Bacterial Resp Diseases - Micro

Front 1

Tuberculosis is a __________ disease of the _______________ _________.

Back 1

Bacterial
resp tract

Front 2

Tuberculosis is gram _______

Back 2

TB is neither gram + or gram - , it is gram + like

Front 3

TB is caused by the organism____

Back 3

Mycobacterium tuberculosis

Front 4

Mycobacterium tuberculosis looks like:

Back 4

rod shaped, gram + like organism

Front 5

TB is spread by

Back 5

droplet - it invades lung destroys tissue

Front 6

What drug is reserved for TB use only?
How is it used?

Back 6

Isoniazid
is used with ethambutol, rifampin, streptomycin

Front 7

What Rx is given prophylactically for TB to family/health care workers?

Back 7

rifampin

Front 8

TB cell envelope is

Back 8

waxy

Front 9

DX of TB is by

Back 9

Mantoux test, Tine test, sputum analysis, CXR

Front 10

Diphtheria is caused by

Back 10

diphtherotoxin, Corynebacterium diphtheriae

Front 11

What does diphtherotoxin do?

Back 11

inhibits the 80S ribosomes of the host, affects the heart and nervous system leading to death

Front 12

What does diphtheria look like?

Back 12

Gram +, club shaped bacillus clumped together like chinese writing.

Front 13

What grows on the tonsils in diphtheria?

Back 13

a pseudomembrane in pharynx that leads to asphyxiation (don't remove or will bleed to death)

Front 14

Is there a vaccine for diphtheria?

Back 14

yes - a toxoid of diphtherotoxin

Front 15

How do we prevent diphtheria?

Back 15

modified diphtherotoxin to render it harmless while remaining immunogenic

Front 16

Historically diphtheria killed _________ of children

Back 16

10%

Front 17

Diphtheria is DX by

Back 17

throat culture, ECG

Front 18

S/S of diphtheria:

Back 18

bluish skin, breathing difficulties, bloody/watery d/c, chills, croup like (barking cough), drooling (airway blockage will occur), fever, horaseness, painful swalloing, skin lesions (in tropical areas), sore throat (mild to severe); there may be no s/s

Front 19

Prevention of diphtheria:

Back 19

DTaP given at 2,4,6,18mo, booster @ 4-6y (unless 4th dose after 4th birthday. Td booster (adult tetanus and diphtheria) Q10y

Front 20

TX of diphtheria:

Back 20

Diphtheria anti toxin IM/IV and ABT (PCN/erythromycin)

Front 21

Complications of Diptheria

Back 21

myocarditis, paralysis, kidney damage

Front 22

Diphtheria is a _________ disease of the ________________

Back 22

bacterial; resp tract

Front 23

Pertussis is a ____________ disease of the ________________

Back 23

bacterial; resp tract

Front 24

The organism that causes pertusis is

Back 24

Bordetella pertussis

Front 25

Bordetella pertussis looks like:

Back 25

Gram - coccobacillus

Front 26

Historically, pertussis killed____
today death rate____

Back 26

50%of infected kids;
today with ABT death rate 0.5%

Front 27

Pertusis is known for

Back 27

paroxysmal sound or whoop generated when coughing finally stops enough that a labored gasp can be inspired, it is so strong it causes subconjuctival hemorrhaging

Front 28

Today pertussis is becoming a problem because

Back 28

young adults whose parents refused the vaccines for their children are now having babies infected with pertussis.

Front 29

What vaccine do we use for pertussis?

Back 29

We use the acellular pertussins vaccine for all people (DaPT) and a modified diphtheria vaccine (daPT) for adults.

Front 30

Pneumonia is caused by

Back 30

bacteria, viruses, parasites, fungi, particulates (smoke)

Front 31

What happens with pneumonia?

Back 31

alveoli damaged and filled with material. gas exchange not possible

Front 32

what protects us from resp microbes

Back 32

mucous lining, cilia, epiglottal reflex, cough reflex, alveolar macrophages guard against microbes that reach deep lung tissue

Front 33

strep pneumoniae is aka

Back 33

diplococcus pneumoniae, pneumococcus

Front 34

Can pneumococcus type a c carb?

Back 34

no

Front 35

What does strep pneumonia look like in a microscope?

Back 35

different lengths of chains of cocci, mostly diplococci

Front 36

strep pneumonia is a __________ disease of the _______________

Back 36

bacterial; resp tract

Front 37

strep pneumonia is ____________ sensitive

Back 37

optochin

Front 38

strep pneumonia causes _______% of all bacterial pneumonia

Back 38

50%

Front 39

_______% are asymptomatic carriers of strep pneumonia

Back 39

40%

Front 40

strep pneumonia structure

Back 40

thick polysaccharide capsule, 90 types = 90 different infections, immunity is type specific to capsule

Front 41

quelling test

Back 41

Ab test, based on anticapsular Abs, distinguishes capsular types

Front 42

in strep pneumonia, nonencapsulated strains are

Back 42

avirulent

Front 43

strep pneumonia creates a

Back 43

pus like exudate, fluid in lungs leads to drowning, rusty sputum d/t bleeding in lungs, phagocytes allow palpitation of infected area

Front 44

DX of strep pneumonia:

Back 44

gram+ cocci in sputum, CXR

Front 45

those at increased risk for strep pneumonia include:

Back 45

elderly, heart pts, smokers

Front 46

Tx of strep pneumonia

Back 46

multiple ABT

Front 47

Vaccine for pneumonia

Back 47

pneumovax vaccine - 23 most common polysaccharide types. because of the repeating polysaccharide structure, most of the response is T cell dependent. booster Q5y

Front 48

Strep pneumonia also causes

Back 48

subacute endocarditis, otitis media, and meningitis.

Front 49

walking pneumonia is a _________ disease of the _____________

Back 49

bacterial;
resp tract

Front 50

walking pneumonia is caused by the organism

Back 50

mycoploasma pneumoniae

Front 51

mycoplasma pneumoniae looks like:

Back 51

gram-, no PG layer (PCN ineffective), round organism, cytoplasmic and outer membranes are unusual it has no cell wall, sterols in its membranes; rich media forms fried egg like colonies, sunny side up

Front 52

best Dx tool for walking pneumonia/mycoplasma pneumonia

Back 52

cold agglutinins over time - they are antibodies that mycoplasma induces in the pt that will agglutinate RBCs when stored in the cold (fridge)

Front 53

Legionnaires' is aka

Back 53

legionellosis

Front 54

legionnaires' is a __________disease of the _______________

Back 54

bacterial;
resp tract

Front 55

Legionnaires' is caused by the organism

Back 55

legionella pneumophila

Front 56

legionella pneumophila looks like

Back 56

gram- bacilli with many vacuoles. it is a fastidious organisms and requires special supplements to culture

Front 57

legionella pneumophila is found in

Back 57

water sources (cooling towers- below 50C)

Front 58

how is legionella pneumophila spread?

Back 58

waters are aerosolized, droplet organisms infect via resp tract . not d/t drinking water

Front 59

what are legionella pneumophila resistant to?

Back 59

chlorine in H2O - suspect it when hosp showers have a high chlorine smell

Front 60

Who is predisposed to legionnaires'?

Back 60

smoking/drinking

Front 61

when was legionnaires' discovered?

Back 61

1976 bicentennial celebration in Phili, many legionnaires died

Front 62

what was the problem with dx legionnaires originally?

Back 62

the microbe didn't stain well and special growth conditions weren't devised for months

Front 63

s/s legionnaires'

Back 63

begins H/A, fever, confusion, shaking chills. cough/SOB develop

Front 64

how does the microbe legionella pneumophila work?

Back 64

the surface componenet - C3b binds to so alveolar macrophages ingest them. L pneumophila grows/multiplies intracellularly in macrophages, the numbers increase until alveolar necrosis develops leading to pneumonia/death d/t decreased O2

Front 65

how is legionnaires like a trojan horse?

Back 65

Amoebae feed on bacteria, but L. pneumonphila turns the tables by killing/eating the host amoebae

Front 66

Chlamydia pneumonia is a _________ disease of the __________

Back 66

bacterial;
resp tract

Front 67

Chlamydia pneumonia structure

Back 67

gram-; no cell wall (hence roundish)

Front 68

Chlamydia pneumonia causes ____% of pneumonias

Back 68

15%, it is difficult to cure

Front 69

Chlamydia pneumonia's developmental cycle:

Back 69

varies- the infectious form different then vegetative form

Front 70

How is Chlamydia pneumonia grown?

Back 70

can't grow on media, must grown in a human cell in culture

Front 71

What type of organism is Chlamydia pneumonia?

Back 71

obligate intracellular pathogen - must get ATP from host cell

Front 72

test for Chlamydia pneumonia:

Back 72

test for Ab is pt serum and DNA hybridization test for chlamydial DNA

Front 73

C. Pneumonia is seen in

Back 73

heart attacks/ strokes (the #1 & 2 killers). The > the Ab titer to c. pneumoniae the > the probability of these diseases

Front 74

Hemophilus influenzae is a _________ disease of the ______________

Back 74

bacterial disease;
resp tract

Front 75

H. influenzae structure

Back 75

gram- pleomorphic rods,

Front 76

H. influenzae growth requirements

Back 76

fastidous; requires vitamins and CO2 for growth

Front 77

the most common cause of meningitis is

Back 77

H. influenzae

Front 78

H. influenzae untreated is:
with tx:

Back 78

90% fatal untreated; with tx even 1/3 of pts will have permanent mental damage

Front 79

what is the most common h. influenzae?

Back 79

b serotype - causes 20,000 US cases of meningitis/y

Front 80

Hib conjugate vaccine

Back 80

protects against the B serotype; T cell dependent. Induces memory - long immunity

Front 81

Hib

Back 81

a capsular vaccine, was useful. it was T cell independent because the antigen is a simple repeating polysaccharide

Front 82

Hib conjugate vaccine

Back 82

a new T cell dependent vaccine which contains the same polysaccharide capsule but the capsular material has been conjugated (chemically linked) now induces a memory response because of the protein so immunity is long lived. incidence has plummeted.

Front 83

H. influenzae also causes:

Back 83

otitis media

Front 84

Bacterial meningitidis is a _________ disease of the ________________

Back 84

bacterial disease; resp tract

Front 85

Bacterial meningitis leads to

Back 85

brain injury / death in infants/young

Front 86

meningitis vaccine

Back 86

for all types of meningitis except type B: menomune

Front 87

meningitis is

Back 87

inflammation of the meninges (covering of the brain and spinal column) d/t a # of organisms

Front 88

meningitis is spread via

Back 88

resp routes, organism invade from throat to spinal column by passing thru host cells

Front 89

meningitis is characterized by

Back 89

stiff neck associated with vomiting and fever

Front 90

Tx of meningitis

Back 90

multiple ABT started ASAP

Front 91

prophylactic tx of health care workers/family exposed to meningitis:

Back 91

rifampin

Front 92

Neisseria meningitidis is aka

Back 92

meningococcus

Front 93

Neisseria meningitidis is a _____________ disease of the ________

Back 93

bacterial disease: resp tract

Front 94

growth requirements for Neisseria meningitidis:

Back 94

fastidious: requires CO2, O2, vitamins

Front 95

Neisseria meningitidis causes

Back 95

serious meningitis, highly invasive, medical emergency

Front 96

Neisseria meningitidis is considered to be a

Back 96

medical emergency

Front 97

Neisseria meningitidis TX:

Back 97

IV ABT STAT,

Front 98

DX of Neisseria meningitidis:

Back 98

spinal tap- look for gram- diplococci

Front 99

Neisseria meningitidis are exceptional in that their:

Back 99

outer membrane allows the entry of PCN aggressive PCN tx is essential

Front 100

Vaccine for N. meningitidis:

Back 100

menomune, available for 4 types of polysaccharide capsule but not type b the most common, very poorly immunogenic.

Front 101

streptococcal diseases are _________ diseases of the ___________

Back 101

bacterial diseases of resp tract

Front 102

strep diseases structure

Back 102

gram+ spheres cocci in chains (strepto) from one to many cells

Front 103

strep diseases growth requirements

Back 103

fastidious, grow on blood agar plates

Front 104

How are strep dx:

Back 104

hemolysis rxn differentiates dx: alpha, beta, gamma

Front 105

alpha hemolysis is strep

Back 105

incomplete hemolysis with greenish tinge

Front 106

beta hemolysis in strep

Back 106

complete hemolysis

Front 107

gamma hemolysis in strep

Back 107

no hemolysis

Front 108

streptococci generally have a

Back 108

C carbohydrate layer in the cell envelopoe to which humans produce Abs. these Abs aren't protective but they do differentiate dx

Front 109

C carbs are called:

Back 109

group A and Group B strep a classification system by rebecca lancefield

Front 110

Streptococci don't secrete

Back 110

catalase, which differentiates fro S. aureus

Front 111

sites of strep infection are

Back 111

throat, oral cavities, vagina, intestines

Front 112

Group A strep aka

Back 112

strep pyogenes

Front 113

group A strep/ strep pyogenes causes

Back 113

acute pharyngitis (strep sore throat)

Front 114

Strep pyogenes aka Group A strep is a __________disease of the _____

Back 114

bacterial disease; resp tract

Front 115

Group A strep/strep pyogenes shows what type of hemolysis?

Back 115

beta hemolytic - complete hemolysis

Front 116

group A strep/ S. pyogenes is

Back 116

pyogenic - creates pus

Front 117

Ab to M protein in S. pyogenes/group A strep

Back 117

is opsonic (gets eady to be eaten) resulting in recovery

Front 118

you can get S. pyogenes ________ different times

Back 118

90

Front 119

in group A strep/S. pyogenes the cell layers from inside out are:

Back 119

cytoplasmic membrane, cell wall, C carb, M protein, capsule of hyaluronic acid,

Front 120

cell wall of S. pyogenes is made up of

Back 120

Peptidoglycan (PG)

Front 121

The C carb prevents

Back 121

lysozyme entry and PG degradation

Front 122

The M protein is

Back 122

an attachment factor, antiphagocytic, 90 different antigenic types

Front 123

the capsule of hyaluronic acid

Back 123

is identical to polysaccharide in connective tissue (considered self by immune system), bacterial cloaking device

Front 124

S. pyogenes makes

Back 124

2 streptolysins: SLO and SLS, they damage cell membranes (heart/WBCs)

Front 125

S. pyogenes secretes:

Back 125

erythrotoxin leading to the rash of scarlet fever

Front 126

S. pyogenes causes

Back 126

acute pharyngitis (strep sore throat), impetigo, necrotizing fasciitis (flesh eating bacteria) and 2 hypersensitivity reactions - post streptococcal states or sequelae that result from damage by hosts own immune system

Front 127

2 sequelae caused by S. pyogenes:

Back 127

Rheumatic fever- heart valve damage and joint damage that occurs several wks after the acute disease because of immune hypersensitivity, after the bacteria are eliminated.

Front 128

The 2 sequelae caused by S. pyogenes are d/t

Back 128

production of Abs to S. pyogenes that cross react with heart tissue. immune complexes may form = permanent kidney damage d/t glomerulonephritis and are the reason for aggressive Tx

Front 129

glomerulonephritis

Back 129

clusters of complex - lumpy-bumpy glomerulonephritis

Front 130

S. pyogenes isn't resistant to

Back 130

PCN, tx with amoxicillin, however noncompliance with tx after pt feels better can cause development of sequelae.

Front 131

group B strep aka

Back 131

strep agalactae

Front 132

group B strep/ S. agalactae is assoc with

Back 132

mastitis of cows and human vaginal tract

Front 133

S. agalactae/ group B strep is

Back 133

generally harmless and normal flora of female however causes 40% of newborn septicemia often = death

Front 134

S. agalactae/ group B strep also causes

Back 134

meningitis (infectio of the meningeal covering of brain/spinal cavity of newborn)

Front 135

vaccine

Back 135

a vaccine to protect newborn in under development

Front 136

expectant moms who test + for S. agalactae/group B strep

Back 136

are given ABT for a few weeks before delivery

Front 137

viridans strep is a _________ disease of _________

Back 137

bacterial; resp tract

Front 138

viridans strep refers to this group of streptococci and is not a genus

Back 138

this group of streptococci and is not a genus

Front 139

viridans strep hemolysis is

Back 139

alpha hemolytic - incomplete hemolysis with a green tinge

Front 140

viridans strep is optochin_________

Back 140

ethyl hydrocupreine resistant

Front 141

viridans strep ______ typeable by C carb

Back 141

is not

Front 142

viridans strep organisms are

Back 142

not usually speciated - commensals, 100%, found in mouth, resp tract

Front 143

viridans strep in normal pts

Back 143

doesn't cause trouble

Front 144

viridans strep in pts with heart damage:

Back 144

are at risk because these organisms attach to/grow on damaged valvle = subacute endocarditis = further damage. don't grow on healthy valves.

Front 145

group A strep causes initial

Back 145

damage to heart valves via toxins (without growing on heart tissue)

Front 146

group B strep grows on

Back 146

damaged heart tissue

Front 147

several bouts of subacute endocarditis

Back 147

is likely lethal

Front 148

dental work can result in

Back 148

normal flora gaining access to the bloodstream, take accurate histories and give prophylactic ABTs when needed.