Exam 1 micro

Question 1

Typical and atypical pneumonia on cheset xray

Answer 1

typical-lobar

atypical-interstitial

Question 2

Most common pneumonia bacteria

Answer 2

strep pneumo

Question 3

Pneumonia in unvaccinated children

Answer 3

H. influenza

also see otitis media

Question 4

Encapsulated organisms (6)

Answer 4

Some killers have pretty nice capsules
Strep pneumo
Klebsiella
H. flu
Pseudomonas
Neisseri meningitidis
Cryptococcus neoformans

Question 5

Opzonization

Answer 5

IgG and C3b

increases phagocytosis 4000 fold

Question 6

Reason for neutrophils in pneumonia

Answer 6

teichoic acid recruits via C5a

Question 7

Use of auramine rhodamine stain

Answer 7

acid fast screening

needs confirmation with acid fast

Question 8

CD4 count and opportunistic infections with AIDS

Answer 8

below 200 CD4 count

Question 9

TB pathogenesis

Answer 9

inhaled, alveolar macrophages take up
inhibit lysosomal fusion, replicate in macrophage
Th1-> IFN alpha-> macrophage activation and granuloma formation
immune system causes damage, not TB

Question 10

Cause of night sweats/cachexia for immune molecules

Answer 10

TNF alpha

Question 11

Virulence factors of TB

Answer 11

cord factor inhibits WBC migration
tuberculin triggers cell mediated immunity
sulfatides prevent macrophage lysosomal fusion

Question 12

Influenza’s virulence factors

Answer 12

hemagglutinen binds sialic acid on epithelium

neuroaminidase cleaves sialic acid/decreases mucus viscosity

Question 13

Antigenic drift vs shift

Answer 13

drift-RNA pol causing mutations

shift-2 or more viruses form completely new virus

Question 14

Cause of type I hypersensitivity

Answer 14

mast cell degranulation

Question 15

Early asthma

Answer 15

involves mediators from mast cells/basophils

within minutes of exposure

Question 16

Late asthma

Answer 16

leukocyte and cytokine mediated
IL4/IL5/TNFalpha/PAF involved
increased endothelial cell adhesion
chronic inflammation/tissue injury

Question 17

Type III hypersensitivity

Answer 17

immune complexes deposited in tissues
activates complement
causes lumpy-bumpy bx of kidney

Question 18

Type II hypersensitivity

Answer 18

tissue specific Abs to self
change in cell function or cytotoxic
linear/smooth bx of kidney

Question 19

Type IV hypersensitivity

Answer 19

delayed
CD4 and cell mediated
macrophage and CTL activation
MS/Guillian Barre/Hasimotos/poison ivy

Question 20

Most common bacterial atypical pneumonia

Answer 20

mycoplasma

Question 21

Rhinovirus characteristics

Answer 21

naked + RNA
labile in acidic pH
uses ICAM-1 receptor
most common cause of cold
replicates at 33 degrees C

Question 22

Coronavirus charge/genome/structure

Answer 22

enveloped
+ RNA
replicates at 33 degrees C

Question 23

Pathogenesis of rhinovirus infection

Answer 23

ICAM-1 receptor attachment
damage epithelium
bradykinin/histamine release

Question 24

Epiglottitis infection bugs

Answer 24

H flu. type B
S. pneumo
S. aureus
usually in kids

Question 25

Coxsackie A pharyngitis

Answer 25

naked virus herpangina types A2-A6 fecal/oral transfer

Question 26

EBV pharyngitis

Answer 26

+ mononucleosis (splenomegaly) in young adults/teens exudative pharyngitis fatigue/weakness

Question 27

CMV pharyngitis

Answer 27

- mononucleosis | in older/sexually active pts

Question 28

Parotitis

Answer 28

from mumps virus - RNA enveloped swollen parotids (bull neck) low grade fever/myalgia/headache

Question 29

Important complication of mumps

Answer 29

orchitis | sterility in post pubertal males

Question 30

Parainfluenza virus laryngitis

Answer 30

stridor (barking cough) types 1 and 2 are major cause Steeple sign on x-ray syncytia can form

Question 31

Cause of most bronchitis

Answer 31

viral -> nonproductive cough

Question 32

Respiratory syncytial virus

Answer 32

bronchiole infection of children/infants tx with ribavirin (inhibits nucleic acid synthesis) ribavirin is teratogenic

Question 33

Difference b/t pneumonia and bronchitis

Answer 33

pneumonia has productive colored sputum with increased HR and fever/chills/SOB

Question 34

Influenza virus

Answer 34

``` - segmented RNA enveloped virus A is humans/animals B and C are only humans hemaglutinin and neuraminidase M protein forms membrane channels ```

Question 35

Genetic shift with influenza

Answer 35

only type A

Question 36

Pathogenesis of influenza

Answer 36

causes increased fluid in lungs | drown in own fluid

Question 37

Vaccine for influenza

Answer 37

killed or live attenuated killed for pregnancy/immunocompromised 4 strains from prior year

Question 38

Adenovirus

Answer 38

naked DNA penton fibers attach and toxic to cells pharyngoconjunctival fever/ARDS serotypes 3,4,7 in live attenuated vaccine

Question 39

Measles virus

Answer 39

- RNA enveloped HN and F proteins cough/coryza/conjunctivitis koplik spots/maculopapular rash

Question 40

Complications of measles

Answer 40

giant cell pneumonia encephalitis subacute sclerosing panencephalitis

Question 41

Vaccine for measles

Answer 41

live attenuated

Question 42

Hantavirus

Answer 42

segmented - RNA enveloped tropism for pulmonary capillary endothelial cells found in US Southwest from rodent feces

Question 43

Hantavirus sx phases

Answer 43

prodrome (fever/headache) cardiopulmonary (dyspnea/pulmonary edema) convalescent

Question 44

SARS

Answer 44

+ RNA enveloped coronavirus Hong Kong/Toronto from civet cats

Question 45

MERS

Answer 45

Middle East respiratory syndrome | from coronavirus

Question 46

SARS sx

Answer 46

flu like prodrome | lower respiratory tract