Microbiology

Bacteria
Should Know
 การใช ้งานกล ้องจุลทรรศน์
เลนส ์ใกล ้ตา

จานหมุนเลนส ์ เเขนกล ้อง

เลนส ์ใกล ้วัตถุ

่ บสไลด ์
ทีหนี
เเท่นวางสไลด ์ ปุ่ มปรับภาพหยาบ
คอนเดนเซอร ์ ปุ่ มปรับภาพละเอียด

หลอดไฟ

ฐานกล ้อง
Gram Stain
วิธก
ี ารย ้อมเเกรม
Bacterial Shape
 Gram reading

gram positive cocci in chain gram positive cocci in cluster gram negative bacilli
 ่ ทยาศาสตร ์
การอ่านชือวิ
“ Binomial nomenclature “ = Genus + Species

Examples

Escherichia coli Escherichia coli

**หากไม่สามารถระบุ species ได ้ ให ้เขียนว่า sp. หรือ spp.

Ex. Samonella spp.
Gram Positive
 Staphylococcus aureus
● Gram positive cocci in cluster
● Catalase + , Coagulase +
● Normal flora found in the upper respiratory tract and on the skin
● Cause of skin and soft tissue infections such as abscesses or cellulitis
Catalase test Coagulase test
 Streptococcus pyogenes
● Gram positive cocci in chain
● Beta hemolysis
● Pharyngitis and Erysipelas
 Streptococcus agalactiae
● Gram positive cocci in chain
● Beta hemolysis
● Normal flora of gut and genital tract
● Neonatal infection : meningitis , pneumonia
● UTI in pregnant woman
Gram Negative
 Vibrio cholerae
● Gram negative curved bacilli
● Shooting star motility
● Free living of saltwater or freshwater
● Cause of rice water diarrhea (Cholera)
 Salmonella spp.
● Gram negative bacilli
● Ingestion of contaminated poultry, egg, meat and exposure to pet reptiles
● Typhoid —> rose spots
 Pseudomonas aeruginosa
● Gram negative bacilli
● Produce blue green pigment
● Medical importance
- Nosocomial infection
- Addict (IV drug abuse)
- Skin (burn, hot tub folliculitis)
Thank You
Parasitology
The common pathogen you SHOULD KNOW.
 Learning guidance

Infective stage Mode of infection

1 2 3 4

Mode of Diagnostic stage

transmission
01 02
Nematodes Arthropods
Hookworm (unembryonated egg) Mosquitoes

03 04
Amoeba Cestodes (tapeworm)
Entamoeba histolytica (trophozoite) Taenia solium & Taenia
saginata (Gravid proglottid)
 01
Nematode
Hookworm (unembryonated egg)
 Hookworm

Infective stage Mode of transmission

Filariform larva in soil Soil transmission

Mode of infection Diagnostic stage

Skin penetration by Unembryonated egg,
filariform larvae in soil larvae in culture media
 Hookworm (Unembryonated egg)

Shape
Ovoidal, bluntly rounded ends

Shell
Smooth, thin, colorless

Embryonic cleavage
2, 4, 8 cell stage

Ref: https://www.cdc.gov/dpdx/hookworm/index.html
Anopheline spp.

Mansonia spp.

02
Arthropods
Mosquitoes
- Anopheline spp.
- Aedes spp.
- Culex spp.
- Mansonia spp.
Aedes spp.

Culex spp.
 Mosquitoes
Order: Diptera

Subfamily: Anophelinae Subfamily: Culicinae

Genus: Anopheles Genus: Culex, Aedes,
Mansonia

Ref: https://kingservice.co.th/en/resource/mosquitoes/
https://www.wrbu.si.edu/vectorspecies/genera/anopheles
https://pt.slideshare.net/BugDoc/mosquitoes-of-georgia/4
 Aedes spp. vs Culex spp.

Snow white scale Pointed end Narrow Wing scale Blunt end

Single, rugby oval-shaped Cluster, cup-shaped corolla

eggs

Ref: https://entnemdept.ufl.edu/creatures/aquatic/aedes_aegypti.htm
https://www.wrbu.si.edu/vectorspecies/genera/culex
 Medical importance

Anopheles spp. Culex spp.

Transmission of Transmission of
● Malaria ● Japanese B encephalitis
● Filariasis (Wucheria bancrofti) ● Filariasis (Wucheria bancrofti)

Aedes spp. Mansonia spp.

Transmission of Transmission of
● Dengue, chikungunya, and ● Filariasis (Brugia malayi)
Zika virus
● Filariasis (Wucheria bancrofti)
 03
Amoeba
Entamoeba histolytica (trophozoite)
 Entamoeba histolytica

Infective stage Mode of transmission

Mature cyst (4 nuclei) Fecal-oral route via food-
borne & water-borne

Mode of infection Diagnostic stage

Ingestion of mature cysts Trophozoites and cysts in
feces
 Entamoeba histolytica, Trophozoite

Central Karyosome

Red blood cell

● Average size: 10 - 60 μm ● Regular peripheral chromatin

● Central karyosome ● Red blood cells ingested
● 1 nucleus

Ref:https://www.medscape.com/answers/212029-38486/following-
ingestion-what-is-the-life-cycle-of-entamoeba-histolytica
https://www.k-state.edu/parasitology/625tutorials/Ehistolytica.html
 04
Cestode (tapeworm )
Taenia solium & Taenia saginata
(Gravid proglottid)
 Taenia saginata Taenia solium

Infective stage Cysticercus bovis Cysticercus cellulosae

Mode of transmission Food-borne transmission

Ingestion of raw beef Ingestion of raw pork

Mode of infection
(Taeniasis) containing C. bovis containing C. cellulosae

Diagnostic stage Embryonated eggs in stool, Gravid proglottid

 Gravid proglottid
T. saginata T. solium
um

Uterine branches > 15 <15

Ref: https://www.microbiologybook.org/parasitology/cestodes.htm
http://www.med-chem.com/para-site.php?url=org/taensoli
 THANKS!
Do you have any questions?
 Anatomical Pathology
& Pharmacology
SLIDESMANIA.COM
 Welcome to lesson
ANATOMICAL PATHOLOGY
SLIDESMANIA.COM
 Hello! We’re...

Faculty of Medicine Vajira Hospital,

SLIDESMANIA.COM

Navamindradhiraj University
 Table of contents

01 Basic Information about

Anatomical Pathology

02 Anatomical Pathology of HSV

Infection

03 Anatomical Pathology of
Peptic Ulcer
SLIDESMANIA.COM
 01
Basic Information about
Anatomical Pathology
SLIDESMANIA.COM
 Anatomical pathology is the branch of medicine that
studies the effect of disease on the structure of body
organs, both as a whole (grossly) and microscopically.
SLIDESMANIA.COM

ANATOMICAL PATHOLOGY
 Anatomical Pathology
To identify abnormalities that can help to diagnose
disease and manage treatment

Two main subdivisions : Histopathology, Cytopathology

Histology technicians and Technologists Pathologist

Health practitioner Patient
SLIDESMANIA.COM
 02
Anatomical Pathology of Herpes
Simplex Virus (HSV) Infection
SLIDESMANIA.COM
 HSV-1
HSV-1 primarily causes oral
herpes, and is generally
Herpes labialis
responsible for cold sores and
fever blisters around the mouth
and on the face.

Herpetic whitlow
Route of transmission

- Direct contact
Herpes gladiatorum
- Respiratory secretions
- Saliva
SLIDESMANIA.COM

Group of painful vesicles on

erythematous base
 HSV-2

HSV-2 primarily causes genital

herpes, and is generally Herpes genitalis
responsible for genital herpes
outbreaks.

Route of transmission
- Sexual contact
SLIDESMANIA.COM

Group of painful vesicles on

erythematous base
 Laboratory Diagnosis
Tzanck test

The choice of stain : Giemsa stain, Toluidine blue

SLIDESMANIA.COM
 Histological
- Acantholysis
- Cowdry type A inclusion bodies Findings
- 3M : Multinucleated giant cell,
Molding and Margination of
nuclear chromatin
SLIDESMANIA.COM
 Acantholysis

Loss of coherence between epidermal cells

SLIDESMANIA.COM
 Cowdry type A inclusion bodies

Intranuclear inclusion body which is surrounded by a clear halo

SLIDESMANIA.COM
 Multinucleated giant cell Nuclear molding

Margination of nuclear chromatin

SLIDESMANIA.COM
 03
Anatomical Pathology of
Peptic Ulcer
SLIDESMANIA.COM
 Peptic ulcer
Gastric ulcer
Peptic ulcers include
: Gastric ulcers
: Duodenal ulcers

The most common symptom

: stomach pain

The most common causes

Duodenal ulcer
: Helicobacter pylori
: long-term use of NSAIDs
SLIDESMANIA.COM

Sharply punched-out lesion with

smooth ulcer base
 - Loss of mucosa Histological
Findings
- Thin layers of fibrinoid debris
with underlying inflammation
merging into granulation tissue
and deep scarring
- Surrounding mucosa : chronic
gastritis
SLIDESMANIA.COM
Loss of mucosa
SLIDESMANIA.COM
SLIDESMANIA.COM
 References
https://dermnetnz.org/topics/tzanck-smear
https://www.pathologyoutlines.com/topic/penscrotumHSV.html
https://www.pathologyoutlines.com/topic/skinnontumorherpeszoster.html
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
https://thepathlab.com/anatomical-pathology/
https://labtestsonline.org/articles/anatomic-pathology
SLIDESMANIA.COM
 OPG 22th

Welcome to the lesson

Pharmacology
Here is how the mechanism of drugs
work
SLIDESMANIA.COM
 Introduction
A drug is any substance or product that is used or
intended to be used to modify or explore physiological
systems or pathological states for the benefit of recipient.
SLIDESMANIA.COM
 Table of contents

01 Pharmacodynamics & Pharmacokinetics

02 Antiherpetic drugs

03 Drugs used in peptic ulcer

SLIDESMANIA.COM
 01
Pharmacodynamics
&
Pharmacokinetics
SLIDESMANIA.COM
 What’s the difference?

Pharmacokinetics
is concerned with the effect of the body on drugs or the movement of
drugs throughout the body including absorption,
distribution,metabolism, and elimination.

Pharmacodynamics
is concerned with the effect of drugs on the body including the
physiologic and molecular effects.
SLIDESMANIA.COM
SLIDESMANIA.COM
 02
Antiherpetic drugs
SLIDESMANIA.COM
Overview
SLIDESMANIA.COM
 Drugs for HSV and VZV infection : Acyclovir
Drugs for CMV infection : Ganciclovir
SLIDESMANIA.COM

Function : Inhibit viral DNA polymerases

 03
Drugs used in “Peptic
Ulcer”
SLIDESMANIA.COM
 What’s Peptic Ulcer disease?
➔ Mucosal defect in gastrointestinal tract
exposed to acid and pepsin secretion
◆ Gastric ulcer
● Pain increased by meal
● Occurs 30-60 mins after meal
● Vomiting occurs
● Not common
◆ Duodenal ulcer
● Pain relieved by meal
● Occurs 2-3 hrs after meal
● Dark,tarry stool(melena)
occurs
SLIDESMANIA.COM

● Most common type

 Regulation of gastric acid secretion
SLIDESMANIA.COM
 Drugs

3.1 3.2 3.3

Antacid Proton pump
Histamine H2
inhibitors(PPIs)
Neutralize gastric acid receptor antagonists
Inhibit gastric acid
secretion
Inhibit gastric acid
secretion
SLIDESMANIA.COM
 3.1 Antacid
★ Sodium bicarbonate , NaHCO3
★ Calcium carbonate , CaCO3
★ Aluminum hydroxide , Al(OH)3
★ Magnesium hydroxide ,
Mg(OH)2
➔ Mechanism of action & Pharmacology
◆ Short acting
◆ Neutralize gastric acid and raise
pH
➔ Adverse effects
◆ Elevate urine pH ; about 1 pH unit
◆ With renal insufficiency ;
absorbed Al3+ contribute to
osetoporosis, encephalopathy
SLIDESMANIA.COM

and proximal myopathy

 3.2 Histamine H2 receptor antagonists
★ Cimetidine
★ Ranitidine
★ Famotidine
★ Nizatidine

➔ Mechanism of action & Pharmacology

◆ Inhibits acid production by reversibly
competing with histamine for binding
to H2 receptor on basolateral
membrane of parietal cells
➔ Adverse effects
◆ Can cross placenta and excrete in
breast milk
◆ Although no teratogenic risk has
been associated with these
SLIDESMANIA.COM

agents
 3.3 Proton pump inhibitors(PPIs)
★ Omeprazole
★ Esomeprazole
★ Lansoprazole
★ Dexlansoprazole
★ Pantoprazole

➔ Mechanism of action & Pharmacology

◆ Most potent suppressors
◆ Block the final step of acid
production
➔ Adverse effects
◆ Interact with warfarin,diazepam
and cyclosporine
◆ With hepatic disease ; dose
reduction is recommended
SLIDESMANIA.COM
 Thank you!
Love you, xoxo <3
SLIDESMANIA.COM
Neurology
Neurology?
Spinal cord?
Brain?
Neurology
Handedness

DOMINANT VS NONDOMINANT
NONDOMINANT DOMINANT
ARE YOU LEFT-HANDED OR RIGHT-HANDED ???
Left-handed
Right-handed
- 70% controlled by
- controlled mainly by
left hemisphere
left hemisphere
- 10% controlled by
right hemisphere
- 20% controlled by
left and right
hemisphere
Dominant hemisphere Wernicke’s area: comprehend meaningful words
● Wernicke’s aphasia:
- impaired comprehension and repetition
- normal fluent speech but meaningless

Broca’s area: produce words and

sentences
● Broca’s aphasia
- mute, decrease fluent of speech
- naming difficulties, impaired
repetition
- intact comprehension
Nondominant hemisphere: Lateralized attention

Left Right
If nondominant lesion occurs???

Attention ray Right hemisphere

- response to both right and left-sided
stimuli

Left hemisphere
- response to right-sided stimuli
Hemineglect syndrome: nondominant lesion
- most common cause is right middle cerebral infarction
- 4 types of hemineglect syndromes
○ Sensory neglect (visual, tactile, auditory)
○ Motor-intention neglect
○ Combined sensory and motor neglect
○ Conceptual neglect : Anosognosia
Half Brain
Ventricle
Clinical correlation:

Obstructive Hydrocephalus

● is also known as non-

communicating hydrocephalus.
Here there's a blockage that
prevents the flow of cerebrospinal
fluid (CSF) between certain
ventricles in the brain.
Brain Stem
Brain Stem
Conciousness System

2 Component of conciousness

● content of conciousness: Cerebrum

○ sensory, motor, emotional,
mnemonic system

● level of conciousness: ARAS (ascending

reticular activating system)
○ alertness, attention, awareness
 mini lecture
SPINAL CORD

NEUROLOGY BMMD
OPG 22nd
 SPINAL CORD
Outline
External morphology of spinal cord

Spinal nerves and dermatome

Reflex
Spinal cord disorder
Lumbar puncture
EXTERNAL MORPHOLOGY OF
SPINAL CORD
SPINAL CORD
หน้าที่ รบั ส่ง
ประกอบดว้ ย

MENINGES
่ ้มไขสันหลัง
เยือหุ
้ สมอง ไขสันหลัง
หุม้ ตังแต่

ประกอบด ้วย ชัน้

หนา เหนี ยว
แผ่นบางๆ
บางสุด
 SPINAL NERVES
AND DERMATOME
Relationship between spinal cord segments and vertebrae
DERMATOME
REFLEX
THE FLEXOR
REFLEX
SPINAL CORD DISORDERS
TRANVERSE CORD LESION
CONUS MEDULLARIS SYNDROME OR
CAUDA QUINA SYNDROME
LUMBAR PUNCTURE
“EX NIHILO, NIHIL FIT”

Parmenides
Gross Anatomy
Gross Anatomy
Musculoskeletal
Bone of shoulder region
Shoulder muscles
Rt side, lateral aspect
 Upper limb

● Arm : Shoulder - Elbow

● Forearm : Elbow - Twist
● Hand
Bone of upper limb Bone of arm
1. Greater tubercle
2. Lesser tubercle
3. Crest of Lesser tubercle
4. Crest of Greater tubercle
5. Internal sulcus
6. Surgical neck
7. Deltoid tuberosity
8. Anterp-lateral surface
9. Lateral supracondylar ridge
10. Radial fossa
11. Lateral epicondyle
12. Capitulum
13. Head
14. Anatomical neck
15. Antero-medial surface
16. Medial supracondylar ridge
17. Coronoid fossa
18. Medial epicondyle
19. Trochlea
20. Posterior surface
21. Groove of ulnar nerve
22. Groove of radial nerve
23. Olecranon fossa
Anterior compartment of the arm
Posterior compartment of the arm
Rt side, lateral aspect
Gastrointestinal
8 - common bile duct
9 - pancreatic duct
10 - major duodenal papilla
17 - unnecessary
pancreatic duct
18 - ucinate process
19 - Plica circularis of
duodenum
20 - head of pancreas
21 - body of pancreas
22- tail of pancreas
23- descending part of
duodenum
24 - incisure of pancreas
https://anatomytool.org/content/characteristics-large-intestine
Cardiovascular
Right atrium Right ventricle
Left atrium Left ventricle
respiratory
 nasal cavity

epiglottid
ฝาปิ ดกล่องเสียง
true vocal cord เส ้นเสียง
larynx
กล่องเสียง

trachea

bronchus

carina

left lung
right lobe left lobe
3 lobe - upper /middle /lower 2 lobe - upper / lower
diaphragm
Reference

Rohen, Johannes. (2016). Anatomy: A Photographic Atlas (8 th ed.). Wolters

Kluwer.