Infection of baby during birth; baby will look ok until multiorgan involvement is clear later with rhinitis, rash, teeth problems, spleen, liver prob.

Front 29

What are nontreponemal reaginic tests?

What are they used for?

Back 29

1. Cardiolipin - lecithin-cholesterol mixures present on mito membrane. (Ab's are not directed against T. Pall)
2. VDRL: Venereal Dz Research Lab
3. RPR: rapid plasma reagin

Used to follow treatment of patients and should revert to (-) in 1-2yrs

Front 30

What are specific treponemal tests? Used for?

Back 30

1. FTA-AB (Fluor Treponemal Ab Absorption Test)
2. MHA0TP (Microhemagglut. T. Pall)

Used to eliminate chance of false positive.

Front 31

What is the treatment for syphilis?

Back 31

Benzathine Penicillin G

Front 32

What is Jarisch Herxheimer Reaction?

Back 32

Fever, chills, headache, and hypotension after treatment (toxic products released)

Front 33

Does Borrelia have a animal reservoir?

Back 33

Yes

Front 34

What is Relapsing Fever?

Back 34

Disease caused by Borrelia recurrentis. That induces a systemic illness of fever, chills, and muscle pain.

Front 35

What causes relapsing fever?

Back 35

Antigenic diversity of Borrelia recurrentis -- they escape specific immunity by altering their antigenic structure during infection --> they do this by switching genes from silent locus to active locus.

The relapsing fever is caused by multiplication of antigenic varients.

Front 36

How does Borrelia Recurrentis exist in ticks?

Back 36

Via transovarial passage

Front 37

Mneumonic for Lyme disease:

Back 37

On a lime:

Looks like syphilis and erythema migrans. There is also late cardiac, arthitis, and encephalopathy problems caused by eating this Lime.

Front 38

SQ

How is Borrelia burgdorferi transmitted to humans?

Back 38

via ticks

Front 39

Describe the two stage illness of Letospirosis:

Back 39

1. Bacteremia - fever, headache, muscle ache, abd pain (contact with animal urine)

2. Detectable antibody - aseptic meningitis or generalized illness with myalgias.

Note: these stages can blend in severe disease