Micro 4. Chap 22

Front 1

Skin flora are ___________ pathogens.

Back 1

Opportunistic

Front 2

The three groups of skin flora are:

Back 2

1. Diptheroids
2. Staphylococci
3. Yeasts

Front 3

Diptheroids are named for their resemblance of _____________ ____________.

Back 3

Corynebacterium diptheriae

Front 4

Diptheroids are Gram ________ bacteria with varied shape and ______ virulence.

Back 4

Positive
Low

Front 5

Diptheroids are _____-_______ producers (like C. diphtheriae).

Back 5

Non-toxin

Front 6

Diptheroids are responsible for ________ _________. The smell is caused by the bacterial break-down of sweat.

Back 6

Body Odor

Front 7

A common diptheroid is _____________ _________, the cause of acne.

Back 7

Propionibacterium acnes

Front 8

Staphylococci is a Gram ________, salt-__________ organism.

Back 8

Positive
Tolerant

Front 9

Staphylococci is relatively ____________, but can cause serious disease in the immunocompromised.

Back 9

Avirulent

Front 10

The principal species of Staphylococci is Staph ________.

Back 10

Epidermidis

Front 11

Staphylococci functions on the skin to prevent ____________ of __________ flora.

Back 11

Colonization
Pathogenic

Front 12

Staphylococci maintains balance among microbial ________ __________.

Back 12

Skin flora

Front 13

Fungi (_________) are tiny __________ yeast universally found on normal skin, from late childhood thru-out life.

Back 13

Yeasts
Lipophilic

Front 14

Fungi shapes vary amoung strains, usually ________ or _________; however, can be short rods.

Back 14

Round
Oval

Front 15

Fungi found on skin are generally ___________, can cause skin conditions such as rash or _____________.

Back 15

Harmless
Dandruff

Front 16

_____________ is infection of the hair follicle.

Back 16

Folliculitis

Front 17

The infection of the hair follicle causes a ______ ________ or pimple, this can spread from follicle to adjacent ___________.

Back 17

Tissue
Red bump

Front 18

A lesion produced by an infected follicle is called a ___________.

Back 18

Furuncle

Front 19

Most infected hair follicles are caused by __________ __________.

Back 19

Staph aureus

Front 20

SSSS is a ________-__________ disease that occurs primarily in infants. SSSS stands for...

Back 20

Toxin-mediated
Staphylococcal scalded skin syndrome

Front 21

Symptoms of SSSS are:
-Apparent ________ of skin
-Begins as a generalized _________.
-Other symptoms include malaise, _________, fever.
-Nose, mouth and _________ may be painful before other indicators.

Back 21

Burning
Redness
Irritability
Genitalia

Front 22

Within ___ hours of SSSS, skin becomes red and wrinkled and large _______-_________ blisters appear. Skin feels like ____________.

Back 22

48
Fluid-filled
Sandpaper

Front 23

The causative agent is the bacteria _______ __________, the disease is caused by _________ produced by the bacteria. These toxins are called ___________.

Back 23

Staph aureus
Toxins
Exfoliatins

Front 24

Exfoliatins destroy integral layers of the outer _________. They are coded by _________ or on the bacterial _____________.

Back 24

Epidermis
Plasmid
Chromosome

Front 25

SSSS toxin is released at the _______ of __________ and is absorbed and carried by the bloodstream to larger areas of the skin.

Back 25

Site of infection

Front 26

SSSS toxin causes splits in the epidermis just below the dead ____________ outer layer of epidermis.

Back 26

Keratinized

Front 27

Outer layer of skin is lost, causing body fluid loss and increased ____________ to secondary infections.

Back 27

Susceptibility

Front 28

Mortality rates of SSSS can reach _____%. Usually die from water loss.

Back 28

40

Front 29

____% of Staph aureus strains produce ___________, meaning only that many have the toxin genes.

Back 29

5
Exfoliatins

Front 30

Disease can appear in any age group, but mostly in:
Transmission is usually _____-___-_______. Disease is usually ___________, however small epidemics can occur in nuseries.

Back 30

Infants, the elderly and immunocompromised.
Person-to-person
Isolated

Front 31

Only preventative measure of SSSS is ________ __________. Treatment includes bactericidal ____________ as well as removal of _______ ________.

Back 31

Patient isolation
Antibiotics
Dead skin

Front 32

The antibiotics used to treat SSSS are _____________ such as penicillinase-___________ penicillin.

Back 32

Antistaphylococcals
Penicillinase-resistant penicillin

Front 33

Streptococcal impetigo is a ____________ infection characterized by _______ production.

Back 33

Pyoderma
Pus

Front 34

Pyodermas can result from insect bites, _______ and scrapes. Such injuries can be so slight that they miss detection.

Back 34

Burns

Front 35

___________ is most common type of pyoderma.

Back 35

Impetigo

Front 36

The causative agent of Strep Impetigo is _____________ __________, although S. aureus is also a causative agent.

Back 36

Streptococcus pyogenes

Front 37

S. ___________ is a Gram positive, beta __________ cocci. These are often referred to as Group ____ due to presence of group A cell wall _____________.

Back 37

Pyogenes
Gram positive
Beta-hemolytic cocci
Group A
Polysaccharides

Front 38

Infection of Strep Impetigo is established through scratches and minor injuries which allows bacteria into _________ ___________ of skin.

Back 38

Deeper layers

Front 39

The two destructive enzymes that are produced by Strep Impetigo are ___________ and ____________. The bacteria surface components interfere with ______________.

Back 39

Proteases=degrade skin proteins
Nucleases=degrade nucleic acids
Phagocytosis

Front 40

Strep Impetigo is contagious through ___________.

Back 40

Contact

Front 41

Rocky Mountain Spotted Fever is a representative of a group of _____________ diseases.

Back 41

Rickettsial

Front 42

The zoonotic agent of RMSF is _________.

Back 42

Ticks

Front 43

___________ were considered viruses but ended up being a ____________.

Back 43

Ricketts
Bacteria

Front 44

Symptoms of RMSF include:
-Start with initial rash of ______ ________ _______.
-Appears 1st on ________, writsts, ankles and soles.
-Spots become raised bumps and are ____________.
-Shock or death can occur when certain body systems are involved (like the ________ or ____________)

Back 44

Faint pink spots
Palms
Hemorrhagic
Heart and kidney

Front 45

The causative agent of RMSF is _____________ ___________. It is an obligate, ____________ bacterium. They are non-mobile _________ a cell, and mobile _________ a cell.

Back 45

Rickettsia rickettsii
Intracellular
Non-mobile outside
Mobile inside

Front 46

The causative agent of RMSF is an obligate intracellular bacterium meaning:

Back 46

It requires a host organism to live

Front 47

Rickettsia rickettsii is a Gram __________, non-motile, cocco__________. They are very small and often hard to see in Gram stains.

Back 47

Negative
Coccobacillus

Front 48

RMSf is aquired when a tick infected with R. ricketsii. Bacteria are released into the blood, they enter cells through _____________.

Back 48

Endocytosis

Front 49

After endocytosis, cell escapes ___________ ___________. Bacterial endotoxin released in bloodstream can cause _________ ______________ ___________.

Back 49

Protective phagosome
Disseminated intravascular coagulation

Front 50

RMSF is a ___________ disease occuring in the US, Canada and __________. Highest incidence in US is in south ___________ and south-central US.

Back 50

Zoonotic
Mexico
Atlantic

Front 51

The main vectors include wood tick (__________ __________) and the dog tick (____________ ____________). These tick vectors remain infected for life.

Back 51

Wood tick = Dermacentor andersoni
Dog tick = Dermacentor variabilis

Front 52

There is no vaccine for RMSF. Prevention should be directed towards:

Back 52

Avoiding tick-infested areas, using tick repellants containing DEET and carefully inspecting body.

Front 53

Antibiotics are highly effective in treatment if...
The antibiotics most commonly used are...
Without treatment, overall mortality reaches ~____% (with early treatment, ____%)

Back 53

Given early
Doxycycline and chloramphenicol
20%, 5%

Front 54

Chickenpox is the popular name for __________. Incidence has declined due to vaccine. Produces a __________ infection that becomes reactive after recovery of initial illness (___________)

Back 54

Varicella
Latent
Shingles

Front 55

Symptoms:
Most cases are mild and recovery is ____________. Symptoms are more severe in older children and adults, _____% of adults develope pneumonia.

Back 55

Uneventful
20%

Front 56

Rash is the ____________ of chickenpox.

Back 56

Diagnostic

Front 57

Rash steps are:
1. Red spots called _________
2. Small bumps called _________
3. Small blisters called ___________
4. pus-filled blisters called __________.

Back 57

1. Macules
2. Papuales
3. Vesicles
4. Pustules

Front 58

Varicella is a major threat to newborns, may lead to __________ ___________ syndrome.

Back 58

Congenital varicella

Front 59

The word sequella means:

Back 59

The manifestations of the disease.

Front 60

Sequella of chickenpox infection include shingles or ________ _________ caused by reactivation of dormant virus and characterized by rash around waist.

Back 60

Herpes zoster

Front 61

Sequella of a chickenpox infection also include _______ Syndrome.

Back 61

Reye's

Front 62

Reye's is evident by ___________ and coma. Mostly seen in children ____-____. Characterized by __________ and _________ damage. The mortality rate is ~____%.

Back 62

Vomiting
5-15
liver and brain
30%

Front 63

Evidence suggests that _________ therapy increases risk of Reye's.

Back 63

Aspirin

Front 64

All herpes viruses are more serious in adults than children, indicating more _____________.

Back 64

Immunopathology

Front 65

The casative agent of chickenpox is the ___________-_________ virus which is a member of the _________ family. It is a medium sized ___________ virus with a very large, double stranded _____ genome.

Back 65

Varicella-zoster
Herpes
Enveloped
DNA

Front 66

Chickenpox virus enters through __________ route, meaning it's very good at getting to new hosts.

Back 66

Respiratory

Front 67

Chickenpox infects living layers of skin and moves to adjacent cells and skin _________ appear.

Back 67

Lesions

Front 68

Infected cells swell and ________ releasing virus to enter _________ nerves.

Back 68

Lyse
Sensory

Front 69

Occurance of shingles correlates with decline in _____ ____________ (Type I) ___________. Latent virus within nerve cell replicates and is carried to the skin (_____________)

Back 69

Cell mediated (Type I) immunity
Recrudescence

Front 70

Chickenpox is transmitted by ____________ secretions and skin lesions. Incidences increase in winter and ________.

Back 70

Repiratory
Spring

Front 71

Chickenpox incubation period is ~2 _______. Infective from 1-2 days before rash until blister crusts over.

Back 71

Weeks

Front 72

Prevention of chickenpox is geared at _____________. The _____________ vaccine was licensed in ________.

Back 72

Vaccination
Attenuated
1995

Front 73

_____________ patients should avoid the vaccine, but can be partially protected by passive immunity via injection of _________ _________ _________ (ZIG).

Back 73

Immunocompromised
Zoster immune globulin

Front 74

Measles, hard measles and red measles are all common names for __________.

Back 74

Rubeola

Front 75

There has been a dramatic reduciton in measles cases within the ______ century due to vaccination.

Back 75

20th

Front 76

Worldwide there are _____-____,000 cases of measles per year.

Back 76

350-400

Front 77

Symptoms:
1. fever, runny nose, cough and _____ ________ eyes.
2. Fine rash appears first on __________, then spreads.
3. Symptoms dissapear within 1 _______.

Back 77

Red, weepy eyes
Forehead
Week

Front 78

Many cases are complicated with __________ infections. The most common of these are __________ and ear infections. The least common of these are ____________ and SSPE (_________ ___________ _______________)which is a brain disorder.

Back 78

-Secondary Infections
-Pneumonia
-Encephalitis
-Subacute sclerosing panencehalitis (SSPE)

Front 79

The causative agent of measles is the _________ virus. This virus is ___________, medium sized and ___________.

Back 79

Rubeola
Pleomorphic
Enveloped

Front 80

The envelope of the Rubeola virus contains _______ proteins. One for ________ attachement to host, one for __________ with host membrane.

Back 80

Spike
Viral
Fusion

Front 81

The Rubeola virus has a _________-__________ RNA genome and belongs to the __________ family.

Back 81

Single-stranded
Paramyxovirus (which is close to the flu virus)

Front 82

Infection of measles is via ___________ route. It replicates in the ___________ of the URT. Then spreads to the ________ _________ where it gets to all parts of the body.

Back 82

Repiratory
Epithelium
Lymph nodes

Front 83

An important diagnostic for the disease is the infected __________ ___________. They are covered with __________ spots.

Back 83

Mucous membranes
Koplik

Front 84

Humans are the only natural host, so this disease could be ___________.

Back 84

Eradicated

Front 85

Before routine immunization, over ____% of the population infected so rare events (like death) were happening a lot.

Back 85

99%

Front 86

Vaccine resulted in the decline of _________ cases and measles are no longer _________ in the US.

Back 86

Annual
Endemic

Front 87

Prevention of measles is directed towards ____________. The vaccine is usually given with mumps, rubella and varicella vaccine (MMRV).

Back 87

Vaccination

Front 88

The MMRV contains all live, ___________ viruses acting as vaccines.

Back 88

Attenuated

Front 89

True or False:
There is an antiviral treatment for measles.

Back 89

False

Front 90

Since adults can recover easily, the vaccination program is mostly to protect ___________.

Back 90

Infants

Front 91

German measles and three-day measles are common names for ___________.

Back 91

Rubella

Front 92

Rubella is typically mild, often un___________ and difficult to diagnose. However, there is a significant infection in __________ women.

Back 92

Unrecognized
Pregnant

Front 93

Rubella in a pregnant woman can cause ____________ ___________ ___________ in the fetus which leads to deafness, ___________ and heart defects.

Back 93

Congenital Rubella Syndrome
Heart defects

Front 94

Rubella enters the body through __________ route. The virus multiplies in the ___________, then enters bloodstream where it causes sustained viremia.

Back 94

Respiratory
Nasopharynx

Front 95

Immunity develops against viral antigens of rubella resulting in an _________-_________ complex most likely responsible for rash and joint pain. (because the complex _____________ out)

Back 95

Antigen-antibody complex
Precipitates

Front 96

Humans are the only natural host, the disease is _________ contagious (less so than measles).

Back 96

Highly

Front 97

_____% of people infected with Rubella fail to develope symptoms. Infectious ____ days before appearance of rash to ____ days after.

Back 97

40%
7
7

Front 98

True or False:
If a person fails to develope symptoms of Rubella, then they are never contagious.

Back 98

False, the virus is still replicating and being shed.

Front 99

Warts are caused by the __________ virus.

Back 99

Papillomavirus

Front 100

Papillomavirus can infect skin through minor ________. This forms small tumors called ___________.

Back 100

Abrasions
Papillomas (warts)

Front 101

True or False:
Most warts are cancerous.

Back 101

False, out of the 50 known species, only 4 are cancerous.

Front 102

Some sexually transmitted warts are associated with ________ cancer (pap smear is diagnosis).

Back 102

Cervical

Front 103

Nearly ____% of warts on the skin dissapear by themselves within ____ years.

Back 103

50%
2 years

Front 104

The papillomaviruses belong to the _________ family. They are small and non___________ with a double stranded ______ genome.

Back 104

Papovirus
Enveloped
DNA

Front 105

Three common objects that warts can live on are:

Back 105

1. Towels
2. Shower floors
3. Wrestling mat

Front 106

The warts virus infects the deeper layers of __________. It reproduces in the nucleus of these cells. These infected cells grow ___________, producing the wart. The incubation period ranges ____-____ months.

Back 106

Epidermis
Abnormally
2-18

Front 107

Treatment is acheived by killing all _________ cells by freezing (liquid _________), cauterization or ____________ removal.

Back 107

Abnormal
Nitrogen
Surgical

Front 108

Skin diseases caused by fungi are called __________ ____________ __________. These are a group of diseases caused by species of ________.

Back 108

Superficial Cutaneous Mycoses
Molds

Front 109

These mycoses invade nails, hair and __________ layers of the skin.

Back 109

Keratinized

Front 110

Examples of mycoses:
1. Tinea __________ = mycosis of the scalp
2. Tinea __________ = mycosis of the underarm
3. Tinea __________ = mycosis of the groin (Jock itch)
4. Tinea __________ = mycosis of the foot (Athlete's Foot)

Back 110

Capitis (scalp)
Axillaris (underarm)
Cruris (groin)
Pedis (foot)

Front 111

Three genera are responsible for most of these mycosal infections:

Back 111

1. Epidermophyton
2. Microsporum
3. Trichophyton

Front 112

Collectively, the three causative agents of the mycosal infections are termed _____________.

Back 112

Dermatophytes

Front 113

Normal skin generally resistant to dermatophytes, excessive __________ allows invasion of keratinized layers of tissue.

Back 113

Moisture

Front 114

Dermatophytes produce ____________, which allow destruction of __________. They use the _______ _______ from the breakdown keratin for nutrients.

Back 114

Keratinase
Keratin
Amino acids

Front 115

Scalp is invaded by through ______ ___________ due to high moisture content. The fungal products defuse to __________ layer and evoke an immune response.

Back 115

Hair follicle
Dermal

Front 116

Prevention and treatment includes attention to cleanliness and maintenance of _________ dryness.

Back 116

Normal

Front 117

Numerous prescription and ______ medications are available for treatment.

Back 117

OTC