General Structure
Structure and Pathway of Blood
4 Chambers --> 2 Atria & 2 Ventricles
Arteries --> Arterioles --> Capillaries --> Venules --> Vein --> Back to the heart
Natural Defenses
Is considered sterile; no resident microflora
Phagocytes and antibodies
If bacteria makes its way into the blood, the result is sepsis or septicemia, which activates an immune response resulting in decreased blood pressure and septic shock
Anthrax
Caused by - Bacillus Anthracis (found in soil)
3 Types - Cutaneous (skin), Inhalation (lungs), Gastrointestinal
Transmission - spores get in thru cut or scrape in skin, breathing in spores, eating food or water that is contaminated with spores
Symptoms - Cutaneous - small group of blisters or bumps. Painless skin sore(ulcer) with black center. - Inhalation - fever and chills, chest discomfort, body aches - Gastrointestinal - fever and chills, diarrhea or bloody diarrhea, sore throat, headache, stomach pain, painful swallowing, vomiting
Strep B Disease
Cause - S. agalactiae
Transmission - vertical; found in vaginal flora, can infect baby (25% of women)
Symptoms - fever, respiratory distress, lethargy; meningitis and sepsis in infants
Treatment - ampicillin for pregnant female in 3rd trimester if bacteria is found in the flora and if the baby is it has contracted the bacteria
Ebola and Marburg
Cause - filoviruses / - sense RNA viruses
Transmission - direct contact with infected person and their bodily fluids, bats are reservoir
Symptoms - fever, hemorrhagic skin, mucous membranes, internal organs, death of liver cells, brain edema, lymph tissue, kidneys
Treatment - alleviating symptoms, potential therapies: antibody transfer and vaccine
**97% mortality rate for Ebola // 25% for Marburg
1/5 of rural population in central Africa have antibodies to Ebola
Blood Components
Plasma --> 90% water protein (albumin, antibodies, fibrinogen, electrolytes, gases)
Leukocytes
Platelets
Erythrocytes ( RBCs) carry oxygen
Bacterial Endocaditis
Causative Agent - S. aureus, S. viridians (normal oral flora) Candida Albicans
Transmission - bacteria enters bloodstream and attach to valves or endocardium. healthcare setting may introduce bacteria by long term catheter
Symptoms - fever, chills, new heart murmur, fast heartrate, night sweats, joint pain, small painless red spots on fingers or toes
Treatment - high doses of intravenous antibiotics
Cat Scratch Fever
Cause - Bartonella Henselae
Symptoms - bump/blister at bite or scratch site, swollen lymph nodes, fatigue, fever and headache
Transmission - Cats get by fighting other cats and scratching at infected fleas. Infected cat licks open wounds, or bites/scratches a person
Treatment - Sometimes clears on its own, antibiotics
Mononucleosis "Kissing Disease"
(Viral)
Cause - herpesviridae (Epstein Barr virus) / Infects B cells, can last months to years and remain latent in Bcells/ Can cause Burkitt's lymphoma
Transmission - contact, especially thru saliva
Symptoms - inflammation of lymphatic tissue, headache, fatigue, malaise, enlarged spleen, tonsils coated with grey exudate, secondary bacterial infections
Treatment - rest, antibiotics if there is a secondary bacterial infection
Chagas & Malaria
Chagas - Cause - Trypanosoma cruzi - Transmission - to humans by triatomine bug - Symptoms - fever, subcutaneous inflammation around bite, pseudocysts (aggregation of parasites in lymph nodes), swelling of eye - Treatment - special drugs from CDC
Malaria - Cause - protozoan species Plasmodium - Transmission - Anopheles mosquitos, most common in Africa, India, South and Central America - Symptoms - high fever, nausea, blood vessels obstruction due to clumping of RBCs, tissue ischemia, anemia, jaundice, kidney damage, death - Treatment - Chloroquine and other antiprotozoans, control mosquitos
General Structure of Lymphatic Symptom
Picks up plasma and interstitial fluid from tissues and circulates it throughout the lymph vessels and returns to blood.
Septicemia / Sepsis
Cause - S. Aureus & S. Pneumoniae
Cause of Septic Shock - low BP, collapse of blood vessel due to release of endotoxin
Transmission - direct entry via puncture, surgery or from abscess or UTI, common nosocomial infection following invasive medical procedure
Symptoms - fever, chills, shock, lymphangitis (red streaks)
Treatment - antibiotics
Tularemia "Rabbit Fever"
Cause - Francisella tularensis / category A bioterrorism agent
Transmission - zoonosis from animals (rabbits) to humans, ticks can be vectors. Acquired by cuts, abrasions, inhalation, consumption of contaminated water or meat
Symptoms - enlargement of regional lymph nodes - buboes, high fever, chills, shaking, severe headache, ulcer at site of entry, typhoid tularemia (septicemia that resembles typhoid fever)
Treatment - antibiotics
Yellow Fever
(Viral)
Cause - Mosquito (Very common in South America and Africa)
Transmission - Female Aedes eagypti mosquito lands on hosts skin and bites the host. this mosquito is known as the transmitter of dengue fever.
Symptoms - fever, headache, myalgia (muscle aches), and malaise (discomfort feeling): 3 Stages
1. Period of Infection - Nausea, dizziness, fever, chills
2. Period of Remission - Occurs when the virus starts to clear, and many people start gaining recovery
3. Period of Intoxication - symptoms start to recover, people start to cross fatal illnesses - abdominal pain, renal fatigue, hemorrhage, fever
Treatment - No specific treatment. Supportive care such as; vasoactive medication, fluid resuscitation, vent, treatment of disseminated intravascular coagulation, hemorrhage, secondary infections, and renal and hepatic dysfunction
Toxoplasmosis
Cause - toxoplasmas gondii (protozoan)
Transmission - consumption of undercooked and contaminated meat, contaminated water, coming in contact with cat feces
Symptoms - healthy people tend to be asymptomatic, swollen lymph glands, muscles aches and pains,
Treatment - Pyrimethamine and sulfadiazine, if pregnant, antibiotics can be taken
Lymphangitis
Inflammation of the lymphatic vessels due to infectious agents
Plague
Caused by - Yersinia Pestis (gram-)
Transmission - bites from wild rodents or infected flea bites
Treatment - preventative antibiotics, oxygen, respiratory support, quarantining.
Lyme Disease
Caused by - Borrelia burgdorferi (spirochete)
Common in US
Transmission - carried by ticks (lxodes scapularis) and transmitted to humans, dogs, horses and cows
*master immune invader by switching antigens
Symptoms - flu-like, bulls eye rash at site of bite / stage 2- arthritis, loss of myelin, leads to Alzheimer's and MS like symptoms / stage 3 - 10-20% develop post treatment Lyme disease syndrome. chronic arthritis bells palsy
Treatment - Antibiotics
Dengue Fever
(Viral)
Cause - Any of the 4 types of viruses - DENV 1-4
Transmission - simple mosquito bite. specifically an infected Ades species
Symptoms - appear 4-10 days after infection / high fever, nausea, vomiting, rash, aches and pains. Severe dengue can cause hemorrhagic fever and shock syndrome
Treatment - No specific treatment. Dengvaxia is the only vaccine
Leishmaniasis
Cause - protozoan species Leishmania
Transmission - by sandflies (zoonosis) / more common in tropical countries
Symptoms - high fever, weakness, protrusion of the abdomen due to liver and spleen enlargement. death if untreated, cutaneous and mucosal lesions
Treatment - antimony compounds
Process of Lymph
Lymphatic capillaries carry lymph (excess fluid and plasma proteins) -->To lymphatic vessels --> Passes through lymph nodes to lymphatic vessels where foreign agents are trapped and destroyed by immune cells --> Returns to blood via right (into jugular vein) and left lymphatic ducts (into left jugular and subclavian veins)
Types of Plague & Symptoms
Bubonic - fever, chills, headache, tender, swollen lymph nodes, overall weakness. Bacteria multiply in the lymph nodes, which cause them to swell up and enlarge and even able to be seen through skin called buboes.
Septicemic - fever, severe abdominal pain, shock, internal bleeding. Skin can turn black and die, mostly extremities. Can form into bubonic if not treated
Pneumonic - fever, headaches, pneumonia, SOB, chest pain, watery and bloody mucus. most dangerous of the plagues. easily spread thru droplets
Rocky Mt Spotted Fever
Cause - Rickettsia rickettsii
Transmission - arthropod vector (ticks), they defecate as they bite the host then scratches bacteria and feces into skin, or by saliva
Symptoms - fever, headache, weakness, rash on ankle, wrists, palms, and soles. 20% fatalities if untreated due to CNS involvement
Treatment - antibiotics
Zika Virus
Cause - arthropod virus. Flavivirus / attacks female reproductive system, cardiovascular system, and immune system.
Symptoms - fever, rash, conjunctivitis, microcephaly in babies, irregular palpitations, and immunodeficiency
Transmission - Mosquito bites, mother to child or sexual contact
Treatment - None
Filariasis
Cause - roundworms ( W. bancrofti)
Transmission - microfilariae and larvae by mosquitos
Symptoms - inflammation of lymph ducts, fever, blockage of lymph channels which leads to elephantiasis (enlargement of limbs)
Treatment - diethylcarbamazine, metronidazole, swollen limbs are wrapped in pressure bandages to force lymph from