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micro 1
the infectious process: pathogenesis and manifestations
80
Science
Graduate
01/12/2010

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Term
infectious disease
Definition
Term
communicable disease
Definition
contagious/transferable disease from one human to another
Term
pathogen
Definition

An agent that causes infection or disease, especially a microorganism, such as a bacterium or protozoan, or a virus

*causing damage to cells tissues


Criteria for pathogen to be causing an infectious disease:

1) organism must get into biological space

2) as it lives, grows, & reproduces, it MUST do damage

3) mustbe able to avoid the removal of bacteria by your normal immune system.

Term

virulence

&

characteristics determining virulence

Definition

Extremely infectious, malignant, or poisonous. Used of a disease or toxin.


 

* degree of pathogenicity/ability and likelihood to cause damage/disease

characteristics determining virulence:

1) protection against nonspecific destruction in the body (nonrecognition & resistance to killing).

2) invasiveness & tissue destruction

Term
colonization
Definition
the ability to grow and reproduce
Term
toxigenicity
Definition

***production of exotoxins:

 

***production of bacterial endotoxins

 

Term
EXOtoxins
Definition

 

1) toxic proteins from living cell or when it undergoes lysis

2) all exotoxins are PROTEINS

3) often encoded on plasmid DNA

4) proteins can be used to form anti-toxins

 

Term
ENDOtoxins
Definition

1)Lipopolysaccharides from gram - cell walls

2) produce effects when large #s of bacterial cells grow in the body (*especially when they are in the blood stream)

3) cause release of endogenous pyrogens from WBCs, causing fever, activates complement system, macrophages, and the Hageman factor

Term
anti-toxin
Definition

antibodies that can detoxify toxins

immunoglobulins

Term
toxoid
Definition
detoxified toxin, immunogenic, but nontoxic
Term
Sepsis
Definition

 

1. The presence of pathogenic organisms or their toxins in the blood or tissues.

Term
septicemia
Definition
blood poisoning caused by pathogenic microorganisms and their toxic products in the bloodstream
Term
septic shock
Definition
vascular and metbaolic effects from an overwhelming infection
Term
toxic shock
Definition

profuction of exotoxin causing toxic shock syndrome

it is related to a super antigen and release another series of cytokines into the bloodstream.

Term

dosage of pathogen

 

Definition
the greater the dosage, teh greater the likelihood of colonization and infection; may overwhelm normal protective mechanisms
Term
portal of entry
Definition
must enter the body and gain access to site in body that will support colonization via inhalation, ingestion, or broken mucocutaneous barrier
Term
symptomatic carrier
Definition

sheeding organism during the symptomatic phase of disease

(we know one has the disease and we can identify they are sick)

Term

incubatory carrier

Definition

sheeding organisms prior to onset of symptoms

examples:

1) chicken pox (most contagious 3-4 days before "pox" arise and spread via respiratory tract)

2)HIV

Term
convalescent carrier
Definition

shedding organisms after disappearance of primary/acute symptoms

examples: typoid fever (typhoid mary) & syphilis

Term
asymptomatic carrier
Definition

shedding organisms without overt symptoms in carrier, thus not being diagnosed

example: Mumps

Term
specific immune response
Definition

immunoglobulins--antibodies

T cell lymphocytes recognize and attack infected cells

Term
incubation period
Definition
the time between exposure to an infectious disease and the appearance of the first signs or symptoms
Term
prodromal symptoms
Definition
nondescript symptoms such as headache, fever, or acheyness
Term
prodromal period
Definition
indicates onset of infection/disease
Term
acute period
Definition
intense symptoms of the disease arise and the numbers of the organisms are rising
Term
convalescent phase
Definition

phase of getting rid of all the bacteria

(pts may see symptoms are gone when bacteria #s get under the clinical horizon, but there is still bacteria present, so must continue taking antibiotics to fully eradicate pathogens)

Term
clinical horizon
Definition
appearance of symptoms
Term
critical horizon
Definition
the ultimate damage that can be done by a disease
Term
acute primary infection
Definition

virus completely disappears from the body at resolution

Example: Hepatitis A

Term
chronic infection
Definition

disease is present after an amoutn of time and it never drops back down below the clincal horizon.

there is always symptoms and ongoing damage from it

example: Hepatitis B/C

Term
Latent Infection
Definition

disease resolves, but virus goes into hiding and survives in neural tissue w/o symptoms. it re-emerges when immune system is vulnerable. after it resolves again, it still does not disappear.

example: chicken pox/shingles 

Term
subclinical infection
Definition

never rises above the clinical horizon. the immune system responds before symptoms arise.

basis of vaccines ("attenuated/weakened viruses")

Term
self-limiting infections
Definition

disease is not lethal; people always recover

example: common cold

Term
local infections
Definition

only infects one location in the body.

organism causes damage where it reproduces

Term
systemic infections
Definition
more serious. distributed throughout entire body
Term
bacteremia/viremia/fungemia:
Definition
pathogens in blood
Term
secondary infection
Definition

Illness caused by new bacteria, viruses, or fungi becoming established in the wake of an initial infection

 

example: get chicken pox from being infected with varicella/zoster pathogen, but if one scratches the "pox," then could be secondarily infected by Staph. aureus.

Term
margination
Definition
accumulation and adhesion of leukocytes to the epithelial cells of blood vessel walls at the site of injury in the early stages of inflammation.
Term
chemotaxis
Definition

a response involving movement that is positive (toward) or negative (away from) to a chemical stimulus.
chemotaxis, leukocyte,
 the phagocytic activity of neutrophils and monocytes in response to chemical factors released by invading microorganisms.

Term
cytokines/chemokines
Definition
regulatory proteins, such as lymphokines and interleukins that are produced by immune system cells and act as intercellular mediators in the modulation of immune response. Cytokines produced by recombinant
Term
cellular exudate
Definition

 

--Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation.

--An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells.

 


 

Term

phagocytic attachment

Definition

--Chemoattractants draw phagocytes to an area &/or recognize molecules that enhance the binding of phagocytes to their targets

--this enhanceent of binding is opsonization & micromolecules that bind to an antigen and increase the efficiency of phagocytosis are opsonins

--opsonins provide molecular handles for the phagocyte to grab onto

Term
phagolysosomes
Definition

the digestive vacuole formed when the membranes of pre-existent lysosomes within the cytoplasm merge with the phagosome; the lysosomes then discharge their hydrolytic enzymes, resulting in digestion of the phagocytized material.

 


Term
definsins
Definition

any of a group of small antimicrobial cationic peptides occurring in neutrophils and macrophages; they act by binding fungal and bacterial membranes and increasing membrane permeability.

Term

TNF

(Tumor Necrosis Factor)

Definition

--produced by activated macrophages and T cells in response to gr- LPS

--most important mediator of acute inflammation

--mediate recruitment of neutrophils and microphages to site of inflammation by stimulating cells to secrete adhesion factor and chemokines

--potent PYROGEN.

Term
IL-1
Definition

secreted by macrophages

responsible for inflammation and hematopoesis

Term
IL-2
Definition
secreted by T lymphocytes and activates T cells and NK cells (auto/self stimulation)
Term
IL-4
Definition
secreted by T-helper cells and promotes IgE switch and stimulates mast cells
Term
IL-5
Definition
secreted by T-helper cells and promotes IgA switch and eosinophila
Term
IL-10
Definition

--produced by T-helper2 cells, macrophages, and B cells

--suppresses inflammatory responses

--stimulates B cells and mast cells

--limits Th-1 response, promotes Th2 cell development

--inhibits expression of MHCII

 

Term
IL-12
Definition

--produced by macrophages, dendritic cells, Tc cells, NK cells

--promotes Th1 cells, stimulates production of INF-gamma

--enhances immunity

Term

IFN-alpha and beta

(I)

Definition

--inhibits viral replication

--increase expression of MHC I and Tc mobilization

--stimulates IFN--gamma by activated T cells

--activates NK cells

Term

IFN-gamma

(II)

Definition

--produced by Th1 cells

--activates NK cells

--increase MHCI and MHCII expression to help Th cells and APC

--promotes B cell differentiation to plasma cell

--promotes Tc cell differentiation

Term
leukocytosis
Definition

a transient increase in the number of leukocytes in the blood; seen normally with strenuous exercise and pathologically accompanying hemorrhage, fever, infection, or inflammation. 

 

Term
leucopenia
Definition

reduction in the number of leukocytes in the blood below about 5000 per mm3. Types are named for the type of cell,

 


Term
neutrophilia
Definition

--increase in the number of neutrophils in the blood;

--it is the most common form of leukocytosis

-- causes: acute infections, intoxications, hemorrhage, and rapidly growing malignant neoplasms. 

 


Term
lymphcytosis
Definition

excess of normal lymphocytes in the blood or in any effusion

 


Term
neutrophil
Definition

 

--a mature granular leukocyte that is polymorphonuclear

-- neutrophils have the properties of chemotaxis, adherence to immune complexes, and phagocytosis

--increase neutrophils tend to indicate increased bacterial infection

 

 

Term
basophil
Definition

--a granular leukocyte with an irregularly shaped, pale-staining nucleus that is partially constricted into two lobes, and with cytoplasm that contains coarse, bluish-black granules of variable size.

--Basophils contain vasoactive amines such as histamine and serotonin, which are released on appropriate stimulation. 

--responsible for allergic rxns


Term
eosinophil
Definition

--a granular leukocyte with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size.

--increased #s tend to indicate parasitic infection


Term
Monocyte
Definition

 

--a mononuclear phagocytic leukocyte, 13 to 25 μm in diameter, with an ovoid or kidney-shaped nucleus, 

--Formed in the bone marrow from promonocytes

--monocytes are transported to tissues such as the lung and liver, where they develop into macrophages. 

 


 

Term
macrophage
Definition

--hematopoietic stem cells in the bone marrow, which develop according to the stages of the monocytic series until they are monocytes;

--these then enter the blood, circulate for about 40 hours, and subsequently enter tissues, where they increase in size, phagocytic activity, and lysosomal enzyme content to become macrophages.

--Two types, fixed macrophages and free macrophages 

--functions include nonspecific phagocytosis & pinocytosis, specific phagocytosis of opsonized microorganisms; killing of ingested microorganisms; digestion & presentation of antigens to T & B lymphocytes; & secretion of many different products, including enzymes


Term
polymorphonuclear leucocyte
Definition
A type of white blood cell with a nucleus that is so deeply lobated or divided that the cell looks to have multiple nuclei
Term
CBC count
Definition
Complete Blood Count
Term
WBC count
Definition

White Blood Cell Count

White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly.

Term
differential count
Definition

a leukocyte count that calculates the percentages of different types of cells

(Dorland, Newman W.. Dorland's Illustrated Medical Dictionary, 31st Edition. Saunders Book Company, 052007.). 

<vbk:978-1-4160-2364-7>


Term
Shift-to-Left
Definition

  • When we look at doing a blood count, used to count starting with most immature going to immature (left to right) thus "shift to the left"
  • chronic inflammation is indicated by releasing more and more neutrophils, and body resorts to releasing the neutrophils when they are less and less mature

Term
 fever
Definition

--elevation of body temperature above the normal;

--it may be due to physiological stresses such as ovulation, excess thyroid hormone secretions, or vigorous exercise; to central nervous system lesions or infection by microorganisms; or to any of a host of noninfectious processes, such as inflammation or the release of certain materials, as in leukemia.

 

Term
hyperthermia
Definition

  • Malignant hyperthermia: life threatening high temp (not based on endog pyro.) usually occurs from gasseous anesthetics get into brain during a surgery...)(if you can remove the gasseous anesthetics, then the temp will go back down)

Term
endogenous pyrogen
Definition

signals released in the body that reset the thermal set point

Term
drug fever
Definition

  • Drug fevers: (sometimes binds to same receptors as the endogenous pyrogens should)

Term
febrile convulsive response
Definition

Self-limiting tonic/c/one seizure-20-60 seconds. 2-5% of young children exhibit brain stem synaptic immaturity usually disappears with childhood maturity cannot predict susceptibility. The actual damage done to the infant/toddler isn't very severe.

Term
antipyretic therapy
Definition

Self-limiting tonic/c/one seizure-20-60 seconds. 2-5% of young children exhibit brain stem synaptic immaturity usually disappears with childhood maturity cannot predict susceptibility. The actual damage done to the infant/toddler isn't very severe.

Term
ESR
Definition

erythrocyte sedimentation rate

--the rate at which red blood cells precipitate in a period of 1 hour.

Term
acute phase proteins (C-reactive proteins)
Definition
protein found in the blood, the levels of which rise in response to inflammation (an acute-phase protein). Its physiological role is to bind to phosphocholine expressed on the surface of dead or dying cells (and some types of bacteria) in order to activate the complement system via c1q[1].
Term
DIC
Definition

disseminated intravascular coagulation

--Bleeding disorder associated with meningococcal infections occuring when bacteria secrete large amounts of LPS molecules into the bloodstream.

--Symptoms: fever and shock accompany a reduction of clotting elements in the blood. Profuse hemorrahaing occurs in the late stages

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