0103human and Disease

8/17/2019 0103human and Disease

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HUMAN AND DISEASE

PROF. TOPO HARSONO

(EMERITUS PROFESSOR OFPATHOLOGY)


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1. RESPECT TO LIFE AND HUMAN BEING

ONLY GOD DECIDE ON THE FATE OF

LIFE OF EVERY HUMAN BEING.


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2. PROMOTION OF HEALTH AND

LONGEVITY.

IT IS THE TASK OF EACH INDIVIDUAL TOMAINTAIN THE BEST CONDITION OF GOD’S

CREATION.


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3. REDUCTION OF MORBIDITY AND

PREVENTION OF DISEASE.

THIS IS THE MAIN TASK OF A MEDICAL

DOCTOR


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4. RELIEVE OF SUFFERINGS

A MEDICAL DOCTOR SHOULD NOT BE TEMPTED TO AGREE ON EUTHANASIA

IN RELIEVING HIS PATIENTS SUFFERINGS


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HEALTH

DISEASE

INJURY

EXOGENOUS

ENDOGENOUS

BODY DEFENCE

MECHANISM

REGENERATION

POTENTIAL

DEATH

PROMOTIVE

PREVENTIVE

CURATIVECURATIVE

REHABILITATIVE

PREVENTIVE


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DISEASE

• Any devi!i"n #$"% "$ in!e$$&'!i"n "# !(en"$%) *!$&+!&$e "$ #&n+!i"n "# '$!, "$-n

"$ *y*!e% "# !(e "dy * %ni#e*!ed y +(/

$+!e$i*!i+ *y%'!"%* nd *i-n*0 !(e e!i")"/-y, '!(")"-y nd '$"-n"*i* %y e 1n"2n

"$ &n1n"2n (DORLANDS MEDICAL

DICTIONARY)


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MORBID:

3. Pe$!inin- !", ##e+!ed 2i!(, "$ ind&+in- di*e*e0

di*e*ed.

4. Un(e)!(y "$ &n2(")e*"%e.

5. C($+!e$i6ed y '$e"++&'!i"n 2i!( -)""%y "$

&n2(")e*"%e #ee)in-* "$ !("&-(!*


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MALFORMATION

P$i%$y e$$"$ "# %"$'("-ene*i*, in!$in*i+ n"$%)

deve)"'%en!) '$"+e**.

U*&))y %&)!i#+!"$i) $!(e$ !(n !(e $e*&)! "# *in-)e

-ene "$ +($"%"*"%) de#e+!.S"%e, *&+( * +"n-eni!) (e$! di*e*e inv")ve *in-)e

"dy *y*!e%. M&)!i')e %)#"$%!i"n* inv")vin- %ny

"$-n* %y +"e7i*!.


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C!"#$# %& C%'$'*!+ A'%,!+$# ' H",!'#

G$'$*-

C($"%"*"%) e$$!i"n* 38 9 3: ;

Mende)in in(e$i!n+e 4 9 38 ;

E'/%',$'*!+

M!*$/'!+ 0 +!-$'*!+ '&$-*%'#: 4 9 5

; R&e))

T"7"')*%"*i*Sy'(i)i*

H&%n I%%&n"de#i+ien+y Vi$&*

M!*$/'!+ #$!#$ #*!*$#: < 9 = ;

Die!e*P(eny)1e!"n&$i

D/"# !' -$,-!+#: 3 ;

A)+"(")

And$"-ene*


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M&)!i#+!"$i) >M&)!i')e -ene* ? Envi$"n%en!@ 48/4:

;

Un1n"2n 8/


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DISORDER

• A de$n-e%en! "$ n"$%)i!y "# #&n+!i"n0

A %"$id '(y*i+) "$ %en!) *!!e


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SYNDROME

• A *e! "# *y%'!"%* 2(i+( "++&$ !"-e!(e$.

• A *y%'!"% +"%')e7

• T(e *&% "# *i-n* "# ny %"$id *!!e


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PAIN

A %"$e "$ )e** )"+)i6ed *en*!i"n "# di*/

+"%#"$!, di*!$e** "$ -"ny, $e*&)!in- #$"%

!(e *!i%&)!i"n "# *'e+i)i6ed ne$ve endin-*.

S&e+!ive #ee)in- "# di*+"%#"$!.

O!(e$ *i%i)$ 2"$d* *"$e 9 +(e 9 (&$! 9

n&% 9 i))ne** / *i+1ne**


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HO D$&'*%' %& HEALTH

• He)!( i* *!!e "# "'!i%) '(y*i+), %en!)

nd *"+i) 2e))/ein-, nd n"! %e$e)y !(e

*en+e "# di*e*e "$ in#i$%i!y.


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PATHOLOGY:

• T(! $n+( "# %edi+ine 2(i+( !$e!* "# !(e e**en!i) n!&$e "# di*e*e, e*'e+i))y "# !(e

*!$&+!&$) nd #&n+!i"n) +(n-e* in !i**&e*

nd "$-n* "# !(e "dy !(! +&*e "$ $e+&*ed y di*e*e (D%/+!'# M$-!+

D-*%'!/6)


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PATHOLOGY:

• T(! *'e+i)!y "# !(e '$+!i+e "# %edi+ine de)in-

2i!( +&*e* nd n!&$e "# di*e*e 2(i+( +"n!$i&!e!" di-n"*i*, '$"-n"*i* nd !$e!%en!, !($"&-(

1n"2)ed-e -ined y )"$!"$y '')i+!i"n "# !(e

i")"-i+, +(e%i+) "$ '(y*i+) *+ien+e* !" %n "$

%!e$i) "!ined #$"% %n (AMERICANPATHOLOGY SOCIETY)


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PATHOGENESIS

(DISEASE PROCESS)• ETIOLOGY ANATOMICAL

PHYSOLOGICAL

MICROBIOLOGICAL CHANGES

PATHOLOGY

DIAGNOSIS

PROGNOSIS


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CLINICAL ANATOMICAL FORENSICPATHOLOGY PATHOLOGY PATHOLOGY

PATHOBIOLOGY GYNAECOPATHOLOGY

IMMUNOPATHOLOGY

SURGICAL PATHOLOGY

NEUROPATHOLOGY DERMATOPATHOLOGY

GEOGRAPHICAL PATH. ONCOPATHOLOGY

PALEOPATHOLOGY GASTERO/ENTERO PATH. PEDIATRIC PATHOLOGY ORTHOPEDIC PATHOLOGY

PATHOLOGY


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GROTH AND DEVELOPMENT

G/%7* !' D$$+%,$'* !/$ $##$'*!++6 #6'%'6,%"# *$/,#

*!* $#-/8$ *$ #$/$# %& -!'$# !' %/!'#, %$#

*/%" *% !**!' ,!*"/*6. I' /!-*-$: G/%7* #'&6 *$ '-/$!#$ ' #9$ !**$'!'*

"%' ,!*"/!*%'.

D$$+%,$'* '-!*$ *$ '-/$!#$ %&

&"'-*%'!+ -!!-*$#.


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T$ &%++%7' &!-*%/# ,"#* 8$ *!?$' '*% !--%"'* ' !'6 #;

-"##%' %& *$ !*%+%6 %& *$ '$78%/' $/%:

T$ #*!*"# %& *$ '&!'* !* *$ *,$ %& 8/* !' *$ *,$ %& $!*=

T$ #9$ %& *$ '&!'* !# !' '-!*%/ %& ,!*"/*6=

$*$/ *$ '&!'* # !8+$ %/ 7*' *$ /!'$ -%'#$/$

'%'!8+$=

T$ $!+* #*!*"# %& *$ ,%*$/ !' *$ '&!'* %& #$-&-

!'!*%,- !8'%/,!+*$# '-%,!*8+$ 7* +&$=

T$ $&&$-*# %& *$ 8/* /%-$## %' *$ '&!'*= 7* #$-!+

!**$'*%' *% *$ "$#*%' %& 8/* */!",! !' *$ ,,$!*$

%#*'!*!+ -!/$ %& *$ '&!'* /$+!*$ *% #"- ,!**$/# !#

!'%


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A#$ &/%, *$#$ /!*$/ 8!#- *$,#= *$/$ !/$ /%8+$,# $-"+!/

*% *$ '$78%/' per se:

T$/$ !/$ #$!#$# *!* %'+6 %--"/ ' *$ '$78%/' $/%=

#"- !# hyaline membrane disease= $'$/!+9$ '&$-*%' 86

*$ herpes virus %/ #%,$ -%'#$"$'-$# %& '$%'!*!+ -!/$ +?$

retrolental fibroplasia.

T$/$ !/$ '-!*%'# *!* #%,$ -%'*%'# !/$ ,#+$!'=

#"- !# *$ $'$/!+ $#'!*%' %& anoxia , %/ !# * # #%,$*,$#

-!++$ abnormal pulmonary ventilation !# ! cause of death . A';

%


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RETROLENTAL FIBROPLASIA

C&*ed y e7'"*&$e "# !(e in#n! !" "7y-en +"n+en!$!i"n*

"# %"$e !(n 8 ; #"$ e7+e**ive 'e$i"d* "# !i%e. Re!in) v*+&/

)$i6!i"n i* in+"%')e!e ! i$!( in '$e%!&$e in#n!*.

Hi-( +"n+en!$!i"n +&*e* +"n*!$i+!i"n "# !(e $e!in) ve**e)*

nd i# !(i* 'e$*i*!* #"$ 5 "$ dy* !(ey e+"%e i$$eve$*i)yd%-ed.

T(e di*!&$n+e "# n&!$i!i"n nd "7y-eni6!i"n "# !(e $e!in

$e*&)!in- #$"% "++)&*i"n "# !(e*e ve**e)*, +&*e* !i**&e$e+!i"n *i%i)$ !" -$n&)!i"n !i**&e, !(! i* n i$$e-&)$ '$"/

)i#e$!i"n "# +'i))$ie* nd #i$"&* !i**&e, )edin- !" (e%"$$(-e

nd !$n*&d!i"n "# #)&id e7!endin- in !" !(e vi!$e"&* nd +"%'/

)e!e de!+(%en! "# !(e $e!in nd )indne**.


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N$%'!*!+ $!*: ny de!( "++&$in- 2i!(in !(e #i$*! 4= dy*

"# )i#e

P$/'!*!+ $!*: in#n!* 2(" died &*! '$i"$ !" i$!( nd 2i!(in !(e #i$*! 2ee1 "# )i#e

8 ; "# ne"n!) de!( "++&$* 2i!(in !(e

!(e #i$*! 2ee1 "# )i#e

'$e%!&$i!y =8 ; "# in#n!* dyin- 2i!(in

#i$*! = ("&$* "# )i#e

P%#*,%/*$, E

Te+(ni&e "# '"*!%"$!e% e7%in!"n "# #e!&* nd ne2"$n

d"e* n"! di##e$ %$1ed)y #$"% !(! "# !(e ")de$ +(i)d nd

d&)!, &! i! +))* #"$ *'e+i) e%'(*i* !" e7%in!i"n "# !(e

&%i)i+) +"$d nd ')+en!.


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F$*!+ #*/$##:

T(e '$in+i') *y%'!"%* "# #e!) di*!$e** d&$inin!$&!e$ine )i#e

$e i$$e-&)$i!y "# !(e #e!) (e$!, $ie# 'e$i"d "# in+$e*ed +!i/

vi!y "# !(e #e!&* nd !(e $e)7!i"n "# !(e n) *'(in+!e$ 2i!( $e/)e*e "# %e+"ni&% in!" !(e %ni"!i+ #)&id.

(en n in#n! i* "$n #!e$ '$")"n-ed 'e$i"d "# #e!) di*!$e**

nd i* *!i)) )ive, !(e$e %y e *)"2 (e$! e!, '))"$, '""$ %&*/

+)e !"ne, nd ye))"2 *!inin- "# !(e *1in nd ni)*. T(e*e +(i)d$en

&*&))y #i) !" e*!)i*( $e*'i$!i"n nd !(e (e$! +e*e* !" e!

*("$!)y #!e$ i$!(. T(i* +"ndi!i"n i* +))ed asphyxia pallida.

Even in in*!n+e 2(e$e !(e$e (* een n" eviden+e "# #e!) di*/

!$e** !(e in#n! %y #i) !" $e!( *'"n!ne"&*)y ! i$!(. T(i* i*

%"*!)y **"+i!ed 2i!( '!(")"-i+) +"ndi!i"n* )i1e in!$+$ni) (e%"$$(-e d&e !" i$!( !$&%, 2i!( '$e**&$e "$

d%-e !" !(e $e*'i$!"$y +en!e$* "# !(e $in *!e%, %e+(ni+) in!e$#e$en+e 2i!( !(e $e*'i$!"$y *y*!e%, *&+(

* in di'($-%!i+ (e$ni "$ ')e&$) e##&*i"n,


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P/$,!*"/*6 !' P%#*,!*"/*6.

P/$,!*"/*6: i$!( 2ei-(! )e** !(n 4:88 -% +$"2n/(ee) )en-!( &nde$ +%

-e*!!i"n )e** !(n 5 2ee1*

I,,!*"/$ : i$!( 2ei-(! e!2een :88 9 3888 -% )en-!( e!2een 4= 9


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H6!+'$ M$,8/!'$ D#$!#$

Sin-)e di*e*e **"+i!ed 2i!( '$e%!&$i!y.

Hi*!")"-i+))y !(e )&n-* $e *een !" +"n!in $e)!ive)y )i!!)e i$

nd !(e 2))* "# %ny "# !(e )ve")$ d&+!* $e +"))'*ed. T(e

"&!*!ndin- #e!&$e i* !(e '$e*en+e "# e"*in"'(i)i+, ("%"-en"&*,+e))&)$ $e#$+!i)e %**e* )inin- !(e i$ *'+e*. T(e$e i* in!en*e

en-"$-e%en! "# !(e +'i))$ie*.

C&$$en! !(e"$y *&--e*! !(e '$e*en+e "# $e*"$'!i"n !e)e!*i*J

nd '$e*en+e "# %ni"!i+ #)&id in !(e )&n-*


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P%#*,!*"/*6

In#n! 2i!( -e*!!i"n) )en-!( "# %"$e !(n 4 2ee1*.

M"!(e$ "# '"*!%!&$e y $e +)**i#ied * !(e e)de$)y

'$i%i'$J %"!(e$ 2(" (* (e$ #i$*! +(i)d #!e$ !(e -e "#

58.

Gin! #e!&*e* (* n" di$e+! +"$$e)!i"n 2i!( !(e )en-!( "#

-e*!!i"n, $!(e$ !(n 2i!( !(e !enden+y "# !(e %"!(e$ (vin-

die!e* "$ (vin- -ene!i+ +"n*!i!&!i"n "# die!e*.


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(y'"')*i "$ %)#"$%!i"n "# !(e )&n-*, de'$e**i"n "# !(e $e*'i$!"$y +en!e$ y e7+e**ive

n)-e*i "$ ne*!(e*i -iven !" !(e %"!(e$ e#"$e

de)ive$y,

B/* T/!",!:

Bi$!( !$&% i* **"+i!ed 2i!( !$&% $e*&)!in- #$"% %e+(ni/

+) #"$+e >%")din- "# !(e (ed d&$in- )"$@ nd i* **"+i!ed 2i!(

(e%"$$(-e*.

In!$+$ni) (e%"$$(-e i* %"$e #$e&en! in '$e%!&$e in#n!*nd '$")y i* $e)!ed !" !(e '(y*i+) +($+!e$ "# !(e $in *&/

*!n+e.

M!>%/ #-%$/$# ' M-/%8!+ P!*%$'$##


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M!>%/ #-%$/$# ' M-/%8!+ P!*%$'$##

1796 Edward Jenner Vaccination against Smallpox

1843 Wendell Holmes Discovery of te iatrogenic nat!re

of "#lac$ deat of cildood%

18&' (o!is )aste!r )roof of germ teory and te #egin*ning of modern #iology

1882 +o#ert ,oc ,oc-s post!late .4/

1884 Elie 0etcni$ov Description of pagocytosis #y macro*

pages

12 +onald +oss dentification of mos5!ito vector for

Plasmodium falciparum malaria 12& )a!l Erlic Description of cemoterape!tic

agents

128 Ellermann 6 7ang Viral oncogenesis in cic$en pox

133 +e#ecca (ancefield Serotyping of organisms and associa*

tion of #acterial clones wit disease

14' very dentification of D9 as genetic materialand start of 0olec!lar #iology revol!tion

14 Jon :ran$lin Enders ;!lt!re of vir!ses and prod!ction of

6 Weller poliovir!s vaccine

183 (!c de 0ontagnier 6 dentification of HV as ca!se of DS

+o#ert


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@OCHS POSTULATE

3. Mi+$""$-ni*% %&*! e "*e$ved in eve$y +*e "# !(e

di*e*e.

4. Mi+$""$-ni*% %&*! e i*")!ed nd -$"2n in '&$e +&)!&$e.

5. T(e '&$e +&)!&$e %&*!, 2(en in"+&)!ed in!"

*&*+e'/

!i)e ni%), $e'$"d&+e !(e di*e*e.

. T(e %i+$""$-ni*% %&*! e "*e$ved in, nd $e+"ve$/

ed #$"%, !(e e7'e$i%en!))y di*e*ed ni%).

CA GO S O C O S AG S


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CATEGORIES OF INFECTIOUS AGENTS

I. PRIONS:

;omposed of modified ost protein

C!"#$ */!'#,##8+$ spongioform encephalopathies:*C uru , associated wit !man canni#alism

*C Creutzfeldt!"aob disease, associated wit

corneal transplants

*C Bovine spongioform encephalopathy #BSE$

mad co% diseaese

*C atypical C!" disease transmitted to !mans from

7SE

II. VIRUSES: All viruses depend on host cell metabolism for their replication &bligate intracellular parasites

Classified b the nucleic acid content of their core !"#A or $#A% and their shape of coat or capsid &ore than 4'' species inhabit humans but onl some cause acute

i(lnesses to humans: common colds or influenza' )thers are capable of lifelon* latenc and of lon*+term reactivation

#Herpes viruses$ or ma *ive rise to chronic diseases #Hepatitis

viruses$


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III BACTERIOPHAGES= PLASMIDS

AND TRANSPONS

IV. BACTERIA

0o#ile genetic elements tat encode #acterial vir!lence factorsA

adhesins( to)ins or enzymes that confer antibiotic resistance #ility to infect #acteria and incorporate temselves into teir genomeA

to)in genes of Vibrio cholerae and Shigella fle)neri ' Excange of tese elements #etween #acterial strains and species

endows te recipients eiter wit survival potentials or capacity to

cause disease

7acterial cells lac$ n!clei and endoplasmic retic!l!m ;ell walls are rigid composed eiter of two pospolipid #ilayers

wit a peptidoglycan layer in #etween .


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V. CHLAMYDIAE= RIC@ETTSIAE AND MYCOPLASMAS

as similarities -ith bacteria divide b binar fission

susceptible to antibodies

but lac. of certain structures:

lac. of cell -all or lac. of certainmetabolic capabilities !A/0 snthesis%

&ost ric.ettsiae are transmitted by insect vectors #lice( tics and mites$ and

are obli*ate intracellular a*ents, replicatin* in ctoplasm of endothelial cells

ca!se a emorragic vasc!litis often visible as s.in rash, transient pneu+

monia, hepatitis, C# inuries and death

0ycoplasma pne!moniae spreads from person to person b aerosols, bindsto the surface of epithelial cells in the air-as b an adhesin !01% and causes

an atpical pneumonia

VI. FUNGI

un*i possess thic., er*osterol+containin* cell -alls and *ro- as perfect, se5uall

reproducin* forms in vitro and as imperfect forms in vivo, includin* buddin* east

cells, hphae and conidia /inea *roup of fun*i are confined to superficial laers of the s.in !athletes foot% )ther dermatophtes dama*e the hair shaft or nails ome fun*al species invade

subcutaneous tissue causin* *ranulomas or spread sstemicall destroin* vital

or*ans in immunocompromised hosts


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VII. PROTOOA

)arasitic protoFoa are sin*le+celled or*anisms endo-ed -ith motilit, pliable

plasma membranes and comple5 ctoplasmic or*anelles >ricomonas vaginalis is transmitted se5uall from person to person

(ntestinal protooas are spread b the fecal+oral route: Entamoe#a istolytica and oxoplasma gondii is ac;uired either b contact -ith oocst+sheddin* .ittens or

b eatin* cst+ridden undercoo.ed meat

VIII. HELMINTHS

)arasitic worms are hi*hl differentiated multicellular or*anisms -ith a comple5

life ccle: alternation of se5ual reproduction in the definitive host and the ase5ual

multipliacation in an intermediar host or vector /hus, dependin* on the parasitic species, humans ma harbor either adult -orms

.scaris/ or immature sta*es .>oxocara canis/ or ase5ual larval forms .Ecino

cocc!s/ d!lt worms, once residin* in humans, do not multipl in number but *enerate

e**s or larvae destined for the ne5t phase of the ccle


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VIII. HELMINTHS (C%'*.) mportant conse5!ences of te lac$ of replication of ad!lt wormsA

disease often ca!sed #y inflammatory responses to te eggs or larvae

rater tan to te ad!lt forms

disease is in proportion to te n!m#er of organisms infecting te indivi* d!al

)arasitic worms are of tree classesA

1I :irst classA 9ematodes .ro!ndworms/ ntestinalA scaris and Strongyloides

>iss!e invadersA :ilariae and >ricinella

I Second classA ;estodes .flat worms/ >apeworms and cystic tapeworm larvaeA

;ysticerci and ydatid cyst 3I >ird classA >rematodes .fl!$es/ oriental liver and l!ng fl!$es

IX. ECTOPARASITES

Ectoparasites are artropods .lice tic$s #ed#!gs and fleas/ tat attac to and live on te s$in Sca#iesA example of severe dermatitis ca!sed #y mites #!rrowing into te strat!m

;orne!m rtropods can #e vectors for oter patogensA (yme disease ca!sed #y spirocetes

.7orrelia #!rgdorferi/ transmitted #y deer tic$s


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HUMAN VIRAL DISEASES AND THEIR PATHOGENS

RESPIRATORY

deno vir!s Bpperlower +esp >r nf

Eco vir!s Bpper +esp >r nfparyngitis

+ino vir!s Bpper +esp >r nf

;oxsac$ie vir!s Hand*foot*mo!t disease

nfl!enFa vir!s *7 nfl!enFa

)arainfl!enFa vir!s Bpperlower +esp >r nf

DIGESTIVE

0!mps vir!s 0!mpspancreatitisorcitis+ota vir!s ;ildood diarrea

Hepatitis vir!s c!te viral epatitis

Hepatitis vir!s c!te or ;ronic epatitis

Hepatitis ; vir!s c!te or ;ronic epatitis

Hepatitis D vir!s c!te or ;ronic epatitis

Hepatitis E vir!s Enterically transmitted

epatitis

SYSTEMIC ITH S@IN ERUPTIONS

0easles vir!s 0easles .r!#eola/

+!#ella vir!s

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0103human and Disease

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