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163 Cards in this Set
- Front
- Back
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List 3 purposes of bacterial toxins.
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1. Inhibit immune cells
2. Kill host epithelial cells 3. Promote inflammation |
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What is one of the most common triggers of inflammation?
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Lysis of bacteria
(leads to release of inflammatory debris) |
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List 3 pathogenic mechanisms to escape destruction and promote inflammation?
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1. Colonization, immune avoidance, toxin production
2. Colonization, immune avoidance, inflammation 3. Colonization, intracellular survival, inflammation |
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How is gas exchange impaired by extensive inflammation?
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Extensive inflammation breaks down critical tight junction barriers at the epithelium, preventing effective gas exchange
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Your first supposition for a runny nose should be what kind of infection?
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Viral infection
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The majority of cases of acute rhinosinusitis are caused by what type of infections?
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Viral infections
However, this can eventually shift to a bacterial infection" 1. Streptococcus pneumoniae 2. Haemophilus infuenzae |
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Pharyngitis is most commonly caused by what sort of infection?
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Viral infection
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Which two bacteria are causes of concern for pharyngitis?
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1. Streptococcus pyogenes
2. Corynebacterium diphtheria |
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What type of bacteria is streptococcus pyogenes?
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Gram (+) cocci
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Rheumatic fever can be caused by which bacterium?
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Streptococcus pyogenes
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What sort of signs and symptoms are typical of streptococcus pyogenes?
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1. Fever, painful (swallow), sudden onset
2. Tonsillopharyngeal erythema 3. lymphadenitis 4. petechiae on palate |
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Which components of streptococcus pyogenes help in its adherence?
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1. M protein
2. Lipoteichoic acid 3. Fibronectin binding protein |
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List 3 virulence factors associated with streptococcus pyogenes.
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1. Hyaluronic acid capsule
2. Hemolysin 3. Proteases |
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What type of bacteria is Corynebacterium diptheriae?
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1. Gram (+)
2. Rod-shaped 3. Toxin-producing |
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Which bacteria is gram-(+), rod shaped, and produces toxins?
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Corynebacterium diphtheria
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Which bacteria causes a sore throat, low-grade fever, membrane on tonsils or pharynx, and neck swelling?
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Corynebacterium diphtheriae
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What is corynebacterium diptheriae's virulence factor?
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Diphtheria toxin (A-B toxin) blocks protein synthesis
(this is the target of the vaccine, DTaP) |
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What does the vaccine for corynebacterium diptheriae target?
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DTaP
*Targets diphtheria toxin (A-B toxin) |
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List 2 treatments for corynebacterium diphtheriae.
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1. Erythromycin
2. Antitoxin |
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Is corynebacterium diphtheria common in the U.S.?
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No. It is uncommon in developed countries
(However, it has been well documented that without the vaccine, the disease will reemerge) |
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Why could the prevalence of C. diptheriae reemerge without the vaccine?
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The vaccine targets the A-B toxin, not the bacterium itself. So, it is not uncommon for C. diphtheria to be found in the throats of healthy individuals.
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Which respiratory bacterium could potentially cause myocarditis and cranial nerve damage?
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Corynebacterium diptheriae
(Release toxin into the bloodstream) |
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Describe how the diptheria illness occurs.
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1. Organism colonizes the mucosal region of the oropharynx
2. Releases diptheria toxin (kills cells by ADP-riboxylation of elongation factor 2)--> blocks protein synthesis 3. Immune cells respond to the killed cells 4. Pseudomembrane forms, which blocks the airway 5. As the organism grows, so does the pseudomembrane |
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What sort of infection typically causes laryngitis?
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Viral infection
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Epiglottitis is typically caused by what infection?
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Haemophilus influenzae
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Which infections typically cause bronchitis?
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1. Mycoplasma pneumoniae
2. Chlamydophila pneumoniae |
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Which organism typically infects the trachea?
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Bordetella pertussis
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Is Haemophilus influenzae gram (+) or (-)?
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Gram (-)
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Which bacteria is a gram(-), encapsulated, pleomorphic, fastidious rod.
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Haemophilus influenzae
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List 2 factors required for the growth of Haemophilus influenzae.
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1. Heme (Factor X)
2. NAD (Factor V) |
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What is the most common Heamophilus influenzae serotype?
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Type B
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List 4 virulence factors associated with Haemophilus influenzae.
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1. Polysaccharide capsule
2. Outer membrane protein (OMP) 3. Lipooligosaccharide LOS (endotoxin-like) 4. IgA protease |
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Besides respiratory tract infections, what other diseases are associated with Haemophilus influenzae?
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1. Otitis media
2. Meningitis |
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Which infections typically cause bronchitis?
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1. Mycoplasma pneumoniae
2. Chlamydophila pneumoniae |
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Which infections typically cause bronchitis?
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1. Mycoplasma pneumoniae
2. Chlamydophila pneumoniae |
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What is the prevention for Haemophilus influenzae?
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1. HIB vaccine (2,4,6 months)
2. Booster at 15 months |
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Which organism typically infects the trachea?
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Bordetella pertussis
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Is Bordetella pertussis gram(+) or (-)?
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Gram(-)
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Which organism typically infects the trachea?
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Bordetella pertussis
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Is Haemophilus influenzae gram (+) or (-)?
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Gram (-)
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Which bacteria is a gram(-), encapsulated, pleomorphic, fastidious rod.
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Haemophilus influenzae
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Is Haemophilus influenzae gram (+) or (-)?
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Gram (-)
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Which bacteria is a gram(-), encapsulated, pleomorphic, fastidious rod.
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Haemophilus influenzae
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List 2 factors required for the growth of Haemophilus influenzae.
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1. Heme (Factor X)
2. NAD (Factor V) |
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List 2 factors required for the growth of Haemophilus influenzae.
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1. Heme (Factor X)
2. NAD (Factor V) |
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What is the most common Heamophilus influenzae serotype?
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Type B
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List 4 virulence factors associated with Haemophilus influenzae.
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1. Polysaccharide capsule
2. Outer membrane protein (OMP) 3. Lipooligosaccharide LOS (endotoxin-like) 4. IgA protease |
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What is the most common Heamophilus influenzae serotype?
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Type B
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Besides respiratory tract infections, what other diseases are associated with Haemophilus influenzae?
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1. Otitis media
2. Meningitis |
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List 4 virulence factors associated with Haemophilus influenzae.
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1. Polysaccharide capsule
2. Outer membrane protein (OMP) 3. Lipooligosaccharide LOS (endotoxin-like) 4. IgA protease |
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What is the prevention for Haemophilus influenzae?
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1. HIB vaccine (2,4,6 months)
2. Booster at 15 months |
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Besides respiratory tract infections, what other diseases are associated with Haemophilus influenzae?
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1. Otitis media
2. Meningitis |
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Is Bordetella pertussis gram(+) or (-)?
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Gram(-)
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What is the prevention for Haemophilus influenzae?
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1. HIB vaccine (2,4,6 months)
2. Booster at 15 months |
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Is Bordetella pertussis gram(+) or (-)?
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Gram(-)
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Which infections typically cause bronchitis?
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1. Mycoplasma pneumoniae
2. Chlamydophila pneumoniae |
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Which organism typically infects the trachea?
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Bordetella pertussis
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Is Haemophilus influenzae gram (+) or (-)?
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Gram (-)
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Which bacteria is a gram(-), encapsulated, pleomorphic, fastidious rod.
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Haemophilus influenzae
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List 2 factors required for the growth of Haemophilus influenzae.
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1. Heme (Factor X)
2. NAD (Factor V) |
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What is the most common Heamophilus influenzae serotype?
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Type B
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List 4 virulence factors associated with Haemophilus influenzae.
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1. Polysaccharide capsule
2. Outer membrane protein (OMP) 3. Lipooligosaccharide LOS (endotoxin-like) 4. IgA protease |
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Besides respiratory tract infections, what other diseases are associated with Haemophilus influenzae?
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1. Otitis media
2. Meningitis |
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What is the prevention for Haemophilus influenzae?
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1. HIB vaccine (2,4,6 months)
2. Booster at 15 months |
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Is Bordetella pertussis gram(+) or (-)?
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Gram(-)
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What virulence factors are associated with bordetella pertussis?
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1. Adherence imbriae
2. Antiphagocytic capsule 3. Toxins (pertussis toxin, tracheal cytotoxin, adenylate cyclase toxin) |
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Which bacteria is a gram(-), encapsulated, aerobic, fastidious, coccobaccillus?
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Bordetella persussis
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List the 4 stages of bordetella pertussis infection.
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1. Incubation (7-10 days)
2. Catarrhal (7-14 days) --> symptoms of common cold 3. Paroxysmal (3-8 weeks) --> severe sustained cough 4. Convalescent (3-12 months) |
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Which stage of bordetella pertussis infection presents with symptoms of common cold?
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Catarrhal (7-14 days)
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Antibiotics are most effective during which stage of bordetella pertussis infection?
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Catarrhal (7-14) --> patient is experiencing symptoms similar to common cold
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Which stage of bordetella pertussis infection can result in coughs so severe that hemorrhages occur around the eyes and brain damage could occur from violent coughs?
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Paroxysmal stage (3-8 weeks)
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What are the actions of B. pertussis' adenylate cyclase toxin?
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1. Impairs leukocyte chemotaxis
2. Inhibits phagocytosis |
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What are the actions of the pertussis toxin (PTx)?
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1. ADP-ribosyltransferase --> blocks an inhibitor of adenylyl cyclase, causing increased levels of cAMP
2. Inhibits phagocyte activity 3. Subunits of PTx can act as adhesions |
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Most death caused by B. pertussis occur in which age group?
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Pediatric (<6 yo)
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Is immunoprotection from pertussis life long?
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NO.
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Which disease is often confused with asthma and postnasal drip in adults?
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Pertussis
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What sort of infection should you consider in adolescents and adults with a cough lasting > 6 days?
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Pertussis
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What is the gold standard test for diagnosing pertussis?
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Culture nasopharyngeal aspirates on Regan-Lowe medium or Bordet-Gengou
*Must be performed within the first 3 weeks of illness--> during catarrhal stage *Remember culture could be negative if patient was treated with antibiotics |
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What sort of lab tests can be done to diagnose pertussis?
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1. Culture nasopharyngeal aspirates
2. PCR 3. Serology (late course diagnosis) |
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What sort of lab testing combinations does the CDC recommend for diagnosing pertussis?
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1. Culture and PCR during first 4 weeks of symptoms
2. PCR and serology for coughs 3 - 4 weeks 4. Serology for cough > 4 weeks |
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What sort of lab testing is recommended by the CDC for coughs lasting 3 - 4 weeks?
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PCR and serology
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What sort of lab testing is recommended by the CDC for coughs lasting longer than 4 weeks?
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Serology
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Which pertussis vaccine has fewer side effects-- whole cell or accellular?
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Acellular vaccine
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Which pertussis vaccine is part of the current DTaP regimen-- whole cell or acellular?
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Acellular vaccine
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Which pertussis vaccine cannot be used in adults-- whole cell or acellular?
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Whole cell vaccine
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What is DTap?
Describe the vaccination regimen for DTaP. |
Diptheria, Tetanus, acellular Pertussis
1. First year--> 2,4,6 months 2. Second year --> 15 - 18 months 3. Subsequent --> 4-6 yrs, 11-12 yrs, adults *11-12 yo and adults should be given Tdap (less diptheria nd pertussis antigens). |
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How often should Tdap be administered in adults?
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Every 10 years
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List the most likely infectious organisms associated with pneumonia in individuals age 0-1 month.
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1. Escherichia coli
2. Group B Strep (Streptococcus agalactiae) |
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List the most likely infectious organisms associated with pneumonia in individuals 1-6 months.
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1. Chlamydia trachomatis
2. Respiratory syncytial virus (RSV) |
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List the most likely infectious organisms associated with pneumonia in individuals 6 months to 5 years old.
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1. RSV
2. Parainfluenzae |
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List the most likely infectious organisms associated with pneumonia in individuals 5 - 15 years old.
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1. Mycoplasma pneumoniae
2. Influenza virus type A |
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List the most likely infectious organisms associated with pneumonia in individuals 16 - 30 years old.
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1. M. pneumoniae
2. Streptococcus pneumoniae |
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List the most likely infectious organisms associated with pneumonia in individuals in adults over 30 years old
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1. S. pneumoniae
2. H. influenzae |
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Is streptococcus pneumoniae gram(+) or (-)?
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Gram (+)
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Which bacterium is a gram(+), catalase(-), optochin sensitive, alpha-hemolytic, encapsulated diplococci?
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Streptococcus pneumoniae
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Which organism causes penumonia with RAPID ONSET and bloody sputum?
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Streptococcus pneumoniae
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Which organism presents a serious respiratory healthcare problem in hospitalized elderly patients?
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Streptococcus pneumoniae
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What is the most prevealent cause of death due to acute infection in the US?
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Streptoccoccus pneumoniae
(6th leading cause of disease in the US) |
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What is the major part of virulence of streptococcus pneumonia?
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Polysaccharide capsule
(target of current vaccines) |
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List 3 characteristics that are used to differentiate streptococcus pneumoniae from other gram (+) cocci.
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1. Optochin sensitivity
2. Catalase(-) 3. Alpha-hemolysis |
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What are some clinical signs and symptoms associated with streptococcus pneumoniae?
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1. Abrupt onset of fever and chills
2. Productive bloody sputum 3. Can follow recent viral infection |
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Does streptococcus pneumoniae primarily target adults or children?
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Children
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List the pathogenic mechanisms of streptococcus pneumoniae.
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1. Prevent phagocytosis (capsule)
2. Block Ab responsis (IgA protease) 3. Destroy cells (PLY) 4. Resist complement (PspA) 5. Adhere to cells (CbpA) 6. Eventually lyse cells (LytA) |
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What is the action of streptococcus pneumoniae's PLY?
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Pore-forming toxin--> disrupts alveolar-capillary boundary
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List the 3 infectious cellular components of S. pneumoniae.
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1. PspA (anti-complement)
2. CbpA (cell adhesin) 3. LytA (autolysin |
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Describe 3 ways the streptococcus pneumoniae disease is initiated.
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1. An individual is colonized with a highly virulent strain (hyperproducer of capsule or PLY)
2. An individual has an underlying illness 3. An individual is exposed to overcrowding, smoke, child care, bottle-feeding |
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List 2 vaccines available in the US for treating S. pneumoniae.
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1. Prevnar
2. Pneumovax |
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Which S. pneumoniae vaccine is recommended for children <2 yo?
Which is recommended for individuals >50 yo? |
Prevnar --> children <2 yo
Pneumovax --> adults >50 yo |
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Which S. pneumonia vaccine covers 23 serotypes?
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Pneumovax
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Which S. pneumonia vaccine is a capsule from 7 serotypes conjugated to a T-cell antigen?
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Prevnar
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List 3 treatments for S. pneumoniae
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1. Cefotaxime
2. Ceftriaxone 3. Clindamycin |
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Is Legionella pneumophila gram(+) or (-)?
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Gram(-)
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Which organism is a gram(-), fastidious, aerobic, facultative intracellular pathogen?
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Legionella pneumophila
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Which two diseases are caused by Legionella pneumophila?
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1. Legionnaire's disease
2. Atypical Walking pneumonia |
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Does Legionella pneumophila have a high or low mortality rate?
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High mortality
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Which pathogen replicates in macrophages?
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Legionella pneumophila
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How is Legionella pneumophila detected?
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1. Direct observation of the organism in sputum
2. Antibody reactivity 3. Urine test for circulating antigen |
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Legionnaire's disease is unusual in combining pneumonia with several other systemic complications. What are some of these other complications?
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1. Altered liver and renal function
2. Heightened serum creatinine phosphokinase |
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List the 3 virulence factors associated with Legionella pneumophila.
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1. Phospholipase
2. Macrophage Infectivity Protein 3. Endotoxin |
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How is Legionella pneumophila transmitted?
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Aerosolization or aspiration of contaminated water
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Which organism survives and grows within single cell organisms, like amoebas, and thus contaminates water supplies?
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Legionella pneumophila
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Is Klebsiella pneumoniae gram(+) or (-)?
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Gram(-)
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Which organism exists in the normal flora of the upper respiratory tract, enteric and genitourinary tracts?
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Klebsiella pneumoniae
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Which organism is responsible for pneumonia observed in alcoholics following aspiration of the pathogen?
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Klebsiella pneumoniae
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Which organism is responsible for hemoptysis-- "currant jelly sputum"?
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Klebsiella pneumoniae
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Does Klebsiella pneumoniae often result in cases requiring hospitalization?
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No
(<1% of cases require hospitalization) |
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List 2 ways Klebsiella pneumoniae is detected in the lab.
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1. Selective media, mucoid, lactose-fermenting colonies
2. PCR-based tests |
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Can Klebsiella pneumoniae be part of the normal flora?
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YES
(reservoirs of infection are GI tracts and hands of hospital staff) |
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How does a host get infected by Klebsiella pneumoniae?
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Host aspirates colonizing oropharyngeal microbes into the lower respiratory tract
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List 2 treatments for Klebsiella pneumonia.
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1. 3rd generation cephalosporins
2. Fluoroquinolones |
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Which respiratory bacterium has the smallest bacterial genome?
|
Mycoplasma pneumoniae
*Similar in size to some viruses |
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Does mycoplasma pneumoniae contain a peptidoglycan cell wall?
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No
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Which bacterium membrane contains cholesterol like eukaryotes?
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Mycoplasma pneumoniae
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Which bacterium is the primary cause of walking or "atypical" pneumoniae?
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Mycoplasma pneumoniae
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Is the infection caused by mycoplasma pneumoniae usually mild or sever?
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Mild infection
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Which bacterium may cause rare extrapulmonary syndromes such as cardiologic, neurologic, and dermatologic findings?
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Mycoplasma pneumoniae
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Which bacterium may lead to tracheobronchitis with fever and nonproductive cough?
|
Mycoplasma pneumoniae
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Which type of people does mycoplasma pneumoniae typically infect?
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1. Infants or immunocompromised individuals
2. People living in close quarters *Worldwide, it mostly infects 5 - 15 year olds |
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Which bacterium has an adhesion protein called P1 and inhibits ciliary action?
|
Mycoplasma pneumoniae
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Which bacterium produces hydrogen peroxide and cytolytic enzymes?
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Mycoplasma pneumoniae
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Cold agglutination associated with respiratory illness is commonly associated with which pathogen?
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Mycoplasma pneumoniae
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How is the diagnosis for mycoplasma pneumoniae made?
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Serological methods based on detecting antibodies to the organism
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What is the treatment for mycoplasma pneumoniae?
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1. Erythromycin
2. Azithromycin 3. Clarithromycin |
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Which respiratory organism is not affected by beta-lactam antibiotics?
|
Mycoplasma pneumoniae
(does not have a peptidoglycan cell wall) |
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Which mycobacteriua is common in AIDS patients?
|
Mycobacterium avium
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Which bacteria are aerobic, acid-fast rods, with high membrane lipid content?
|
Mycobacteria
|
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Which mycobacteria has a unique cell wall, and what makes it unique?
What is the significance of this? |
Mycobacterium tuberculosis
In addition to peptidoglycan, it contains: 1. Mycolic acid 2. Arabinogalactan *This cell wall makes the organism impervious to many different antibiotics and allows it to survive within macrophages |
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Describe the areas of the body infected by mycobacterium tuberculosis.
|
1. Pulmonary
2. Systemic spread 3. Miliary tuberculosis (widespread in multiple organisms) 4. Tuberculous cervical lymphadenitis (TB of the neck) |
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Which organism is responsible for the most common infectious cause of mortality worldwide? (alternates with malaria)
|
Mycobacterium tuberculosis
|
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Does M. tuberculosis produce toxins?
|
No
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List 3 virulence factors associated with mycobacterium tuberculosis. Which is the major factor?
|
1. Cord factor (trehalose dimycolate, cell wall component) <-- MAJOR
2. Sulfatides 3. Tuberculin 2. |
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Which bacterium contains a trehalose dimycolate cell wall component that contributes to its virulence?
What is the action of this factor? |
M. tuberculosis
"Cord factor": 1. inhibits neutrophil chemotaxis and causes granuloma formation 2. Prevents lysosomal killing |
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Which virulence factor associated with M. tuberculosis inhibits phagosome-lysosome fusion in macrophages, allowing intracellular survival?
|
Sulfatides
|
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Which M. tuberculosis virulence factor stimulates cell-mediated immunity, promoting granuloma formation?
|
Tuberculin
|
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What is a tuberculosis granuloma?
|
Collection of activated macrophages surrounding an area of necrosis
(caseous necrosis) |
|
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List 4 lab tests required for detection of M. tuberculosis.
|
1. Acid-fast bacilli in the sputum
2. Serum test for immune response to antigens 3. Growth on Lowenstein-Jensen Agar 4. PPD (purified-protein derivative) skin test |
|
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Which medication can be taken for 6-9 months to prevent disease in TB-infected individuals?
|
Isoniazid
|
|
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How is M. tuberculosis transmitted?
|
Small droplets initially inhaled into lungs
|
|
|
What is the vaccine for tuberculosis?
|
Bacillus Calmette-Guerin (BCG)
|
|
|
Describe the treatment regime for M. tuberculosis.
|
First 2 months --> Isoniazid + Rifampin + Pyrazinamide
Next 4 months --> Isoniazid + Rifampin |
|
|
Which medications are used for possible drug resistant cases of M. tuberculosis?
|
1. Ethambutol
2. Streptomycin |
|
|
The characteristic whooping cough develops during which stage of pertussis infection?
|
Paroxysmal stage
|
|
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Humans are the ONLY known host of which respiratory bacterium?
|
Bordetella pertussis
|
