2024 Intro & Micro Lecture Handout-11 PDF

Welcome to HTH SCI 2CO6 Dr. Ruth Hannon McMaster University Course Planner HTH SCI 2CO6 Details!!! Contact Information Dr Ruth Hannon Course Planner Email: [email protected] or within A2L Phone: 905‐525‐9140 Ext. 22569 Office: HSC 2J21C (McMaster Campus) If you want to meet, please reach out to bo...

Welcome to HTH SCI 2CO6 Dr. Ruth Hannon McMaster University Course Planner HTH SCI 2CO6 Details!!! Contact Information Dr Ruth Hannon Course Planner Email: [email protected] or within A2L Phone: 905‐525‐9140 Ext. 22569 Office: HSC 2J21C (McMaster Campus) If you want to meet, please reach out to book an appt! Teaching assistant for Grand Rounds/Tutorials Book Power‐Kean, K., Zettel, S., & El‐Hussein, M.T. (2023). Huether and McCance’s understanding pathophysiology, Second Canadian Edition. Elsevier. i>clickers OR Requires subscription Requires you to send email of your remote number Remember: Student ID = MAC ID (NOT student number) Recommended Book Course Code: hannon07107 Adams, M.P., Urban, C.Q., Sutter, R.E., El-Hussein, M., & Osuji, J. (2021). Pharmacology for Nurses: A Pathophysiological Approach, Third Canadian Edition. Pearson Education, Inc. A2L Content Course Outline Student Resources (Handbook) Participation Learning Sequence (Site specific Schedule and Lists for Lectures) Tutorial Information (Grand Rounds info and dates) Course Policies and Procedures Tutorial Absences Midterm exam deferral (and reviewing) Online Modules Weeks at a Glance A2L Communication tab Welcome / Announcements / Discussions Tutorial Discussion Groups Assessments tab Assignments – Grand Rounds individual submissions Quizzes – start next week Grades Email Course Evaluation 15% Online Tutorial Performance Quizzes will be time sensitive for one week only Total of 10 on‐line tutorials and quizzes on A2L Note online tutorials are open, will remain open, and this material is testable 13% In‐person Tutorials 6 Grand Rounds each with 2 care scenarios Information is testable Grand Rounds Leading x 2 over term Facilitating x 2 over term Participation required for each scenario! TA will review groups / grading / expectations during first tutorial Please review tutorial absence policy 2% ‐ Clickers / Participation Participation mark Answer 50% of total questions over term During lectures (some Guest Lecturers) NO penalty for incorrect answers Provides feedback for you (and me!) Requires a paid subscription for your responses to be registered if using the Student App If you have a remote device – send me an email with your remote device number on the back Course Evaluation 15% Online Tutorial Performance 13% Grand Rounds (in‐person) 2% Participation 30% Midterm exam (Week 6) 40% Final Exam (April Exam Time Period) = 100%! HTH SCI 2CO6 What it IS What it is NOT Level 2 course Science course Key topics discussed Assumes that there will be self directed learning plus some lectures Level 1 Course True nursing course Not exhaustive Only lectures HTH SCI 2CO6 Focus Remember: Homeostasis = steady state (1CC6!) Disequilibrium Triggers variety of responses Disease – physiological malfunctioning Pathophysiology / pathogenesis Sign – objective evidence Symptom – subjective perceptions Syndrome – group or combo of S&S HTH SCI 2CO6 Terms Etiology – cause of disease (Epidemiology) Pathology – science or study of disease Pathophysiology – understanding of disease, study of disordered functions or functions altered by disease processes Pathogenesis – sequence of events in development of disease Microbiology Overview and Antimicrobials Ruth Hannon [email protected] Bauman (2018) Table 14.11 Classified according to: Medically Important Bacteria Physical properties Lacking cell wall Rigid cell wall Flexible cell wall Morphology Simple unicellular Filamentous Growth inside or outside host cell Obligate intracellular parasite Free Living Gram‐staining process Gram‐negative Gram‐positive Shape Cocci Rods Cocci Rods Oxygen tolerance Aerobes Anaerobes Adapted from Harvey, Cornelissen & Fisher (2013) Figure 1.4 Medically Important Microorganisms Rickettsia / Actinomyces / diphtheroids Streptococcus / Staphylococcus / Enterococcus Bacillus / Listeria / Clostridium / Lactobacillus Neisseria / Moraxella Borrelia / Syphilis Hemophilus influenzae / Pseudomonas aeruginosa Escherichia coli / Proteus / Salmonella / Klebsiella / Helicobacter pylori Possible Outcomes Harvey, Cornelissen & Fisher (2013) Figure 1.1 Stages of Infectious Diseases Bauman (2018) Figure 14.10 Bacteria Shapes or Morphology Bacteria Cell Walls Enzyme: transpeptidase or PBP Bauman (2018) Figure 3.16 Summary of Differences GRAM POSITIVE  2 layers  Low lipid content  NO endotoxin  NO periplasmic space  Vulnerable to lysozyme and penicillin attack Adams, Urban, Sutter, El-Hussein & Osuji (2021) Figure 43.1 GRAM NEGATIVE  3 layers  High lipid content  Endotoxin (LPS) – Lipid A  Periplasmic space  Resistant to lysozyme and penicillin attack Gram Stain Shapes  Gram positive  6 classic:  2 cocci  Streptococcus  Staphylococcus  4 bacilli     Bacillus Clostridium Corynebacterium Listeria (only positive bacteria with endotoxin!) Shapes  Gram negative    1 cocci – diplococci = Neisseria 1 spiral shaped (spirochete) = syphilis Rest are rods or pleomorphic  Exceptions    Mycobacteria – acid-fast stain Spirochetes – often need specialized dark field Mycoplasma – no cell wall Virulence Factors  Extracellular enzymes     Hyaluronidase Collagenase Coagulase Kinase Bauman (2018) Figure 14.9a Virulence Factors  Toxins  Exotoxins  cytotoxins, neurotoxins, enterotoxins, (antitoxins)  Endotoxins Bauman (2018) Figure 14.9b Comparison Bauman (2015) Table 14.8 Virulence Factors  Antiphagocytic factors Bauman (2018) Figure 14.9c Normal Flora – Microbiome  Same as Commensals  Distribution   Skin: Transient and resident flora Eye, mouth, nose, GI tract, [urogenital tract]  Benefits  Harmful effects Flora Bauman (2018) Table 14.2 Major Action by Antibacterial Drugs Bauman (2018) Figure 10.2 Overview of Antibacterial Drugs Major families:  Penicillins  Cephalosporins  Tetracyclines  Macrolides  Aminoglycosides  Fluroquinolones  Sulfonamides (plus others!) Penicillins  Beta lactam ring  Inhibitors of cell wall synthesis  Bactericidal  Least toxic drug  Examples     Penicillin G & V Ampicillin Amoxicillin (Oxacillin / Methicillin)  Side effects Cloxacillin Piperacillin Cephalosporins  Beta lactam ring  Inhibitors of cell wall synthesis  Bactericidal  Examples     1st generation – Cefazolin/Cephalexin 2nd generation – Cefuroxime, Cefaclor, Cefprozil 3rd generation – Cefotaxime, Ceftazidime, Ceftriaxone 4th generation – Cefepime  Side effects Tetracyclines  Targets protein synthesis  Broad spectrum  Bacteriostatic  Examples    Doxycycline Minocycline Tetracycline  Implications < 8 yrs Macrolides  Inhibits protein synthesis  Bacteriostatic  Commonly used for penicillin allergies  Examples    Azithromycin Clarithromycin Erythromycin  Side effects Aminoglycosides      Inhibits bacterial protein synthesis Large molecule, polar compound Bactericidal Oxygen dependent Examples      Gentamicin Neomycin Streptomycin Tobramycin Amikacin  Side effects Fluroquinolones (Quinolones)  Inhibits replication of DNA  Bactericidal  Examples     1st generation – Nalidixic acid (quinolone) 2nd generation – Ciprofloxacin, Ofloxacin, Norfloxacin 3rd generation – Levofloxacin 4th generation – Moxifloxacin, Gemifloxacin  Side effects  Implications < 18 yrs Sulfonamides  Inhibits folic acid pathway  Trimethoprim  Bactericidal  Sulfamethoxazole  Bacteriostatic  1-part TMP/5-parts SMZ  Single strength  Side effects  Renal, rash, resistance Adams, Urban, Sutter, El-Hussein & Osuji (2021) Figure 44.4 Others!  Vancomycin  Carbapenems – Imipenem, Meropenem  Nitrofurantoin – Macrobid, Macrodantin  Clindamycin  Linezolid  Combinations   Clavulanate (Clavulin) Tazobactam (Tazocin)  [Chloramphenicol] Summary Hannon & Porth (2017) Table 16.4 Medically Important Viruses RNA Double Stranded Icosahedral Nonenveloped DNA Single stranded Single Stranded Nonenveloped Nonenveloped Double stranded Enveloped Positive strand Negative strand Helical Enveloped Nonenveloped Icosahedral Enveloped Isosahedral Helical Adapted from Harvey, Cornelissen & Fisher (2013) Figure 1.5 Viruses  Genome  Capsid/Shape  Envelope  Size Brooks, Butel & Morse (1998) Figure 29.5 Classification – FYI only! Interesting … Bauman (2018) Figure 13.4 Remember… # of organisms Hannon & Porth (2017) Figure 16.6 References Adams, M.P., Urban, C.Q., Sutter, R.E., El-Hussein, M., & Osuji, J. (2021). Pharmacology for nurses, Third Canadian edition. Pearson Canada Inc. Bauman, R.W. (2018). Microbiology with diseases by body system (5th ed.). Pearson Education, Inc. Brooks, G., Butel, J. & Morse, S. (1998). Jawetz, Melnick & Adelberg’s medical microbiology. Appleton & Lange. Hannon, R. & Porth, C. (2017). Porth Pathophysiology (2nd Canadian ed.). Lippincott Williams & Wilkins. Harvey, R.A., Cornelissen C.N., & Fisher, B. (2013). Lippincott’s illustrated reviews: Microbiology (3rd ed.). Lippincott Williams & Wilkins. McCance, K., & Huether, S. (2019). Pathophysiology (8th ed.). Mosby, Inc.