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579 Cards in this Set

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(T/F) The outer membrane for G+ and the cell membrane for G- act as major surface antigens.
FALSE: they DO act a major surface antigens BUT the outer mb for G- and the cell membrane for G+
Are endotoxins heat stable?
yes, stable at 100C for 1 hr.
Are endotoxins secreted from cells?
NO
Are endotoxins used as antigens in vaccines?
no, they don\\'t produce protective immune response
Are exotoxins heat stable?
no, destroyed rapidly at 60C (exception: Staphylococcal enterotoxin)
Are exotoxins secreted from cells?
YES
Are exotoxins used as antigens in vaccines?
Yes, TOXOIDS are used as vaccines
Describe the chemical composition of peptidoglycan.
Sugar backbone with cross-linked peptide side chains.
Describe the major components of a G- cell wall.
inner and outer lipid bilayer membranes - thin layer of peptidoglycan - periplasmic space - contains lipopolysaccharide, lipoprotein and phospholipid
Describe the major components of a G+ cell wall.
one lipid bilayer membrane - thick layer of peptidoglycan - contains teichoic acid
Describe the process of conjugation.
DNA transfer from one bacterium to another.
Describe the process of transduction.
DNA transfer by a virus from one cell to another
Describe the process of transformation.
purified DNA is taken up by a cell
Does endotoxin induce and antigenic response?
no, not well
Does exotoxin induce and antigenic response?
Yes, induces high-titer antibodies called antitoxins
Give two general functions of peptidoglycan
Gives rigid support - protects against osmotic pressure
How are Group A and Group B Strep primarily differentiated?
Group A are Bacitracin sensitive - Group B are Bacitracin resistant
How are the pathogenic Neisseria species differentiated?
on the basis of sugar fermentation
How are the species of Streptococcus primarily differentiated?
on the basis of their HEMOLYTIC capabilities
List the four phases of the bacterial growth curve.
Lag phase - log (exponential) phase - stationary phase - death phase
Name 2 G- rods that are considered slow lactose fermenters.
Citrobacter and Serratia
Name 3 G- rods that are considered fast lactose fermenters.
1) Klebsiella 2) E. coli 3) Enterobacter
Name 3 G- rods which are lactose nonfermenters and Oxidase(-)?
Shigella, Salmonella, Proteus
Name 4 bacteria that use IgA protease to colonize mucosal surfaces.
1) Strep. pneumoniae 2) Neisseria meningitidis 3) Neisseria gonorrhea 4) H. flu
Name 4 genus of bacteria that are G- \\'coccoid\\' rods.
1) H. flu 2) Pasteruella 3) Brucella 4) Bordetella pertussis
Name 6 bacteria that don\\'t Gram\\'s stain well?
Treponema - Rickettsia - Mycobacteria - Mycoplasma - Legionella pneumophila - Chlamydia
Name four genus of bacteria that are G+ rods.
1) Clostridium (an anaerobe) 2) Coynebacterium 3) Listeria 4) Bacillus
Name seven G+ bacteria species that make exotoxins.
1) Corynebacterium diphtheriae 2) Clostridium tetani 3) Clostridium botulinum 4) Clostridium perfringens 5) Bacillus anthracis 6) Staph. aureus 7) Strep. pyogenes
Name three diseases caused by exotoxins.
Tetanus - botulism - diptheria
Name three G- bacteria species that make exotoxins.
1) E. coli 2) Vibrio cholerae 3) Bordetella pertussis
Name three Lactose-fermenting enterics.
Eschericia, Klebsiella, Enterobacter
Name two diseases caused by endotoxins.
Meningococcemia - sepsis by G(-) rods
Name two type of Strep that exhibit alpha hemolysis?
S. pneumoniae - Viridans strep. (e.g. S. mutans)
Name two types of Strep. that are non-hemolytic (gamma hemolysis).
Enterococcus (E. faecalis) and Peptostreptococcus (anaerobe)
Name two types of Strep. that exhibit beta hemolysis.
Group A Strep. (GAS) and Group B Strep. (GBS)
Teichoic acid induces what two cytokines?
TNF and IL-1
What are the effects of erythrogenic toxin?
it is a superantigen - it causes rash of Scarlet fever
What are the effects of streptolysin O?
it is a hemolysin - it is the antigen for ASO-antibody found in rheumatic fever
What are the effects of the exotoxin secreted by Bacillus anthracis? (1)
one toxin in the toxin complex is an adenylate cyclase
What are the effects of the exotoxin secreted by Bordetella pertussis? (3)
Stimulates adenylate cyclase by ADP ribosylation - causes whooping cough - inhibits chemokine receptor, causing lymphocytosis
What are the effects of the exotoxin secreted by Clostridium botulinum?
blocks release of acetylcholine: causes anticholenergic symptoms, CNS paralysis; can cause \\'floppy baby\\'
What are the effects of the exotoxin secreted by Clostridium perfringens?
alpha toxin is a lecithinase - causes gas gangrene - get a double zone of hemolysis on blood agar
What are the effects of the exotoxin secreted by Clostridium tetani?
blocks release of the inhibitory NT glycine; causes \\'lockjaw\\'
What are the effects of the exotoxin secreted by Corynebacterium diphtheria? (3)
1) inactivates EF-2 by ADP ribosylation 2) pharyngitis 3) \\'pseudomembrane\\' in throat
What are the effects of the exotoxin secreted by E. coli? (2)
this heat labile toxin stimulates adenylate cyclase by ADP ribosylation of G protein - causes watery diarrhea
What are the effects of the exotoxin secreted by Staph. aureus?
superantigen; induces IL-1 and IL-2 synthesis in Toxic Shock Syndrome; also causes food poisoning
What are the effects of the exotoxin secreted by Vibro cholerae? (3)
Stimulates adenylate cyclase by ADP ribosylation of G protein - increases pumping of Cl- and H2O into gut - causes voluminous rice-water diarrhea
What are the general clinical effects of endotoxin?(2)
fever, shock
What are three primary/general effects of endotoxin (especially lipid A)?
1) Acivates macrophages 2) Activates completment (alt. pathway) 3) Activates Hageman factor
What are two exotoxins secreted by Strep. pyogenes?
Erythrogenic toxin and streptolysin O
What are two functions of the pilus/fimbrae?
Mediate adherence of bacteria to the cell surface - sex pilus forms attachment b/t 2 bacteria during conjugation
What are two species of Gram (-) cocci and how are they differentiated?
1) Neisseria memingitidis: maltose fermenter 2) Neisseria gonorrhoeae: maltose NONfementer
What bacteria produces a blue-green pigment?
Pseudomonas aeruginosa
What bacteria produces a red pigment?
Serratia marcescens (\\'maraschino cherries are red\\')
What bacteria produces a yellow pigment?
Staph. aureus (Aureus-> gold in Latin)
What culture requirements do Fungi have?
Sabouraud\\'s agar
What culture requirements do Lactose-fermenting enterics have?
MacConkey\\'s agar (make pink colonies)
What culture requirements does B. pertussis have?
Bordet-Gengou (potato) agar
What culture requirements does C. diphtheriae have?
Tellurite agar
What culture requirements does H. flu have?
chocolate agar with factors V (NAD) and X (hematin)
What culture requirements does Legionella pneumophia have?
Charcol yeast extract agar buffered with increased iron and cysteine
What culture requirements does N. gonorrhea have?
Thayer-Martin (VCN) media
What G- rod is a lactose nonfermenter and is Oxidase+ ?
Pseudomonas
What is a function of the plasma membrane in bacterial cells.
site of oxidative and transport enzymes
What is a toxoid?
exotoxin treated with formaldehyde (or acid or heat); retains antigeniciy but looses toxicity
What is an acronym for remembering 6 bacteria that don\\'t Gram\\'s stain well?
TRMMLC: These Rascals May Microscopically Lack Color
What is meant by alpha, beta, and gamma hemolysis?
On a Blood agar plate: alpha-> complete; clear - beta-> partial; green - gamma-> no hemolysis; red
What is the chemical composition of a glycocalix?
polysaccharide
What is the chemical composition of bacterial ribosomes?
RNA and protein in 30S and 50S subunits
What is the chemical composition of endotoxin?
Lipopolysaccharide
What is the chemical composition of exotoxin?
polypeptide
What is the chemical composition of spores?
keratin-like coat - dipicolinic acid
What is the funciton and chemical composition of the flagellum?
for motility - made of protein
What is the function of a glycocalix?
mediates adherence to surfaces, especially foreign surfaces (i.e. catheters)
What is the function of spores?
provides resistance to dehydration, heat, and chemicals
What is the major chemical composition of the capsule?
Polysaccharide (*except Bacillus anthracis, which contains D-Glutamate)
What is the major function of the capsule?
antiphagocytic
What is the mode of action of endotoxin?
includes TNF and IL-1
What is the nature of the DNA transferred in conjugation?
Chromosomal or plasmid
What is the nature of the DNA transferred in transduction?
Any gene in generalized transduction; only certain genes in specialized transduction
What is the nature of the DNA transferred in transformation?
Any DNA
What is the periplasm? Where is it found?
the space between the inner and outer cell membranes found in G(-) bacteria.
What is the primary test to subcatergorize G- rods?
are they Lactose Fermenters?
What is the source of endotoxins?
cell wall of most G- bacteria (think N-dotoxin-> gram Negative)
What is the source of exotoxins?
certain species of some G+ and G- bacteria
What is the unique chemical component of Gram (-) cell membranes?
Lipopolysaccharide
What is the unique chemical component of Gram + cell membranes?
Teichoic acid
What is used to stain Legionella?
Use silver stain.
What species is Group A Strep?
S. pyogenes
What species is Group B Strep?
S. agalactiae
What stain is amyloid and gives an apple-green birefringence in polarized light?
Congo red
What stain is used for acid fast bacteria?
Ziehl-Neelsen
What stain is used for Borrelia, Plasmodium, trypanosomes, and Chlamydia?
Giemsa\\'s
What stain is used for Cryptococcus neoformans?
India ink
What stains gylcogen, mucopolysaccharides and is used to diagnose Whipple\\'s disease?
PAS (periodic acid Schiff)
What test distinguishes Staph. and Strep?
Staph. are Catalase (+) and are in clusters - Strep. are Catalase (-) and are in chains
What test distinguishes Staph. aureus from Staph. epidermidis and Staph. saprophyticus?
S. aureus is Coagulase (+) - S. epidermidis and S. saprophyticus are Coagulase (-)
What two things distinguish S. pneumoniae from Viridans Strep.?
S. pneumoniae: have Capsule; Optochin Sensitive - Viridans strep: No capsule; Optochin Resistant
What type of enzymes allows certain bacteria to colonize mucosal surfaces?
IgA proteases
When endotoxin activates complement, what are the secondary effects?
C3a: hypotension, edema - C5a: neutrophil chemotaxis
When endotoxin activates Hageman, what are the secondary effects?
coagulation cascade: DIC
When endotoxin activates macrophages, what 3 cytokines are released and what are the secondary effects?
IL-1--fever - TNF--fever, hemmoragic tissue necrosis - Nitic oxide--hypotension, shock
Where are the genes for endotoxin located?
on the bacterial chromosome
Where are the genes for exotoxin located?
on a plasmid or in a bacteriophage
Where are the spores of Clostridium botulinum found?
canned food - honey
Where is LPS found?
in the outer membrane of G (-) cell walls
Which has a higher toxicity: exotoxin or endotoxin?
EXOTOXIN: fatal dose is ~1ug! (for endotoxin, fatal dose is hundreds of micrograms)
Which type of Neisseria ferment Glucose only?
Gonococci (Glucose-> Gonococci)
Which type of Neisseria ferment maltose and glucose?
Meningococci (MaltoseGlucose-> MeninGococci)
Which types of transfer can eukaryotic cells do?
only transformation
Which types of transfer can prokaryotic cells do?
all 3: conjugation, transduction, and transformation
Why don\\'t Mycobacteria Gram\\'s stain well?
high lipid content cell wall requires acid-fast stain
Why don\\'t Mycoplasma Gram\\'s stain well?
no cell wall
Why don\\'t Rickettsia, Chlamydia, and Legionella Gram\\'s stain well?
they are intracellular (Legionella is Mainly intracellular)
Why don\\'t Treponema Gram\\'s stain well?
too thin to be visualized (use darkfield microscopy and antibody staining)
Name 5 species of bacteria that are transmitted to humans from animals.(Acronym: BBugs From Your Pet.)
Borrelia burgdorferi - Brucella spp. - Francisella tularensis - Yersinia pestis - Pasteurella multocida
All Rickettsiae (except one genus) are transmitted by what type of vector?
arthropod (Coxiella is atypical: transmitted by aeresol)
Are G(-) bugs resistant to Pen G? to ampicillin? to vancomycin?
G- bugs are resistant to PenG but may be susceptible to pen. derivative like ampicillin. The G- outer mb inhibits entry of PenG and vancomycin.
Are Strep. pneumoniae sensitve to optochin? Are Viridans strep.?
Strep. pneumoniae is optochin-Sensitive - Viridans streptococci is optochin-Resistant
Are Strep. pyogenes Bacitracin-sensitive?
YES.
Are Viridans strep. alpha, beta, or non-hemolytic?
alpha
Because of drug resistance, what in an alternate treatment combination for leprosy?
rifampin with dapsone and clofazimine
Besides the rash, what other body systems are affected by Lyme disease? (3)
joints -CNS -heart
Describe lab-findings for Pseudomonas aeruginosa.
Aerobic, G(-) rod. - Non-lactose fermenting - Oxidase positive - Produces pyocyanin (blue-green pigment)
Describe the disease associated with M. avium-intracellulare.
often resistant to multiple drugs; causes disseminated disease in AIDS.
Describe the H. flu vaccine. When is it given?
contains type b capsulare polysaccharide conjugated to diphtheria toxoid or other protein. -Given b/t 2m and 18m.
Describe the typical findings with diarrhea caused by enterotoxigenic E. coli. (3)
1) Ferments lactose 2) watery diarrhea 3) no fever/leukocytosis
Describe the typical findings with Vibro cholerae. (3)
1) Comma-shaped organisms 2) rice-water stools 3) no fever/leukocytosis
Do Streptococcus pneumonia have catalase? Do Viridans Strep. have catalase?
NO. both are catalase -
Enterococci are hardier than nonenterococcal group D bacteria. What lab conditions can they grow in?
6.5% NaCl (used as lab test)
Following primary infection with TB, if preallergic lymphatic or hematogenous dissemination occurs, what follows?
=-dormant tubercle bacilli form in several organs - REACTIVATION can occur in adult life
Following primary infection with TB, if severe bacteremia occurs, what follows?
Miliary tuberculosis and possibly death
Following primary infection with TB, if the lesion heals by fibrosis, what is the result?
Immunity and hypersensitivity---> tuberculin positive
Following primary infection with TB, under what conditions would the lesion likely progress to lung disease?
HIV, malnutrition. This progressive lung disease can rarely lead to death.
Following primary infection with TB, what are 4 possible courses the disease could take?
1) Heals by fibrosis 2) Progressive lung disease 3) Severe bacteremia 4) Preallergic lymphatic or hematogenous dissemination
Give 3 examples of obligate anaerobes.
Clostridium - Bacteroides - Actinomyces
Give 3 types of infection Pseudomonas aeruginosa is commonly responsible for.
1) burn wound infection 2) nosocomial pneumonia 3) pneumonia with cystic fibrosis
Give 4 examples of encapsulated bacteria.
1) Strep. pneumoniae 2) Haemophilus influenza (especially b) 3) Neisseria memingitidis 4) Klebsiella pneumoniae
H. flu causes what? (4)
Epiglottitis -Meningitis -Otitis media -Pneumonia (haEMOPhilus)
How are Borrelia visualized?
using aniline dyes (Wright\\'s or Giemsa stain) in light microscopy
How are Mycobacteria visualized in the lab?
acid-fast stain -> Ziehl-Neelson
How are Treponema visualized?
by dark-field microscopy
How can secondary tuberculosis in the lung occur?(2)
1) Reinfection of partially immune hypersensitized hosts (usu. adults) -> exogenous source 2) Reactivation of dormant tubercle bacilli in immunocompromised or debilitated hosts -> endogenous source
How can you remember that Viridans strep are resistant to optochin?
they live in the mouth and are not afraid of the (opto-)CHIN
How does primary syphilis present?
with a painless chancre (localized disease; 2-10 wks).
How does secondary syphilis present?
disseminated disease (1-3m later) with constitutional symptoms, maculopapular rash, condylomata lata (genital lesions)
How does tertiary syphilis present?
gummas (granulomas), aortitis, neurosyphilis (tabes dorsalis), Argyll-Robertson pupil
How does the bacterium cause the disease?
via exotoxin encoded by beta-prophage; exotoxin inhibits protein synthesis via ADP-ribosylation of EF-2
How does the rash with typhus differ from the rash with RMSF?
typhus: maculopapillary rash BEGINS ON TRUNCK, moves peripherally -RMSF: macules progressing to petichiae BEGIN ON HANDS &FFET and move inward.
How is Brucellosis/Undulant fever transmitted?
dairy products, contact with animals
How is Cellulitis transmitted?
Animal bite; cats, dogs
How is H. flu transmitted?
aeresol
How is Legionnaires\\' disease diagnosed in lab?
use silver stain (doesn\\'t Gram stain well) -culture with charcoal yeast extract with iron and cysteine.
How is Legionnaires\\' disease transmitted?
aeresol transmission from envirnomental water source habitat (NO human-to-human transmission).
How is Lyme disease transmitted?
Tick bite; Ixodes ticks that live of deer and mice
How is Shigella spread?
food, fingers, feces, and flies\\'
How is the Plague transmitted?
Flea bite; rodents, especially prairie dogs
How is Tuleremia transmitted?
Tick bite; rabbits, deer
Is Bacillus anthracis G+ or G-? What is its morphology?
It is a G+, spore-forming rod
Is there an animal reservoir for leprosy?
Yes, armadillos in the US
List 5 findings associated with rheumatic fever. (Hint: PECCS)
Polyarthritis - Erythema marginatum -Chorea - Carditis - Subcutaneous nodules
List the \\'ABCDEFG\\' of diphtheria.
ADP ribosylation -Beta-prophage -Corynebacterium - Diphtheria - Elongation Factor 2 - Granules
Name 2 alpha-hemolytic bacteria.
Strep. pneumoniae - Viridans streptococci
Name 2 bugs that cause diarrhea but NOT fever and leukocytosis?
E. coli and Vibro cholerae
Name 2 disease processes that can be caused by enterococci.
1) UTI 2) subacute endocarditis
Name 2 species of enterococci.
Enterococcus faecalis -Enterococcus faecium
Name 2 symptoms of diphtheria.
pseudomembraneous pharyngitis (grayish white membrane) - lymphadenopathy
Name 3 spore forming bacteria.
Bacillus anthracis - Clostridium perfringens - C. tetani
Name 4 beta-hemolytic bacteria.
1) Staph. aureus 2) Strep. pyogenes (GAS) 3) Strep. agalactiae (GBS) 4) Listeria monocytogenes
Name 4 lactose-fermenting enteric bacteria.
Klebsiella -E. coli -Enterobacter Citrobacter (think Lactose is KEE for first three listed)
Name 4 obligate aerobic bacteria.
Norcardia - Pserudomonas aeruginosa - Mycobacterium tuberculosis - Bacillus
Name 5 bugs that cause watery diarrhea.
1) Vibrio cholerae 2) enterotoxigenic E. coli 3) viruses (rotavirus) 4) protozoa (Cryptosporidium and (5) Giardia)
Name 6 bugs that cause bloody diarrhea.
1) Salmonella 2) Shigella 3) Campylobacter jejuni 4) enterohemorrhagic/enteroinvasive E.coli 5) Yersinia enterocilitica 6) Entamoeba histolytica (a protozoan)
Name 7 faculatative intracellular bacteria.
1) Mycobacterium 2) Brucella 3) Francisella 4) Listeria 5) Yersinia 6) Legionella 7) Salmonella
Name three genera of spirochetes.
Borrelia (big size) - Leptospira -Treponema (think: BLT; B is big)
Name two lab tests used to detect syphilis?
VDRL and FTA-ABS
Name two non-lactose fermenting bacteria that invade intestinal mucosa and can cause bloody diarrhea.
Salmonella and Shigella
Name two obligate intracellular bacteria.
Rickettsia and Chlamydia (Hint: \\'stay inside when its Really Cold.\\')
RMSF is endemic to what part of the US?
the East Coast (in spite of the name)
Spore are formed by certain species of what type of bacteria?
Gram+ rods, usually in soil; form spores only when nutrients are limited
T/F Chlamydia are obligate intracellular parasites that cause mucosal infections.
TRUE
T/F Chlamys means cloak.
TRUE (intracellular)
T/F Enterobacteriaceae are oxidase negative and are glucose fermenters.
TRUE
T/F H. pylori infection is a risk factor for peptic ulcer and gastric carcinoma.
TRUE
T/F Penicillin is not an effective treatment against Mycoplasma pneumoniae.
TRUE Mycoplama are naturally resistant b/c they have no cell wall.
T/F Pseudomonas produces both endotoxin and exotoxin.
TRUE: endotoxin---> fever, shock -exotoxin---> inactivates EF-2
T/F Rickettsiae are obligate intracellular parasites and need CoA and NAD.
TRUE
T/F Some enterococci are resistant to PenG.
FALSE: ALL enterococci are naturally resistant to Pen/cephlosporins.
T/F Spores have no metabolic activity.
TRUE
T/F: S. aureus food poisoning is due to the ingestion of bacteria that rapidly secrete toxin once they enter the GI tract.
FALSE: rapid onset of S. aureus food poisoning is due to injestion of PREFORMED toxin
The Weil-Felix reaction usually tests positive for what two diseases? Negative for what? Cross reacts with what?
Positive: typhus and RMSF -Negative: Q fever -Cross-reacts: with Proteus antigen
Think COFFEe for Enterobacteriaceae. What does that stand for?
Capsular -O-antigen -Flagellar antigen -Ferment glucose -Enterobacteriaceae
What\\'s a pneumonic for remembering 4 obligate aerobes?
Nagging Pests Must Breath (-> Norcardia - Pserudomonas aeruginosa - Mycobacterium tuberculosis - Bacillus
What (6) infections can Pseudomonas aeruginosa cause?
burn-wound infections -Pneumonia (esp. in cystic fibrosis) -Sepsis (black skin lesions) -External Otitis (swimmer\\'s ear) - UTI -hot tub folliculitis
What 2 bugs can cause bloody diarrhea, fever, and leukocytosis, but do not ferment lactose?
Salmonella and Shigella
What animals carry Lyme disease?
The Ixodes tick transmits it. - Deer are required for tick life cycle. - Mice are important resservoirs.
What anitbody class is necessary for an immune response to encapsulated bacteria?
IgG2.
What are 2 disease processes caused by Viridans strep and what species are responsible?
1) dental caries: Strep. mutans 2) bacterial endocarditis: Strep. sanguis
What are 2 options for triple thearpy treatment of H. pylori?
(1) bismuth (Pepto-Bismal), metronidazole, and tetracyclin or amoxicillin. OR (2) metronidazole, omeprazole, and clarithromycin (#2 is more expensive)
What are 3 advantages/differences between VDRL and FTA-ABS?
FTA-ABS is 1) more specific 2) positive earlier in disease 3) remains positive longer than VDRL
What are 3 disease processes caused by Strep. pyogenes?
1) Pyogenic--pharyngitis, cellulitis, skin infection 2) Toxigenic--scarlet fever, TSS 3) Immunologic--rheumatic fever, acute glomerulonephritis
What are 4 biological false positives for VDRL?
1) Viruses (mono, hepatitis) 2) Drugs 3) Rheumatic fever and rheumatic arthritis 4) Lupus and leprosy (-> VDRL)
What are 4 clinical symptoms of \\'walking\\' pneumonia?
1) insidious onset 2) headache 3) nonproductive cough 4) diffuse interstitial infiltrate
What are 4 clinical symptoms of TB?
1) fever 2) night sweats 3) weight loss 4) hemoptysis
What are 5 areas that can be affected by extrapulmonary TB?
1) CNS (parenchmal tuberculoma or meningitis) 2) Vertebral body (Pott\\'s disease) 3) Lymphadenitis 4) Renal 5) GI
What are the culture requirement for H. flu?
culture on chocolate agar with factor V (NAD) and X (hematin). [Think: \\'Child has \\'flu\\'; mom goes to five (V) and dime (X) store to buy chocolate.\\']
What are the lab findings with Chlamydia?
cytoplasmic inclusions on Giemsa fluorescent antibody-stains smear
What are the symptoms of RMSF? (3)
1) rash on palms and soles (migrating to wrists, ankles, then trunck) 2) headache 3) fever
What are the three stages of Lyme disease?
1) erythema chronicum migrans, flu-like symptoms 2) neurologic and cardiac manefestations 3) autoimmune migratory polyarthritis
What are the two forms of chlamydia?
1) Elementary body (small, dense): Enters cell via endocytosis 2) Initial or Reticulate body: Replicates in the cell by fission
What are the two forms of leprosy (or Hansen\\'s disease)?
1) lepromatous- failed cell-mediated immunity, worse 2) tuberculoid- self-limited.
What are two drugs that could be used to treat \\'walking\\' pneumonia?
tetracycline or erythromycin
What are two drugs that could treat Chlmydia?
erythromycin or tetracycline
What are two lab findings associated with \\'walking\\' pneumonia?
1) X-ray looks worse than patient 2)High titer of cold agglutinins (IgM)
What are usually associated with pseudomembraneous colitis?
Clostridium difficile; it kills enterocytes, usu. is overgrowth secondary to antibiotic use (esp. clindamycin or ampicillin)
What bacteria are G+, spore-forming, anaerobic bacilli?
Clostridia
What bacteria causes a malignant pustule (painless ulcer); black skin lesions that are vesicular papules covered by a blak eschar?
Bacillus anthracis
What bacteria exhibits a \\'tumbling\\' motility, is found in unpasteurized milk, and causes meningitis in newborns?
Listeria monocytogenes
What bacteria is catalase(-) and bacitracin-resistant?
Strep. agalactiae
What bacteria is catalase(-) and bacitracin-sensitive?
Strep. pyogenes
What bacteria is catalase+ and coagulase+?
Staph. aureus
What bacteria produces alpha-toxin, a hemolytic lecithinase that causes myonecrosis or gas gangrene?
Clostridium perfringens
What bacterium causes Cellulitis?
Pasteurella multocida
What bacterium causes leprosy?
Mycobacterium leprae
What bacterium causes Lyme disease?
Borrelia burgdorferi
What bacterium causes the Plague?
Yersinia pestis
What bacterium causes Tularemia?
Francisella tularensis
What bacterium causes Undulant fever?
Brucella spp. (a.k.a. Brucellosis)
What bug causes atypical \\'walking\\' pneumonia?
Mycoplama pneumoniae
What bug causes gastroenteritis and up to 90% of duodenal ulcers?
Helicobacter pylori
What bug causes Legionnaire\\'s disease?
Legionella pneumophila
What bug is associated with burn wound infections?
Pseudomonas aeruginosa
What bug is comma- or S-shaped and grows at 42C, and causes bloody diarrhea with fever and leukocytosis?
Campylobacter jejuni
What bug that causes diarrhea is usually transmitted from pet feces (e.g. puppies)?
Yersinia enterocolitica
What causes tetanus? (give bacteria and disease process)
Clostridium tetani: exotoxin produced blocks glycine release (inhibitory NT) from Renshaw cells in spinal cord
What causes the flu?
NOT H. flu -it is caused by influenza virus
What chemical is found in the core of spores?
dipicolinic acid
What coccobacillus causes vaginosis: greenish vaginal discharge with a fishy smell; nonpainful?
Gardnerella vaginalis
What disease does Bordetella perussis cause? How?
Whooping cough: toxin permanently disables G-protein in respiratory mucosa (turns the \\'off\\' off);ciliated epithelial cells are killed; mucosal cells are overactive.
What disease does Vibrio cholerae cause? How?
Cholera: toxin permanently activates G-protein in intestinal mucosa (turns the \\'on\\' on) causing rice-water diarrhea
What disease is caused by Borrelia?
Lyme Disease
What disease is caused by Clostridium botulinum? What pathophys. does it cause?
Botulism: associated with contaminated canned food, produces a preformed, heat-labile toxin that inhibits ACh release---> flaccid paralysis.
What diseases (2) are caused by Treponema?
Syphilis (T. pallidum) -yaws (T. pertenue; not and STD)
What diseases can be caused by Staph. aureus?
Inflammatory disease: skin infections, organ abcess, pneumonia - Toxin-mediated disease: Toxic Shock Syn., scalded skin syndrome (exfoliative toxin), rapid onset food poisoning (enterotoxins)
What do Chlamydia trachomatis serotypes A, B, and C cause?
chronic infection, cause blindness in Africa (ABC-> Africa / Blindness / Chronic
What do Chlamydia trachomatis serotypes D-K cause? (3)
urethritis/ PID - neonatal pneumonia -neonatal conjuctivitis
What do Chlamydia trachomatis serotypes L1,L2, and L3 cause?
lymphogranuloma venereum (acute lymphadentis: positive Frei test)
What do RMSF, syphilis, and coxsackievirus A infection have in common?
rash on palm and sole is seen in each (coxasackievirus A -> hand, foot, and mouth disease)
What does catalase do? Which bacteria have it?
it degrades H2O2, an antimicrobial product of PMNs. - Staphlococci make catalase; Strep. do NOT.
What does the H-antigen represent?
H: flagellar antigen, found on motile species
What does the K-antigen represent?
K: capsular, relates to virulence
What does the O-antigen represent?
O-antigen is the polysaccharide of endotoxin (found on all species)
What does VDRL detect? (It detects non-specific antibody that reacts with what?)
detects antibody that reacts with beef cardiolipin
What drug of choice is used to treat Norcardia? Actinomyces? (Acronym: SNAP)
Sulfa for Norcarida, Actinomyces gets Penicillin
What enteric bacterial infection may be prolonged with antibiotic treatment?
Salmonellosis
What enzyme allows H. pylori to creat an alkaline environment?
urease (cleaves urea to ammonia); used in urease breath test
What family includes E. coli, Salmonella, Klebsiella, Enterobacter, Serratia, and Proteus?
Enterobacteriaceae
What family of bacteria uses the O-, K-, and H-antigen nomenclature?
Enterobacteriaceae
What function does the capsule serve? (2: one for the bacterium, one other)
1) antiphagocytic 2) antigen in vaccines (Pneumovax, H. flu b, meningococcal vaccines)
What G+ anaerobe causes oral/facial abscesses with \\'sulfur granules\\' that may drain through sinus tracts in skin?
Acinomyces israelii
What G+ and also weakly acid fast aorobe found in soil causes pulmonary infections in immunocompromised patients?
Norcardia asteroides
What general type of bacteria are normal flora in GI tract but pathogenic elsewhere?
Anaerobes
What general type of bacteria grow pink colonies on MacConkey\\'s agar?
Lactose-fermenting enteric bacteria
What is a Ghon complex and in whom does it occur?
Occurs in Primary TB (usually a child) -Ghon complex-> draining Hilar nodes and Ghon focus, exudative parenchymal lesion (usu. in LOWER lobes of lung)
What is a lab diagnosis of diphtheria based on?
G+ rods with metachromatic granules; grows on tellurite agar. (Coryne-> club shaped)
What is a major difference between Salmonella and Shigella observable in the lab?
Salmonella are motile; Shigella are nonmotile
What is a positive Quellung reaction?
if encapsulated bug is present, capsule SWELLS when specific anticapsular antisera are added.
What is notable about Chrmydia psittaci?
has an avian reservoir
What is one reason M. leparae infects skin and superficial nerves?
It likes cool temperatures
What is the classic symptom of Lyme Disease?
erythema chronicum migrans, an expanding \\'bull\\'s eys\\' red rash with central clearing.
What is the classic triad of symptoms associated with Rickettsiae?
1) headache 2) fever 3) rash (vasiculitis)
What is the common manifestation of secondary TB?
Fibrocaseous cavitary lesion usu. in APICIES of lung
What is the common site of infection for Mycobacterium tuberculosis?
the apicies of the lung (which have the highest PO2)
What is the D.O.C. to treat Gardnerella vaginalis?
Metroidazole
What is the DOC for treating rickettsial infections?
tetracycline
What is the DOC for treatment of most rickettsial infections?
tetracycline
What is the DOC to treat Lyme Disease?
tetracycline
What is the DOC to treat syphilis?
Penicillin G
What is the drug of choice for H. flu meningitis? What DOC for prophylaxis in close-contacts?
Treat meningitis with CEFTRIAXONE; Rifampin for prophylaxis.
What is the drug of choice for Legionaires\\' disease?
Erythromycin
What is the morphology of H. flu?
Small G(-) (coccobacillary) rod
What is the morphology of H. pylori?
Gram (-) rod
What is the primary drug used to treat leprosy?
dapsone (toxicity is hemolysis and methemoglobinemia)
What is the recommended treatment for Pseudomonas aeruginosa infection?
aminoglycoside plus extended-spectrum penicillin (e.g. piperacillin or ticarcillin)
What is the source of infection and the bacterium that causes endemic typhus?
R. typhi; from fleas
What is the source of infection and the bacterium that causes epidemic typhus?
R. prowazekii; from human body louse
What is the source of infection and the bacterium that causes Q fever?
Coxiella burnetii; from inhaled aersols
What is the source of infection and the bacterium that causes Rocky Mountain Spotted Fever?
Rickettsia rickettsii; from tick bite
What is the toxin responsible for TSS is Staph. aureus?
TSST-1; it is a superantigen that binds to class II MHC and T-cell receptors---> polyclonal T-cell activation
What is the unique component found in Mycoplamsa bacterial membranes?
cholesterol
What is the unique feature of Chlamydiae cell walls?
its peptidoglycan wall lacks muramic acid
What is woolsorter\\'s disease?
inhalation anthrax; can cause life-threatening pneumonia
What lab test assays for antirickettsial antibodies?
Weil-Felix reaction
What Lancefield Antigen Group are enterococci in?
Group D
What Lancefield Antigen Group are Viridans strep in?
They are non-typealbe. They do not have a C-carbohydrate on their cell wall to be classified by.
What level of disinfection is required to kill spores?
autoclaving; they are highly resistant to destruction by heat and chemicals
What populations are most likely to get Mycoplama pneumoniae infection?
patients younger than age 30 - military recruits - prisons
What rickettsial disease is atypical in that it has no rash, no vector, negative Weil-Felix reaction, and its causative organism can survive outside for a long time?
Q fever (Coxiella burnetii)
What species are associated with food poisoning in contaminated seafood?
Vibrio parahaemolytica and Virbrio vulnificus
What species causes diphtheria?
Corynebacterium diptheriae
What species is associated with food poisoning in improperly canned foods (bulging cans)?
Clostridium botulinum
What species is associated with food poisoning in meats, mayonnaise, and custard?
Staphylococcus aureus (this food poisoining usu. starts quickly and ends quickly)
What species is associated with food poisoning in poultry, meat, and eggs?
Salmonella
What species is associated with food poisoning in reheated meat dishes?
Clostridium perfringens
What species is associated with food poisoning in reheated rice?
Bacillus cereus (\\'Food poisoning from reheated rice? Be serious!\\')
What species is associated with food poisoning in undercooked meat and unpasteurized juices?
E. coli 0157-H7
What species of Mycobacteria causes pulmonary, TB-like symptoms?
M. kansasii
What strain of Haemophilus influenza causes most invasive disease?
capsular type b
What symptoms are associated with M. scrofulaceum
cervical lymphadenitis in kids
What test differentiates Viridans from S. pneumoniae?
Viridans are resistant to optochin; S. pneu. are sensitive to optochin
What two bugs secrete exotoxins that act via ADP ribosylation of G-proteins, permanently activating adenyl cyclase (resulting in increased cAMP)?
Vibrio cholerae - Bordetella pertussis
What two genera of G+ rods form long branching filaments resembling fungi?
Acinomyces and Nocardia
What type of bacteria are difficult to culture, produce gas in tissue (CO2 and H2), and are generally foul-smelling?
Anaerobes
What type of bacteria is associated with rusty sputum, sepsis in sickle cell, and splenectomy?
Pneumoccocus
What type of E. coli are associated with bloody diarrhea?
enterohemmoragic/ enteroinvasive E. coli
What type of immunologic response is elicited by a Salmonella infection?
monocyte response
What types of infection can chlamydia cause? (4)
arthritis - conjunctivitis - pneumonia - nongonococcal urethritis
What virulence factor of Staph. aureus binds Fc-IgG, inhibiting complement fixation and phagocytosis?
Protein A
What virulence factor of Strep. pyogenes also serves as an antigen to which the host makes antibodies?
M-protein
What will likely be visible under the microscope in the case of Gardnerella vaginallis infection?
Clue cell, or vaginal epithelial cells covered with bacteria
Where are Viridans strep. found (reservoir)?
normal flora of oropharynx
Where are when is Lyme disease common?
common in northeast US in summer months
Which disease/toxin causes lymphocytosis? (Cholera or Pertussis)
Pertussis toxin: by inhibiting chemokine receptors
Which has an animal reservoir? (Salmonella or Shigella)
Salmonella: poultry, meat, eggs
Which is more specific for syphilis: VDRL or FTA-ABS?
FTA-ABS is more specific
Which is more virulent? (Salmonella or Shigella)
Shigella (10^1 organisms vs. Salmonella 10^5 organisms)
Which is motile? (Salmonella or Shigella)
Salmonella (think: salmon swim)
Which species of chlamydia causes and atypical pneumonia? How is it transmitted?
C. pneumonia -transmitted via aeresol
Which two species of chlamydia infect only humans?
C. trachomatis -C. pneumoniae
Why are anaerobes susceptible to oxygen?
they lack catalase and/or oxidase and are susceptible to oxidative damage
Why does TB usually infect the upper lobes of the lung?
M.tuberculosis is an aerobe; there is more oxygen at the apicies
Why must rickettsia and chlamydia always be intracellular?
they can\\'t make their own ATP
Are most fungal spores asexual?
yes
Are most P. Carinii infections symptomatic?
no, most of are asymptomatic
Are the above mentioned systemic mycoses dimorphic?
yes, except coccioidomycosis which is a spherule in tissue
How do the S. Schenckii yeast appear in the pus?
Cigar-shaped budding yeast
How do you diagnose cryptosporidium?
cysts on acid fast stain
How do you diagnose giardiasis?
Trophozoites or cysts in stool
How do you get P. Carinii?
Inhalation
How do you treat systemic mycoses?
fluconazole or ketoconazole for local infection, amphotericin B for systemic infection
How do you Tx S. Schenckii?
Itraconazole or Potassium Iodide
How does Aspergillus appear microscopically?
Mold with septate hyphae that branch at a V-shaped (45 degree angle) , they are NOT dimorphic
How does Mucor species appear microscopically?
It is a mold with irregular nonseptate hyphae branching at wide angles>90 degrees
How does Paracocciodioidomycosis appear histologically?
Captain\\'s wheel\\' appearance (like on a sailboat)
How is Clonorchis sinensis transmitted and what disease results?
undercooked fish; causes inflammation of the biliary tract
How is Schistosoma transmitted and what disease results?
snails are host; cercariae penetrate skin of humans; causes granulomas, fibrosis, and inflammation of the spleen and liver
How is Ancylostoma Duodenale transmitted and what disease results?
Larvae penetrate skin of feet; intestinal infection can cause anemia
How is Ascaris Lumbricoides transmitted and what disease results?
Eggs are visible in feces; intestinal infection
How is cryptosporidium transmitted?
Cysts in Water
How is Dracunculus medinensis transmitted and what disease results?
In drinking water; sink inflammation and ulceration
How is E. granulosis transmitted and what disease results?
Eggs in dog feces cause cysts in liver; causes anaphylaxis if echinococcal antigens released from cysts
How is E. Histolytica transmitted?
Cysts in Water
How is Enterobius Vermicularis transmitted and what disease results?
food contaminated with eggs; intestinal infections; causes anal pruritus
How is giardia transmitted?
Cysts in Water
How is Loa loa transmitted and what disease results?
Transmitted by deer fly; causes swelling the in the skin (can see worm crawling in conjunctiva)
How is malaria dx?
Blood smear
How is malaria transmitted?
mosquito (Anopheles)
How is Onchocerca volvulus transmitted and what disease results?
transmitted by female blackflies; causes river blindness
How is Paragonimus Westermani transmitted and what disease results?
Undercooked crab meat; causes inflammation and secondary bacterial infection of the lung
How is Sporothrix schenckii appear under the scope?
Dimorphic fugus that lives on vegetation
How is Strongyloides Stercoralis transmitted and what disease results?
larvae in soil penetrate the skin; intestinal infection
How is T. Canis transmitted and what disease results?
food contaminated with eggs; causes granulomas (if in retina-> blindness)
How is T. Solium transmitted and what disease results?
undercooked pork tapeworm; causes mass lesions in the brain, cysticercosis
How is T. Vaginalis transmitted?
sexually
How is Toxo transmitted?
cysts in meat or cat feces
How is Trichinella Spiralis transmitted and what disease results?
undercooked meat, usually pork; inflammation of muscle, periorbital edema
How is Wucheria transmitted and what disease results?
female mosquito; causes blockage of lymphatic vessels (elephantiasis)
In what cells do you find histoplasmosis?
macrophages
Is Pneumocystis Carinii a yeast?
Yes, but originally classified as a Protozoa
Microscopically how does Candida appear?
budding yeast with pseudohyphae, germ tube formation at 37 degrees C)
Name 3 Trematodes (Flukes) .
Schistosoma, Clonorchis sinensis, Paragonimus Westermani
Name 4 opportunistic fungal infections.
Candida Albicans, Aspergillus fumigatus, Cryptococcus Neoformans, Mucor and Rhizopus species
Name 4 systemic mycoses.
Coccidiomycosis, Histoplasmosis, Paracoccidioidomycosis, Blastomycosis
Name two asexual spores transmitted by inhalation.
Hisoplasmosis and Coccidiodomycosis
Name two Cestodes (Tapeworms) .
Taenia Solium, and Echinococcus Ganulosus
What agar is used to culture for systemic mycoses?
Sabouraud\\'s Agar
What are Conidia?
asexual fungal spores (ex. Blastoconidia, and arthroconidia)
What are some common Candida infections?
Thrush in Immunocompromised pts (neonates, patients on steroids, diabetics and AIDS pts) , endocarditis in IV drug users, vaginitis (high pH, Diabetes, post-antibiotic) , diaper rash, disseminated candidiasis (to any organ)
What are some infections caused by cryptococcus?
Cryptococcal meningitis, cryptococcosis
What are the 10 Nematodes (roundworms) we are concerned with?
Ancylostoma duodenale (hookworm) , Ascaris Lumbricoides, Enterobius Vermicularis (pinworm) , Strongyloides stercoralis, Trichinella Spiralis, Dracunculus Medinensis, Loa loa, Onchocerca Volvulus, Toxocara Canis, Wucheria Bancrofti
What are the 4 B\\'s of Blastomycosis?
Big, Broad-Based, Budding
What are the diseases caused by Cryptosporidium?
Severe diarrhea in AIDS, Mild disease (watery diarrhea) in non-HIV
What are the diseases caused by Toxoplasma?
Brain Abscess in HIV and birth defects
What are the infections caused by Aspergillus?
Ear fungus, Lung cavity Aspergilloma (\\'fungus ball\\') , invasive aspergillosis.
What can systemic mycoses mimic?
TB (granuloma formation)
What disease are caused by Entamoeba Histolytica?
Amebiasis: bloody diarrhea, dysentery, liver abscess, RUQ pain
What disease does Mucor species cause?
Mucormycosis
What disease does Pneumocystis carinii cause?
Pneumocystis Carinii Pneumonia
What disease does Sporothrix Schenckii cause?
Sprotricosis
What disease does Trypanosoma Cruzi casue?
Chaga\\'s Disease (heart disease)
What disease is caused by Giardia Lamblia?
Giardiasis: bloating, flatulence, foul-smelling diarrhea
What disease is caused by Leishmanina donovani?
Visceral Leishmaniasis (Kala-azar)
What disease is caused by P. Carinii?
Diffuse interstitial pneumonia in HIV
What disease is caused by the plasmodium species (vivax, ovale, malariae, falciparum) ?
Malaria: cyclic fever, headache, anemia, splenomegaly
What disease is caused by Trypanosma Gambiense and Rhodesiense?
African Sleeping sickness
What disesase does Trichomonas Vaginalis cause?
Vaginitis: foul-smeilling, greenish discharge; itching and burning
What do you tx P. Carinii with?
TMP-SMZ, or pentamidine, or dapsone
What do you use to culture cryptococcus?
Asabouraud\\'s Agar
What do you use to Diagnose E. Histolytica?
Serology and/or trophozoites or cysts in stool
What do you use to stain Cryptococcus?
India Ink
What do you use to tx cryptosporidium?
nothing
What do you use to Tx Giardiasis?
Metronidazole
What do you use to tx T. Vaginalis?
Metronidazole
What do you used to dx P. Carinii?
Lung biopsy or lavage, methenamine silver stain
What do you used to Tx Candida Albicans?
Nystatin for superficial infection, Amphotericin B for systemic
What does Alba mean?
white
What does dimorphic mean?
fungi that are mold in the soil (low temp) and yeast in tissue (higher/body temp 37 C)
What is diagnositic for L. donovani?
Macrophages containg amastigotes
What is diagnositic of T. Vaginalis?
Trophozoites on wet mount
What is histoplasmosis associated with?
bird or bat droppings
What is the progression of S. Schenckii infection?
traumatic introduction into the skin, typically by a thorn (\\'rose gardner\\'s\\' disease) , causes local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) . Little systemic illness.
What is the vector for L. donovani?
Sandfly
What is the vector for T. Cruzi?
Reduviid Bug
What is the vector for T. Gambiense and Rhodesiense?
Tstese fly
What is used to dx African sleeping sickness?
Blood smear
What is used to dx T. Cruzii?
blood smear
What is used to dx toxoplasma?
serology and biopsy
What is used to treat D. Medinensis?
Niridazole
What is used to Treat E. Histolytica?
Metronidazole and Iodoquinol
What is used to tx african sleeping sickness?
Suramin for bloodborne disease or melaroprol for CNS penetration
What is used to tx Ancylostoma duodenale?
Mebendazole/pyrantel pamoate
What is used to tx Ascaris Lumbricoides?
Mebendazole/pyrantel pamoate
What is used to tx Clonorhis sinensis?
Praziquantel
What is used to tx E. Granulosus?
Albendazole
What is used to tx E. Vermicularis?
Mebendazole/pyrantel pamoate
What is used to tx L. Donovani?
Sodium Stibogluconate
What is used to tx Loa loa?
diethylcarbamazine
What is used to tx malaria?
Chloroquine ( primaquine for vivax, ovale) , sulfadoxine + pyrimethamine, mefloquine, quinine
What is used to tx O. Volvulus?
Ivermectin
What is used to tx Paragonimus Wetermani?
Praziquantel
What is used to tx S. Stercoralis?
Ivermectin/thiabendazole
What is used to tx schistosoma?
Praziquantel
What is used to tx T. Canis?
diethylcarbamazine
What is used to tx T. Cruzii?
Nifurtimox
What is used to tx T. Spiralis?
Thiabendazole
What is used to tx taenia solium infection?
Praziquantel/niclosamide; albendazole for cysticercosis
What is used to tx toxoplasma?
sulfadiazine + pyrimethamine
What is used to tx W. Bancrofti?
diethylcarbamazine
What patient population is susceptible to Mucor disease?
Ketoacidotic patients and Leukemic patients
What stain do you use for lung tissue when you are detecting P. Carinii?
silver
What state predisposes you to P. Carinii infection?
Immunosuppression
What test can be used to detect polysaccharide capsular antigen of Cryptococcus?
latex agglutination test
What types of infections can Candida Albicans cause?
systemic or superficial fungal in fections
When do you start prophylaxis in HIV patients?
when the CD4 drops below 200 cells/mL
Where do the mucor and rhizopus species fungi proliferate?
in the walls of blood vessels and cause infarction of distal tissue
Where is Blastomycosis endemic?
States east of the Mississippi River and Central America
Where is Coccidioidomycosis endemic?
SWUS, California (San Joaquin Valley or destert (desert bumps) \\'Valley fever\\')
Where is Histoplasmosis endemic?
Mississippi and Ohio River valleys
Where is Paracoccioidomycosis endemic?
Rural Latin America
All viruses are haploid except _________?(1)
Retroviruses, which have two identical ssRNA molecules (diploid).
Bites from what 3 animals are more prone to rabies infection than a bite from a dog?
Bat, Raccoon, and Skunk
Define complementation?
When one of 2 viruses that infects the cell has a mutation that results in a nonfunctional protein. The nonmutated virus \\'complements\\' the mutated one by making a functional protein that serves both viruses.
Define genetic drift.
Minor changes based on random mutations.
Define genetic shift.
Reassorment of viral genome (such as when human flu A virus recombines with swin flu A virus.)
Define phenotypic mixing?
When virus A acquires virus B coat proteins and acts like virus B buts its progeny will have virus A genome and coat.
Define reassortment?
=-When viruses with segmented genomes (eg. influenza virus) exchange segments. -High frequency recombination. Cause of worldwide pandemics.
Define recombination?
Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology.
Describe its incubation period and whether or not it has a carrier.
-Short incubation period (3 weeks) -No carriers
Describe its incubation period and whether or not it has a carrier.
-Long incubation (3 months) - has carriers
Describe the general concept of bacterial super infection which can occur with influenza infection?
A life-threatening illness where a bacterial infection is superimposed on an existing viral infection.
Describe the genetic and physical properties of influenza virus?
=-Enveloped -ssRNA virus with segmented genome -prone to genetic changes
Describe the migration of rabies within the CNS.
It migrates in a retrograde fashion within the CNS up n. axons.
Describe the physical shape and duration of incubation for rabies.
-Bullet-shaped capsid (illus. in book) -long incubation period (wks. - 3 months)
Describe the technique and purpose for performing a Tzanck test?
=-assay for herpes -make a smear of an opened skin vesicle to detect multinucleated giant cells
Describe whether or not it has a carrier.
has carriers
Does HDV have carriers?
Yes
Explain the concept of a slow virus infection.
Virus exists in patient for months to years before it manifests as clinical disease.
From the following selection which classes are considered infectious and which aren\\'t: dsDNA, ds RNA, (-)ssRNA, (+)ssRNA.
-Infectious: dsDNA (except poxviruses and HBV) and (+)ssRNA -Noninfectious: dsRNA and (-)ssRNA
HCV is a common form of hepatitis in what US population?
IV drug users
How does a Monospot test work?
It detects heterophil antibodies by agglutination to sheep RBC\\'s
How is RNA translated and processed in picornaviruses?
RNA is translated into one long polypeptide that is cleaved by proteases into many small proteins.
How many segments and what sense is the RNA genome of influenza viruses?
-8 segments -negative sense
How may serotypes do paramyxoviruses have except parainfluenza which has ___?
-5
Into what class RNA or DNA to all segmented viruses fall?
RNA
Killed vaccines induce what type of immunity?
Humoral, with no possibility of the virus reverting to virulence
Live attenuated vaccines induce what type of immunity?
Humoral and Cellular -with a risk of the virus reverting to virulence
Mneumonic for rotavirus symptoms: ROTA
Right Out The Anus
Mneumonic: Hep D:
Defective, Dependent on HBV
Mneumonic: Hep E:
Enteric, Expectant mothers, Epidemics
Mneumonic: Hep A:
Asymptomatic (usually)
Mneumonic: Hep B:
Blood-borne
Mneumonic: picoRNAvirus
pico -> \\'small\\' RNA viruses
Name 2 common bacterial infections in AIDS pts.
TB, M. avium-intracellulare complex
Name 2 common protozoan infections in AIDS pts.
Toxoplasmosis, cryptosporidiosis
Name 3 members of the arborvirus family.
Flavivirus, Togavirus, and Bunyavirus
Name 3 possible sequelae of measles infection?
-SSPE -encephalitis -giant cell pneumonia (rare;found in immunocompromised persons)
Name 4 common fungal infections in AIDS pts.
=-Thrush (Candida ablicans) -cryptococcosis (cryptococcal meningitis) -histoplasmosis -Pneumocystis pneumonia
Name 4 common viral infections in AIDS pts.
=-HSV -VZV -CMV -progressive multifocal leukoencephalopathy (JC virus)
Name 4 herpesviruses using the mneumonic: Get herpes in a CHEVrolet.
=-CMV -HSV -EBV -VZV
Name 4 main segmented viruses using the mneumonic BOAR.
=-Bunyaviruses -Orthomyxoviruses (influenza virus) -Arenaviruses -Reoviruses
Name eveloped DNA viruses (3). HPH
=-Hepadna -Pox -herpes
Name naked DNA viruses (3). PAP
-Parvo -Adeno -Papova \\'You need to be naked for a PAP smear.\\'
Name the 3 naked RNA viruses Naked CPR).
=-Calcivivirus -Picornavirus -Reovirus
Name the characteristic cytoplasmic inclusions seen in neurons infected with rabies.
Negri bodies
Name the DNA enveloped viruses (3).
-Herpesviruses (herpes simplex virus types 1 and 2, VZV, CMV, EBV) -HBV -smallpox virus
Name the DNA nucleocapsid viruses (2).
Adenovirus, Papillomaviruses
Name the DNA viruses using the mneumonic \\'HHAPPPy viruses.\\'
=-Hepadnavirus -Herpesviruses -Adenovirus -Parvovirus -Papovavirus -Poxvirus
Name the illness caused by rabies and 2 primary symptoms.
Encephalitis, fatal is not prevented, with seizures and hydrophobia.
Name the members of the PaRaMyxovirus using the letters in bold (4 viruses).
=-Parainfluenza -RSV -Measles -Mumps
Name the recombinant vaccine available (1).
HBV (antigen -> recombinant HBsAg)
Name the RNA enveloped viruses (9).
=-influenza viruses -Parainfluenza viruses -RSV -Measles -Mumps -rubella -rabies -HTLV -HIV
Name the RNA nucleocapsid viruses (3).
=-Enteroviruses (poliovirus, coxsackievirus, echovirus, hepatitis a virus) -rhinovirus -reovirus.
Name the vaccines that are killed (4).
-rabies -influenza -hepatitis A -SalK-> Killed
Name the vaccines that are live attenuated (6).
=-MMR -Sabin polio -VZV -yellow fever
Of these 3 markers (HBsAg, HBsAb, HBcAg), which ones are positive in each of the 4 phases below: (acute disease, window phase, complete recovery, chronic carrier).
=-HBsAg, HBcAg -HBcAg -HBsAb, HBcAg -HBsAg, HBcAg
On HIV, what is gp41 and gp120?
envelope protein
On HIV, what is p24? (illus. p. 205)
rectangular nucleocapsid protein
Roughly, what are the time periods for acute, latent, and immunodeficient stages of HIV?
Acute: 1-3 months Latent: 3 months-3years Immunodefic.: 3 yrs.-death (diagram p. 205 that follows serologic course).
Statement: HEV resembles HAV in:
course, severity, and incubation,
Use the mneumonic PERCH to name members of the Picornavirus family.
=-poliovirus -echovirus -rhinovirus -coxsackievirus -hepatitis a
Viral nucleic acids with (choose) same/different nucleic acids as host are infective alone; others require special enzymes (contained in intact virion.)
same
What 2 antigens are used to classify influenza?
Neuraminadase, Hemagglutinin
What age group is the primary target of paramyxoviruses?
children
What antiviral treatment is approved for influenza A (especially prophylaxis) but not for influenza B & C
Amantadine and Rimantadine
What antiviral treatment is approved for influenza A and B?
Zanamivir
What are Councilman bodies and what are they pathomneumonic for?
acidophilic inclusions seen in the liver of those with yellow fever
What are the 3 C\\'s of measles?
=-Cough -Coryza -Conjunctivitis
What are the 4 C\\'s of HCV.
Chronic, Cirrhosis, Carcinoma, Carriers
What are the 4 most common diseases caused by prions?
-Creutzfeldt-Jakob disease (CJD: rapid progressive dementia) -kuru -scrapie (sheep -\\'mad cow disease\\'
What are the causes of SSPE and PML in immunocompromised pts.
=-Late sequelae of Measles -REACTIVATION of JC virus
What are the classic symptoms of yellow fever?
=-High fever -black vomitous -jaundice
What are the common diseases (1) and routes of transmission(1) for HHV-8?
-Kaposi\\'s sarcoma (HIV pts.) -sexual contact
What are the common diseases (2) and routes of transmission(2) for EBV?
-infectious mono, Burkitt\\'s lymphoma -resp. secretions, saliva
What are the common diseases (2) and routes of transmission(2) for HSV-2?
=-herpes genitalis, neonatal herpes -sexual contact, perinatal
What are the common diseases (3) and routes of transmission(1) for VZV?
=-varicella zoster (shingles) -encephalitis -pneumonia
What are the common diseases (3) and routes of transmission(2) for HSV-1?
=-gingivostomatitis keratoconjunctivitis temporal lobe encephalitis herpes labialis -respiratory secretions and saliva
What are the common diseases (3) and routes of transmission(6) for CMV?
=-congenital infection, mono, pneumonia -congenital, transfusion, sexual contact, saliva, urine, transplant
What are the general characteristics of a prion?
infectious agent that does not contain RNA or DNA, consists only of protein
What are the major viruses of the paramyxovirus family? (4)
=-Parainfluenza (croup) -RSV -Measles -Mumps
What are the primary symptoms of the mumps virus? (MOP)
-aseptic Meningitis -Orchitis -Parotitis (mumps give you bumps -> parotitis)
What are the primary viruses of the picornavirus family? (PERCH)
=-poliovirus -echovirus -rhinovirus -coxsackievirus -hepatitis a
What are two classic illness caused by arborviruses?
-dengue fever (break-bone fever) -yellow fever
What general form of encephalopathies do prions present as?
spongiform encephalopathies
What genetic property does segmentation afford viruses and how does this play into flu epidemics?
=-Segmentation allows reassorment to occur in RNA viruses -this contributes to antigenic shifts which Cause most flu pandemics.
What group has a high mortality rate from HEV?
pregnant women
What hematologic finding is characteristic of mono?
abnormal circulating cytotoxic T cells (atypical lymphocytes)
What is HBcAb, and what does it indicate?
Antibody to HBcAg; IgM HBcAb indicates recent disease
What is HBcAg?
Antigen associated with core of HBV
What is HBeAb, and what does it indicate?
Antibody to e antigen; indicates low transmissibility
What is HBeAg, and what does it indicate?
it is a 2nd different antigen marker of HBV core; indicates transmissibility (HBeAg-> Beware)
What is HBsAb, and what does it do?
Antibody to HBsAg; provides immunity to hepatitis B
What is HBsAg, and what does it indicate?
Antigen found on surface of HBV; continued presence indicates carrier state
What is IgM HAVAb, and what is it used to detect?
IgM antibody to HAV; best test to detect active hepatitis A
What is meant by the \\'window period\\' in HBV infection, and what is positive in this period?
It is the period between disappearance of HBsAg and appearance of Anti-HBs; HBcAb is pos. during this period.
What is the classic vector for arborvirus?
Arthropods (mosquitos, ticks, etc.) ARBOR-> Arthropod Borne
What is the function of reverse transcriptase in HIV?
synthesize dsDNA from RNA for integration into host genome.
What is the major mode of protection from influenza virus?
Killed viral vaccine which is reformulated each year and is given to those in high risk of infection (elderly, health-workers, etc.)
What is the method behind ELISA/Western blot and during what period of HIV infection are they often negative?
look for abs to viral proteins; false negatives common in first 1-2 months of infection
What is the mneumonic for remembering the Tzanck smear?
Tzanck heavens I don\\'t have herpes.
What is the only DNA virus that is not double stranded?
Parvoviridae (ssDNA)
What is the only RNA virus that has dsRNA?
Reoviridae [\\'repeatovirus\\' (reovirus) is dsRNA]
What is the viral cause of the common cold?
-Rhinovirus, 100+ serotypes -Rhino has a Runny nose.
What neurologic infection can picornaviruses (except rhinoviruses and hepatitis A viruses) cause?
Aseptic Meningitis
What physical finding is diagnostic for measles?
Koplik spots (bluish-gray spots on buccal mucosa)
What population should not receive a live vaccine?
Those who are immunocompromised and their close contacts.
What reproductive complication can mumps cause?
sterility; especially after puberty
What shape are all the DNA viruses? Which virus (1) is the exception?
=-Icosahedral -Poxvirus (COMPLEX)
What test is used to make the presumptive dx of HIV, and then, which test confirms the dx?
ELISA (sensitive w/ high false + and low threshold); Western blot (specific, high false - rate with high threshold)
What tests are gaining popularity for monitoring drug tx efficacy in HIV?
PCR/viral load tests
What type of genome does HIV have?
diploid RNA
What type of nucleic acid structure does rotavirus have?
segmented dsRNA
What type of transcription occurs and what type of polymerase does it possess?
=-Reverse transcription -the virion contains an RNA-dependent DNA polymerase
What type of virus is HAV and how is it transmitted?
=-RNA Picornavirus -fecal-oral route
What type of virus is HBV and how is it transmitted?
=-DNA Hepadnavirus -parenteral, sexual, and maternal-fetal routes
What type of virus is HCV and how is it transmitted?
=-RNA flavivirus -via blood and resembles HBV in its course and severity
What type of virus is HDV and what is special about its envelope?
=-DELTA agent, it is a defective virus -requires HBsAg as its evelope
What type of virus is HEV and how is it transmitted?
-RNA calicivirus -enteric transmission; causes water-borne epidemics
What variant of dengue fever is found in Southeast Asia?
hemorrhagic shock syndrome
What virus causes and what are the classic symptoms of mononucleosis?
=-EBV -fever, hepatosplenomegaly, pharyngitis, lymphadenopathy (esp. posterior auricular nodes)
What virus causes yellow (-> flavi) fever, and what is its vector and reservoirs (2)?
=-flavivirus -Aedes mosquitos -monkey or human reservoir
What virus is the most common global cause of infantile gastroenteritis and acute diarrhea (in the US).
Rotavirus
Where do enveloped viruses acquire their envelopes, and what virus is the exception to this rule?
=-Plasma membrane -Herpesviruses which acquire their envelope from the nuclear membrane
Where in the cell do DNA viruses replicate, and which virus is the exception to this rule?
-Nucleus -exception: poxvirus in cytoplasm (carries DNA-dependent RNA polymerase)
Where in the cell do RNA viruses replicate, and what 2 viruses are the exception to this rule?
=-cytoplasm -exception: influenza virus and retroviruses
Which marker tests are appropriate for each phase of hepatitis infection: Incubation, Prodrome/acute illness, Early Convalescence, Late Convalescence.
-HBsAg -HBsAg (Anti-HBc) -Anti-HBc -Anti-HBs (anti-HBc)
Which two DNA viruses don\\'t have a linear genome? (they\\'re circular)
Papovaviruses and Hepadnaviruses
Which two hepatitis viruses follow the fecal-oral route?
A and E; \\'The vowels hit your bowels.\\'
Which two hepatitis viruses predispose to hepatocellular carcinoma?
HBV and HCV
Why is mono called the \\'kissing disease?\\'
-Peak incidence occurs during peak kissing years 15-20 yo -(saliva transmission)