Week 07 - Microbiology contd

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mewinstanley@googlemail.com
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130969
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Week 07 - Microbiology contd
Updated:
2012-02-02 09:25:01
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microbiology
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GI infections, tropical diseases etc.
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  1. For Campylobacter Jejuni give
    -microbiology
    -pathology
    • Microbiology
    • curved gram neg bacilli
    • majority of all 'food poisoning'

    • Pathology
    • inflamm, ulceration & bleeding of SI & LI
    • bacteraemia
    • assoc w Guillan-barre
  2. For Salmonella give
    -Microbiology
    -Pathology
    -Clinical features
    • Microbiology
    • gram neg bacilli
    • enterobacteriaciae

    • Pathology
    • Typhi & Paratyphi cause enteric fever
    • diarrhoea → invasion of epithelial in distal SI
    • bacteraemia

    • CF
    • incubate 6-48hr
    • watery diarrhoea, Bad fever
  3. For Shigella give
    -Microbiology
    -Pathology
    -CF
    • Microbiology
    • gram neg bacilli
    • enterobacteriaciae

    • Pathology
    • att to mucosal epithelium of terminal ileum & colon
    • prod shiga toxin → damage epithelium, target glomerular epithelium [HUS]

    • CF
    • incubate 1-4d
    • duration 2-3d
    • watery diarrhoea → bloody diarrhoea
    • cramping abdo pain
  4. For Vibrio Cholerae give
    -Microbiology
    -Pathology
    -CF
    • Microbiology
    • comma shaped gram neg bacilli

    • Pathology
    • contaminated water
    • penetrate intestinal mucus → flagellae + mucinase
    • Att to mucosa
    • Diarrhoea due to exotoxin [^cAMP, fluid & electrolyte loss]

    • CF
    • Cholera
    • Rice water stool [severe profuse non-bloody]
    • profound fluid loss [cardiac shock]
  5. For E.Coli outline the various types & their main pathological features.
    • Enteropathogenic EHEC → attaching effacing lesions, infants & children, travellers
    • Enterotoxigenic ETEC → Heat-stabile & Heat-labile toxins, developing world infant diarrhoea
    • Enterohaemorrhagic EHEC → 0157:H7, attaching effacing lesion + shiga toxins cause HUS
    • Enteroinvasive EIEC → endocytosed into LI, blooody diarrhoea
    • Enteroaggregative EAEC
    • Diffuse Aggregative DEAC → fimbraie facilitate adherence
  6. For H. Pylori infection give
    -Microbiology
    -Pathology
    -CF
    -Tx
    • Microbiology
    • Gram neg spiral bacilli
    • Urease +ve [Dx via urea breath test]

    • Pathology
    • cytotoxin production
    • adhesion & colonisation of gastric environment
    • digest mucus → ulceration

    • CF
    • duodenal ulcers

    • Tx
    • Clarithromycin + Metronidazole + PPI
  7. Define Diarrhoea?
    • Abn frequency and/or fluid stool
    • small bowel infection
    • >200mls stool
  8. Define Dysentery
    • inflamm of large bowel
    • blood & pus in faeces
    • pain, fever & abdo cramps
  9. For Foetal Life
    -What are the defences?
    -What are the infections?
    • Defences
    • Physical barrier of uterus
    • Vulnerable to blood borne

    • Infections → TORCH
    • Toxoplasma
    • Other → Syphilis, HIV, PArvovirus, chicken pox, measles
    • Rubella
    • CMV
    • HSV
  10. For the Perinatal period
    -What are the defences?
    -What are the infections?
    • Defences
    • Skin & mucous membranes
    • Maturing adaptive
    • Maternal Ig

    • Infections
    • Genital tract orgs → Group B strep, Enterobacteriaciae, Chlamydia, HSV
    • Blood borne → HIV, HBV, HCV
  11. In the baby
    -What are the defences?
    -What are teh offences?

    [Duffy, offences means potential infectious insults to the baby.]
    • Defences
    • Skin & mucous membs
    • Mucousal immunity [IgA]
    • Pasive Ig [If breastfed]
    • Protective gut flora

    • Offences
    • Direct contact
    • food borne → breast milk pathogens
    • Aerosol → bronchiolotis [RSV]
  12. In the Preschool child
    -What are the Defences?
    -What are the offences?
    • Defences
    • Matuer immune system
    • ?Breast milk
    • Parental control 'No Michael, your not allowed to eat poo!'

    • Offences
    • Encapsulated orgs → strep pneumoniae, Neisseria meningitidis, Haemophilus Influenzae
    • Airborne infections
    • Oral exploration behaviour
  13. In the School age child
    -What are the defences?
    -What are the offences?
    • Defences
    • Immunological repetoire
    • Personal hygiene
    • Memory resp

    • Offences
    • Wide exposure
    • Measles
    • Rubella [German measles]
    • Slap cheek [Parvovirus]
    • Scarlet fever [Group A strep]
    • Mumps
    • Chicken pox
  14. Define Immunodeficiency & describe Primary & secondary immunodeficiency with a couple of examples.
    • Immunodeficiency
    • Abscnece of innate/ adaptive immune system

    • Primary
    • inherited
    • exposure in utero to environmental factors
    • Rare
    • e.g. Chronic Granulomatous disease [defective intracellular kill, widespred granulomas]

    • Secondary
    • Due to underlying disease state
    • often during Tx for disease [Ct for Ca/TPx]
    • Common
    • e.g. Neutropaenia secondary to Ct [Dec proliferation of HSc, depletion of marrow reserves → neutropenia]
  15. Outiline the CF, Dx & Tx of PCP?
    • Pneumocystis jirovecii penumonia
    • Bad in immunocompromised

    • CF
    • Fever, dry cough, SOB, hypoxia

    • Dx
    • Induced sputum, BAL, biopsy
    • Methanamine silver stain/PCR

    • Tx
    • ^^dose cotrimoxazole
  16. Give 3 Viruses that are commonly found in the immunosuppressed?
    • HSV 1&2
    • VZV [Chicken pox/ Shingles]
    • CMV
    • EBV
    • HBV [Can reactivate, sAg + → sAg -ve]
    • RSV
  17. What are the 4 main species of Malaria parasite & what are their geographical distributions?
    Plasmodium Faciparum → Africa, E asia, India & S America

    Plasmodium Vivax → SE asia, India, N africa, Central america

    Plasmodium Ovale → W africa

    Plasmodium Malariae → Africa
  18. What are the CF of Malaria?
    Incubation → >8d between bite & infection

    • Fever
    • Irregular → falciparum
    • 2nd day → vivax & ovale
    • 3rd day → malariae [cos theres 3 As in mAlAriAe]

    Cerebral malaria → Falciparum

    Relapse → Vivax & Ovale [Form hypnozoites]
  19. Draw the life cycle of Malaria
    **copy in from 2nd year notes**
  20. Outline Ix for Malaria
    • Blood film
    • Thick → [parasite]
    • Thin → speciate

    Falciparum → ^^parasitaemia, banana shaped gametocyte

    Also Ag testing & PCR DNA detection
  21. What is Schistosomiasis & what are the CF?
    Trematode infection

    • Acute CF
    • Penetrate skin → local dermititis [swimmers itch]
    • Symptom free for 3-4wk
    • Systemic allergy features appear [fever, rash, myalgia, pneumonitis]
    • Eggs present in stool

    • Chronic CF
    • Ulceration & Calcification of bladder
    • Bloody diarrhoea
    • Liver haemorrhage
    • Epilepsy & Paralysis [Eggs in CNS]
  22. What is Giardiasis? What are the CF?
    Non invasive protozoal infection of small intestine

    • CF
    • 12-15d incubation
    • Nausea, low grade fecer, chills
    • Eplosive watery fould diarrhoea
    • Belching, dehydration, weight loss
    • Can lead to IBS
  23. Outline the life cycle of Giardia lamblia
    • faecal oral spread
    • Cyst/Trophozoite ingested from faeces
    • survive stomach acid & migrate to SI
    • acid → excystation → release trophozoites
    • Attach to villi
    • asexual multiplication
    • migrate towards LI → encystation
    • mature cysts & trophozoites excreted in faeces
    • No intermediate host
  24. What are the encapsulated organisms?
    • Strep Pneumoniae
    • Neisseria Meningitidis
    • Haemophilus influenza

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