Microbiology & Immunolgy

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Staining

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allows clinician to determine *shape* of organism

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Gram +

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stain blue
thick cell wall
2 layers
No periplasmic space/porin channel
NO ENDOTOXIN

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Gram -

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stain red
thin cell wall
3 layers
(selective entry - highly resistant)

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What caused TB?

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*bacteria* call mycobacterium tuberculosis
require acid-fast stain

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Spirochetes require

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dark field microscopy

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What are most disease causing organisms?

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gram - RODS
gram- PLEOMORPHIC bacteria

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all streptococcus are ___________

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catalase negative

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3 groups based on their ability to hemolyse RBC's

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BAG!
Beta-hemolytic streptococcus
Alpha-hemolytic streptococcus
Gamma-hemolytic streptococcus

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Beta-hemolytic streptococcus

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completely lyse RBCs
hemolytic ability --> production of hemolysins (blow up!)
Groups A-U
Group A are most important human pathogens
S.pyrogens produces streptokinase (disolves clots) and hyaluronidase (spreading factor)

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Alpha-hemolytic streptococcus

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partially lyse RBCs

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Gamma-hemolytic streptococcus

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unable to lyse RBCs

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staphylococcus

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GENERALLY harmless
powerful arsenal of enzymatic and exotoxis weapoins
penicillin-G resistant (streptococcus is not)
*grape like cluster*
abscess formation

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staphylococcus aureaus

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atttacks white blood cells
MRSA (Methicillin Resistant STaphylococcus Aureus)
MOST resistant disease-causing organism

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Clostridium

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gram + rod - tetanus
casuses lockjaw
** spores are generally DUST BORN **

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Neisseria

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Gram - cocci
meningitis and gonorrhea

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Spirochetes

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gram - spiral shaped
syphilis
lyme disease

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Lactobacillus

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created an acidic environment
(considered aciduric)
produces lexan (not dextran!)

***associated with advanced carious lesions DEEP in enaml AND are aciduric****

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Actinomyce

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root caries

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Cocci

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spherical

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bacilli

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rods
most of dieases causers

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spiral forms

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comma shaped
s shaped
spiral shaped

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pleomorphic

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lacking distinct shape

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appendage bacteria

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arms and legs

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filamentous bacteria

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hair

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Growth phase of bacteria

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There are 4- but know 2!
** Lag phase **
** Logarithmic **
stationary phase
death phase

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lag phase

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growth is SLOW at first while they acclimate to their environmant
**cellular metabolic activity was NOT increased during the LAG PHASE**

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Logarithmic phase

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"exponential" phase
growth occurs exponentially
****phase that the organism is most prone to physical and chemical agents!!!!!**
(they're too busy having sex so we can kill them)

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Metabolic Characteristics of Bacteria

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#5 pg. 178

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obligate aerobes

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need air to live!
*neisseria
*pseudomonas
*legionella
*mycobacterium (tb)

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faculative anaerobes

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can grow in abscence of o2 by using fermentation
*staphylococcus
*listeria
*actinomyces (root caries!)
*most ofther gram - rods
^ all the bad guys!

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microaerophilic bacteria

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use fermentation
can tolerate low amounts of O2 because they have superoxide dismutase
*streptococcus
*spirochetes
*camphylobacter (implicated in pregnancy gingivitis)

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obligate anaerobes

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HATE oxygen!
Prevotella (HORMONAL gingivitis, facial cellylitis and NUP/NUG)
Porphyromonas gingivalis ( <important pathogin for perio!! Have fimbrea that adhere to epithelial and tooth surfaces!! Produces COLLAGENASE (an enxyme capable of breaking down collagen in connective tissue and periodontal attachment apparatus)

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normal flora of skin and mucous membrane ___________ fungi.

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suppress

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fungi are what type of cells?

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eukaryotic

(we are prokaryotic)

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What drug is used TOPICALLY to treat oral candidiasis?

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Nystatin

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What drug is used SYSTEMICALLY to treat oral candidiasis?

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Fluconazole

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Candidia albicans

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most common funus
can invade tissed of individuals with impaired resistance (exist among normal flora)
superficial candidiasis appears as thrush
systemic infection of candida may involve the ESOPHAGUS

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Viruses

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energy-less
must have *host cell*
capsid
may have envelope or may be naked -both are hard to treat

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host range

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different kinds of organisms a virus can infect

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helical or icosahedral

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20 faces (shape)

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once a host cell has been infected by a virus there are four possible outcomes:

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death
transformation
latent infection
chronic slow infection

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classification of viruses is based on:

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type and structure of viral nucleic acids (RNA or DNA ---NEVER both!!)

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primary function of mRNA

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TRANSLATION

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Transcription

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is from DNA and RNA

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epstein bar

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is the herpes virus family
causes infectious mononucleosis (Mono!)
one of the most common human viruses

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Measles

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**********can cross placental barrier!!!**********
Koplik's spots (small red-based lesions with blue centers in the mouth)

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coxsackie virus

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herpangina (NOT herpes virus)

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4 RNA hepatitis viruses:

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Hep A (HAV)
Hep C (HCV)
Hep D (HDV)
Hep E (HEV)

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1 DNA hepatitis virus:

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Hep B (HBV)

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intact virus is called ________

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a Dane particle

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anti-HBsAG are _________
(HBV)

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PROTECTIVE (confers immunity

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HBeAg
(HBV)

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active infection and viral growth

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Hepatitis B vaccine is an example of

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artificial acquired active immunity

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gamma globulin is an example of

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passive immunity

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HBsAg
(Serology of HBV)

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DISEASE (acute or chronic)

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Anti-HBsAg
(Serology of HBV)

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immune; NO ACTIVE DISEASE

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HBcAg
(Serology of HBV)

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acute, chronic or resolving infection

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HBeAg
(Serology of HBV)

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High infectivity and active infection

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Anti-HBeAg
(Serology of HBV)

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low infectivity

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Immunity is less than optimal at ______

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either end of life

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immune system main function

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prevent or limit infections by microorganisms

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two systems:

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cell mediated immunity
antibody mediated (humora) immunity

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Cell-mediated Immunity

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T-cells
defense against infections (especially mycobacterium tuberculosis (tb), viral and fungal***)
allergic response (poison oak)
graft and tumor rejection
REGULATION of antibody response

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Antibody-mediated (Humoral) Immunity

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B-cells
Allergic response (hay fever)
autoimmunity

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Specificity of Immune Response involves

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recognition, activation, and response
may be natural (innate)
or acquired (adaptive)

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Natural Immunity

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non specific
NOT acquired f rom previous antigen exposure
does NOT imporve after exposure
Natural immune processes have **no memory**

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Host defenses in natural immunity include

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barriers (skin, mucous membranes)
certain cells (natural killer cells)
phagocytosis
****inflammation***
Certain proteins (complement)

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certain proteins (complement)
and the two pathways

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system also know as "the complement cascade"
20+ proteins that circulate in the blood and serve to complement or assist other defensive mechanisms
1. classical- antibody dependent
2. alternative -spontaneous

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Acquired Immunity

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occurs after exposure
mediated with antibodies and t cells
long-term memory
can be passive or active

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Antigens

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Foregness (non-self)
high moleculuar weight
Dosage, route and timing of exposure

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Cells of the Immune system

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Made of leukocytes
produced int he bone marrow

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T Cells

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constitue 65-80% of lymphocytes
T lymphocystes arise in the bone marrow and eventually migrate to the THYMUS to mature

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T helper Cells

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some helper T's turn B-cells on so they can make antibodies

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Types of T cells

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T helper cell (or CD4 T-cell)
T-cytotoxic cell ( the only T cells that can DIRECTLY attack and kill diseased cells - including cancer cells)

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Regulatroy functions of T cells

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Regulates antibody production
cell-mediated immunity
supression of certain immune responses

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B cells

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differentiate into plasma cells and produce antibodies
have capability to form memory cells
antigen-presenting cells
involved in humoral immune response

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antibodies are from _______

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plasma cells
(not B cells!)

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Macrophages 3 main functions

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phagocytosis
antigen transportation, processing and presentation
cytokine production (communication)

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macrophages are responsible for ________

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transporting and processing antigens

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Natural Killer Cells

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kill virus and tumor infected cells
non specific

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polymorphonuclear neutrophils

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most numerous WBC 60%!!!!!!
capable of phagocytosis
migrate in responseto chemotactic factors (diapedesis) - squeezing out
******** FIRST LINE OF DEFENSE!!!! ***********

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Dendritic Cells

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key regulator
antigen presenting cell (APC)

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Antibodies (5 classes)

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IgG
IgM
IgA
IgD
IgE

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Fab ( fragment antibody)

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where the antibody binds to antigen

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Fc (fragment constand)

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same configuarion regardless of antigen

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IgG

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secondary response
****only antibody to cross placenta!!!****
capable of activating the classical "antibody" complement pathway

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IgM

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primary response
***largest antibody***
capable of activating the classical "antibody" complement pathway

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IgA

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secretions (saliva)
prevents attachment of antigen to mucous membranes

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IgE

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mediates anaphylactic hypersensitivity by binding to mast cell (makes hystamines)

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Type I- Hypersensitivity Reactions

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Anaphylactic (Immediate)
IgE antibody
bind to mast cells and basophils
histamine
requires previous exposure to allergen
**pallor is NOT a sign of histamine release**

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Type II- Hypersensitivity Reactions

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Cytotoxic
complement-mediated lysis
Example: Rh and transfusion reactions
IgG

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Type III- Hypersensitivity Reactions

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Immune Complex
tissue destruction
IgG

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Type IV- Hypersensitivity Reactions

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Delayed
cell versus antibody mediated
tuberculin skin test (mantoux)

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Autoimmune Disorders

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systemic lupus erythematosus
Rheumatoid arthritis
Scleroderma***

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Scleroderma

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an autoimmune disorder
associated with RAYNAUD'S PHENOMENON and GENERALIZED widening of the PDL space

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Rough endoplasmic reticulum is the cellure site for _______systhesis

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protein

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Amino acids make up _______

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protein

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Amino acids are the _________ unit of protine

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SMALLEST

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Mycobacterium tuberculosis is used to teset _____

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intermediate sterilization

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Bacillus stearothermophilus is used as a __________ for sterilization equipment

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biological marker

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Sodium bicarbonat is a ________ in saliva

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buffer

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Mitochondria are involved with _________

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cellular respiration

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Fibroblasts are the primary cell in the ___________

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periodontal ligament

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Movements of cells to the site of inflammation is known as __________

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chemotaxis