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39 Cards in this Set

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Chlamydia is an obligate intercellular bacteria, what does that mean?
It means it needs the cell host to cell ATP from; can't survive on their own.
Describe the morphonlogy of Chlamydia: (4)
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
What do you use to treat Chlamydia?
Erythromycin
Does Chlamydia contain DNA or RNA?
BOTH!
What is Chlamydia's virulence factor?
Heat shock proteins that cause a potent inflammatory response.
Describe the two forms in the reproductive cycle of Chlamydia:
1. Elementary body - infectious form

2. Reticulate body - replicates through binary fission
What are the three types of Chlamydia?
C. Trachomatis
C. Pneumoniae
C. Psittaci
What are the clinical manifestations of each of the three types of Chlamydia?
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.
How are the three types of Chlamydia Dx-ed?
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)
What bacteria that causes pneumonia lacks cells walls?
Mycoplasma - but has a triple layer membrane
What is the pathogenesis of Mycoplasma?
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!
What is the mneumonic for Mycoplasma?
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!!
Who are mainly effected by mycoplasma induced pneumonia?
Young individuals (just like C. Pneumoniae)
What is the treatment of Mycoplasma?
Eythromycin (NOT TREAT WITH MACROLIDES)
SQ:

What is responsible for the unique mobility of Treponema Pallidum and the other spirocetes?
They are helical shaped and have axial fibrils which wind around the cell wall of the organism!
SQ
What is the mechanism of transmission of Treponema Pallidum?
Sexual contact
Is Treponema Pallidum visible by light microscope?

What else shares the same?
What two are opposite?
Treponema Pallidum = not visible
Leptospira Interrogans isn't either

Both Borrelia recurrentis and burgdorferi are visible by light microscope.
SQ
Widespread dissemination of Treponema Pallidum first occurs during what stage?
Secondary stage
Persons with syphilis are infectious for sex partners during which stages of the disease?
Primary and Secondary
What is the pathogenesis of Treponema Pallidum?
Passes through intact mucus membrane or abraded skin and multiplies locally in subepithelial tissue --> disseminates to lymph nodes and other organs.
What is the pathologic lesion of Treponema Pallidum?
Obliterative endarteritis
What stages of syphilis are self-limiting?
Primary and secondary
If immunity to reinfection after treatment for syphilis enough to prevent reinfection?
NO!
Mainfestations of primary syphilis?
Red ulcerative lesions (chancre that has a crusted dry base) at site of incoulation.
Mainfestations of secondary syphilis
Mucocutaneous rash with generalized lymphadenopathy & Papulosquamous rash over entir body (including palms and soles)
How is latent syphilis diagnosed?
With the presence of a positive treponemal serologic test in the absence of clinical manifestiations and a normal CSF examination.
What are the Manifestations of late syphilis?
1. Neurosyphilis
2. Cardiovascular - aneurysms in proximal aorta
3. Benign "gummatous" - granulomatous lesion in skin and bones.
What is congenital syphilis?
Infection of baby during birth; baby will look ok until multiorgan involvement is clear later with rhinitis, rash, teeth problems, spleen, liver prob.
What are nontreponemal reaginic tests?

What are they used for?
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
What are specific treponemal tests? Used for?
1. FTA-AB (Fluor Treponemal Ab Absorption Test)
2. MHA0TP (Microhemagglut. T. Pall)

Used to eliminate chance of false positive.
What is the treatment for syphilis?
Benzathine Penicillin G
What is Jarisch Herxheimer Reaction?
Fever, chills, headache, and hypotension after treatment (toxic products released)
Does Borrelia have a animal reservoir?
Yes
What is Relapsing Fever?
Disease caused by Borrelia recurrentis. That induces a systemic illness of fever, chills, and muscle pain.
What causes relapsing fever?
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.
How does Borrelia Recurrentis exist in ticks?
Via transovarial passage
Mneumonic for Lyme disease:
On a lime:

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

How is Borrelia burgdorferi transmitted to humans?
via ticks
Describe the two stage illness of Letospirosis:
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