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Medical micro
1. Incubation period.
Incidence and
geographical distribution.
Aetiology and associations.
Clinical symptoms
and presentation.
Pathology.
Diagnosis and differential.
Treatment - preventative
- curative
Course and prognosis.
Complications.
2. Incubation period.
A few weeks to years
Incidence and
geographical distribution.
Worldwide. High in HIV Treatment - preventative
and deprived areas - curative
BCG useful for prevention.
Aetiology and associations.
Triple+ Rx for active
Mycobacterium tuberculosis
Infections.Rifampicin,
Primary and secondary
isoniazid, ethambutol
infections
+ or - pyrazinamide
Diagnosis and differential.
Microscopy and culture Course and prognosis.
Clinical symptoms Slow course usually.
and presentation. Prognosis variable
Fever, cough, organ
dysfunctions Complications.
Healing with fibrosis,
Pathology. calcification and/or
Granuloma formation. cavitation
Heals with fibrosis and Tuberculosis
calcification. Cavitation
in lungs
3. Incubation period. Diagnosis and differential.
2-10days, commonly Microscopy of organism on
3-4 days sin scarification. Culture
from blood and/or CSF
Incidence and Treatment - preventative
geographical distribution. - curative
Epidemic and endemic. Give contacts rifampicin
More common in or ciprofloxacin. Give
crowded conditions patients ceftriaxone or
Aetiology and associations. Penicillin + treatment
Infection with Neisseria of hypotension etc.
meningitidis
Course and prognosis.
Clinical symptoms Fatal if untreated. The
and presentation. earlier the treatment
Meningitic – fever, headache, The better
neck stiffness, haemorrhagic rash.
Septicaemic – hypotension and shock Complications.
(meningeal signs may be later) Neurological damage,
organ system damage,
Pathology. death
Organ and blood
vessel damage Meningococcal infection
7. Other common causes of meningitis include:
Streptococcus pneumoniae
Haemophilus influenzae
8. Incubation period. Pathology.
Variable, probably a day or Sepsis
so from introduction of
organism Diagnosis and differential.
Necrotising fasciitis. If on
Aetiology and associations. lower limb DVT
Infection usually with Strep.
pyogenes to give erysipelas
Treatment - preventative
(a superficial infection with
- curative
sharply defined borders) or
Penicillin + flucloxacillin
Staph. aureus to give cellulitis
An erythromycin or
(a deeper infection with less
clindamycin
well defined borders).
Organism introduction via skin
breeches or other infections (eg. Course and prognosis.
Athlete’s foot) Variable.
Clinical symptoms Complications.
and presentation. Lymphangitis, lymphadenitis,
Symptoms and signs of septicaemia
inflammation
Cellulitis/erysipelas
9. Incubation period. Diagnosis and differential.
2-5 days usually Clinical plus microscopy
and culture
Incidence and
geographical distribution. Treatment - preventative
Areas with low immunization - curative
rates, often children, Vaccination for prevention
Antitoxin + antibiotic +
Aetiology and associations. isolation
Corynebacterium diphtheriae
Infection, usually of the throat Course and prognosis.
Variable
Clinical symptoms
and presentation. Complications.
Throat and/or laryngeal Heart and nervous
infection with membrane system damage, respiratory
obstruction, death
Pathology.
Respiratory obstruction +
Toxin production to harm heart, Diphtheria
or nervous system
13. Clinical symptoms
and presentation.
LOWER URINARY TRACT SYMPTOMS
“CYSTITIS”
•Possibility of no symptoms Fifty percent chance of UTI
•Pain/burning on micturition if one or more symptoms.
•Frequency and nocturia Exclude vaginal discharge/
•Urgency irritation then chance of UTI
•Cloudy urine about 90 percent
•Malodorous urine
•Suprapubic pain
•Haematuria if “full house” of other symptoms
Patients are usually afebrile
do not have lateralised back pain
do not have chills or rigors
14. Aetiology and associations. Diagnosis and differential.
CAUSES OF “CYSTITIS”
•Bacterial urinary tract infection
•Chlamydia
•Trichomonas
•Candida
•Viruses
•Trauma – sexual intercourse
•Allergies
•Senile vaginitis
E.coli in 89 percent
Staphylococcus saprophyticus in 5-15 percent
15. Clinical symptoms
and presentation.
UPPER URINARY TRACT INFECTIONS
“PYLEONEPHRITIS”
•Usually, but not always, symptoms of cystitis
•Fever
•Chills or rigors
•Lateralised back pain
•Pain on percussion over kidneys
•Patients are systemically unwell.
17. Formation of poisons Bacterial cell wall damage
Hexamine Treatment - preventative Cephalosporins
- curative Penicillins (ampicillin/
Multifactorial Amoxicillin)
Aminoglycosides Teichoplanin
(mostly on bacterial Vancomycin
Lipopolysaccharides)
Ribosomes (site of
Metabolic protein synthesis)
Pyrimethamine
Protein synthesis impairment
Sulphonamides
Chloramphenicol
Trimethoprim
Clindamycin
Erythromycin
Nucleic acid synthesis Fusidic acid
Metronidazole Linezolid
Nitrofurantoin Nuclear apparatus Tetracyclines
Quinolones (bacteria do not have
Rifampicin a true nucleus)
18. Treatment - preventative
Incubation period.
- curative
About 18 days
VZV Immunglobulin given
Incidence and Early does not prevent
geographical distribution. Disease but reduces its
Worldwide, except where Severity
Vaccination practiced Aciclovir and similar
drugs stop progressing
Aetiology and associations. infection
Infection with Varicella- Course and prognosis.
zoster virus from someone Mostly heals without
with chickenpox or shingles scarring. Pneumonia
especially in the pregnant
Clinical symptoms
and presentation. Complications.
1-5 crops of itchy vesicles Secondary bacterial
over about one week in a skin sepsis, encephalitis
centripetal distribution
Diagnosis and differential.
Herpes simplex infection.
Other rare “poxes”
Chickenpox
21. Incubation period. Diagnosis and differential.
Usually years after Culture or electron
chickenpox microscopy of virus
Incidence and Treatment - preventative
geographical distribution. - curative
Worldwide Aciclovir and similar
drugs, if given early,
Aetiology and associations. Will miminse further
Reactivation of VZV which damage and (slightly)
had been acquired during an reduce incidence of
Attack of chickenpox. zoster associated pain
Shingles can thus transmit
chickenpox but not shingles Course and prognosis.
Heals with scarring.
Zoster associated pain,
Particularly in the elderly
Clinical symptoms
and presentation.
After a dermatomal prodrome
of itching or pain there is a Ophthalmic shingles
dense simultaneous confluent
chickenpox eruption.
22. Incubation period. Diagnosis and differential.
7-17 days, usually Chickenpox or monkeypox
10-12 days
Treatment - preventative
Incidence and - curative
geographical distribution. Vaccination pre and
Who knows what who post exposure.
Might have in a deep freeze? Certain anti-retroviral
drugs are probably
Aetiology and associations. effective
Infection with Variola virus
Course and prognosis.
Fatality rate between
Clinical symptoms 20-40%
and presentation.
Dense simultaneous eruption Smallpox Complications.
of a centrifugal seep-seated rash Scarring, death
23. Incubation period. Diagnosis and differential.
About 10 days to fever in Other viral rashes. Drug
the prodrome, about 14 days Rashes seldom spread from
to the rash above downwards and
rarely stain.
Incidence and
geographical distribution. Treatment - preventative
Was worldwide and “every - curative
child had it” before Vaccination is
vaccination. highly effective
Aetiology and associations.
Measles virus Course and prognosis.
Rash lasts for about
Clinical symptoms four day and then
and presentation. begins to stain
Patients have high fever
and may be very unwell
in the prodrome. Complications.
Bacterial pneumonia,
Patients have respiratory
tract symptoms including
Measles encephalitis
cough and coryza.
Rash spreads from above
downwards and stains
within a few days
26. Incubation period. Diagnosis and differential.
6 weeks to 6 months to Uncomplicated but unusual
seroconversion illness (if infections or neoplasms
any), average of 10 years
from infection until AIDS Treatment - preventative
(in the untreated), average - curative
of 14 months from AIDS to Prevention – avoid or minimise risk
death (in the untreated) Cure not possible: long term HIV
Incidence and
HIV infection Suppression is the aim. Neither cure
useful vaccination will occur soon.
geographical distribution.
Worldwide. Main reservoir (2003) Course and prognosis.
is in sub-Saharan Africa. Depends on access to high
technology and highly
expensive medical care
Aetiology and associations.
Infection with Human Immune Deficiency virus Complications.
Clinical symptoms Of immune deficiency AND
and presentation. from the multiple drugs used
Mostly opportunistic infections and
neoplasms associated with immune
deficiency.
27. Pathology. HIV AND HOST DEFENCES AGAINST INFECTION
Localisation and combination with
Progressively antigens and, ideally, destruction of
Organism or cells bearing its associated organisms
reduced in number Antigens are attacked directly
and function -> INFECTING ORGANISM
intracellular T (THYMUS DERIVED) LYMPHOCYTES
Are responsible for cell mediated immunity
ATTACKED BY:
Opsonification
infections which deals with intracellular pathogens and Precipitation
neoplasms. They also produce lymphokines Agglutination
and inflammatory mediators Neutralisation
Complement activation
Phagocytic PHAGOCYTIC SYSTEM IgM “reacts against surfaces of
functions stay A rapid relatively non-specific defence
system which eats up invading pathogens
invading pathogens” and is the
the first immunoglobulin to rise
normal until and destroys them and/or presents in an acute infection.
relevant antigens to the immune system
late-stage disease
IgG “protects bodily fluids” and
B LYMPHOCYTES Rises later than IgM and a rise in
Reacting B lymphocytes react with their IgG indicates an infection at some
own target antigens and change into plasma Time. A greater than fourfold
cells which produce immunoglobulins (most change in concentration to a
of which are antibodies specific organism on paired sera
examination suggest an acute
infection.
Polyclonal stimulation ->
IgA “protects body surfaces.”
hypergammaglobulinamia but
IgD. Function in largely unknown.
functionally hypogammoglobulinaemic
IgE is responsible for some allergic
reactions. It does not play a significant
part in most infections
