Exam 3 Fastidious, Intracellular, Other Flashcards
(164 cards)
1
Q
Respiratory disease-causing bacteria
A
- Corynebacterium diphtheriae
- Bordatella pertussis
- Haemophilus influenzae
- Legionella pneumophila
- Mycoplasma pneumonia
2
Q
Meningitis-causing bacteria
A
Listeria monocytogenes
3
Q
STD bacteria
A
Chlamydia trachomatis
4
Q
Zoonotic disease causing bacteria
A
- Francisella tularensis
- Rickettsia ricketsii
5
Q
C. diphtheria has ____ growth on what agar?
A
aerobic; Loeffler’s agar or Tisdale’s (tellurite) agar
6
Q
How is diphtheria transmitted?
A
Aerosol, human to human
youbreathe it out
7
Q
Diphtheria causes disease in what part of the body?
A
Upper respiratory tract or skin
8
Q
Where does C. diphtheria colonize?
A
Nasopharynx or adjacent regions
9
Q
____ is responsible for the severe symptoms of diphtheria
A
Prophage-coded diphtheria toxin
10
Q
Diphtheria causes a ____ in the back of the throat which can lead to _____
A
Thick covering; respiratory obstruction and myocarditis
11
Q
Diphtheria - thick covering in the back of the throat presents as:
A
Pharyngitis with grayish adherent pseudomembrane
12
Q
Diphtheria can lead to ____ damage
A
- kidney
- heart
- nerve
13
Q
Diphtheria toxin is a phage tox gene produced by:
A
Lysogenized strains
14
Q
Diphtheria toxin structure
A
A-B toxin
15
Q
Diphtheria toxin blocks:
A
Protein synthesis
16
Q
____ inhibits transcription of diphtheria toxin operon
A
Iron (corepressor)
Excess iron represses toxin production
17
Q
A subunit of AB toxin - function
A
- Possesses catalytic activity
- inactivates elongation factor 2 (EF-2), prevents protein synthesis by ribosome
18
Q
B subunit of AB toxin - function
Corynebacterium diphtheria
A
Membrane binding region
19
Q
Diphtheria treatment
A
- DOC penicillin
- anti toxin
20
Q
Prevention of diphtheria
A
Toxoid vaccine (DTAP)
21
Q
True or false: diphtheria is rare in the US
A
True - due to effective vaccine
22
Q
Diphtheria toxin is inactivated by:
A
Heat or chemical
23
Q
Diphtheria is a _____ disease
A
Reportable (by law)
24
Q
Bordatella pertussis classification
A
Gram negative coccobacillus
25
Bordatella pertussis causes:
Whooping cough
26
Bordatella pertussis invades what cells?
Alveolar macrophages
27
Bordatella pertussis is aerobic/nonaerobic
Strict aerobe
28
Whooping cough is described as:
- uncontrollable violent coughing
- hard to breathe
29
Whooping cough is highly _____. _____ are at greatest risk
Communicable; Children less than a year old
30
Whooping cough is endemic in the:
US
31
Whooping cough mortality before vaccination
21-31%
32
Bordatella pertussis virulence factors
- Adhesins (FHA)
- 2 distinct toxins (pertussis toxin, tracheal cytotoxin)
33
Bordatella pertussis adhesins
- **filamentous hemagglutinin** (FHA)
- pertactin
- fimbriae
34
____ is a major colonizing factor in nasopharynx
| Bordatella pertussis
FHA
| Bordatella pertussis
35
Pertussis toxin is secreted by ____
Type IV secretion system
36
Pertussis toxin function
increases mucus, leading to cough
37
Tracheal cytotoxin function
- damages respiratory tissues and **paralyzes cilia**
- leads to stagnant mucus and prevention of pathogen removal
- damage leads to paroxysmal cough
38
Tracheal cytotoxin damage leads to
Paroxysmal cough (whooping cough)
39
Bordatella pertussis - pertussis toxin pathogenesis
1. AB toxin binds to ciliated respiratory cells
2. unregulated activation of adenylate cyclase leads to **increase in cAMP**, increasing signal transduction
3. increase in **respiratory secretions and mucus**
4. mucus leads to **coughing**
40
Tracheal cytotoxin causes inflammation and ciliostasis to interfere with:
Secretions clearance
41
Where does Bordatella pertussis colonize?
Trachea - attach to cilia of respiratory epithelial cells
42
True or false: If you have whooping cough, you are most contagious during the paroxysmal (coughing) phase
False - you are more contagious (higher bacterial culture) during the catarrhal phase
More infectious before the cough starts
43
Bordatella pertussis diagnosis
PCR
Can culture but is is much slower
44
Bordatella pertussis DOC
Erythromycin
45
Whooping cough incidence is highest in ____ since 1955
2012
46
Decrease in whooping cough due to
DTAP vaccine
47
DTAP/Tdap vaccine contains ____ to stimulate immune response to toxin
inactivated tetanus toxin
48
Tdap must be given to all:
Pregnant women (between weeks 27-36)
49
H. influenza main virulence factor
- **PRP capsule (antiphagocytic)**
- Also has IgA protease and endotoxin
50
PRP capsule stands for:
**P**hospho**r**ibosylribitol **p**hosphate
51
Most serious serotype of H. flu
Type b (Hib)
52
H. influenzae grows as satellite colonies around:
S. aureus (secretes required growth factors - X factor and V factor)
53
H. influenzae causes major diseases among
Infants and elderly
54
H. influenzae infection can cause:
- **epiglottitis** (can be life threatening)
- **meningitis** (before vaccines)
- **bacteremia**
55
Before vaccines, H. flu meningitis was a major cause of:
90% of meningitis in children 6 months - 2 years
56
H. influenzae treatment
Broad spectrum antibiotics (cephalosporins, azithromycin)
57
Ampicillin resistant strains are common in _____ and conferred by ____
H. influenza; plasmid
58
True or false: there is no vaccine for H. influenzae
False - conjugate vaccine (PRP-tetanus toxoid) is very effective
59
H. flu ____ vaccine is poorly immunogenic
PRP capsule polysaccharide
60
When is H. flu vaccine administered?
- 2, 4, 6 months
- booster at 12 months
61
____ vaccine is T dependent, efficient, has good memory
Conjugate
62
True or false: H. influenzae cases have decreased
True due to effective Hib vaccine
< 1 case/100,000 children under 5 years of age
63
H. influenzae *primarily* affects:
unvaccinated/incompletely vaccinated children
64
H. influenzae and H. aegyptius can both cause:
Bacterial conjunctivitis
65
Legionella pneumophila killed 34 at:
American Legion convention in Philadelphia (1976)
66
Legionella pneumophila is fastidious - it is best seen with:
Silver stains
67
_______ is facultative intracellular
Legionella pneumophila
68
_____ causes 90% of legionellosis in US
Legionella pneumophila
69
Legionella pneumophila inhabits _____ environments
Aquatic
70
Legionella pneumophila is transmitted by:
inhalation of aerosolized bacteria
71
True or false: Legionella pneumophila can be spread person to person
False - is not spread person to person
72
Legionella pneumophila produces:
Beta lactamase
73
Legionellosis: types of disease
- pontiac fever
- Legionnaire's disease (pneumonia)
74
Pontiac fever is a milder form of _____. It is characterized by acute ____ with no _____
legionellosis; flu-like syndrome; no lung involvement
75
Pontiac fever is usually ____ with good prognosis
Self-limiting
76
Legionnaire's disease incubation time
2-10 days
77
Legionnaire's disease causes pneumonia that can lead to:
Septic shock and kidney failure
78
Major predisposing factors to getting Legionnaire's disease
- chronic lung diseases
- smoking
- older males
79
Legionnaire's disease symptoms
- fever
- chills
- headache
- cough
- diarrhea
- changes in mental status
80
Legionella pneumophila clinical presentation
Lower lobe filled with fluid, obscuration of hemidiaphragm silhouette
81
Smallest free living organisms
Mycoplasmas
82
____ lack a cell wall so they do not gram stain
Mycoplasmas
83
Mycoplasma cell membranes contain:
Sterols (modified steroid)
84
Which type of bacteria forms fried egg colonies?
Mycoplasmas
85
True or false: Mycoplasma pneumoniae is not as deadly as other pneumonia-causing bacteria
True
86
Mycoplasma pneumoniae causes ____ in 70-80% of infections
Tracheobronchitis
87
Mycoplasma pneumoniae causes ____ in 10% of infections
Walking pneumonia
88
Mycoplasma pneumoniae causes pneumonia in what age groups?
Teens and young adults
89
Walking pneumonia is also called:
Atypical pneumonia
90
True or false: walking pneumonia has a severe disease but short duration
False - mild disease but long duration
91
Walking pneumonia is characterized by what kind of cough?
Persistent, non productive
92
Walking pneumonia presentation on xray
Patchy lower lobe
93
Walking pneumonia is ____ fatal
Rarely
94
Recommended method of diagnosis for Mycoplasma pneumoniae
PCR (amplify its genes)
95
_____ not recommended for diagnosis of Mycoplasma pneumoniae
Cold agglutins (does not work at body temp - only lower temps 4 degrees C)
96
M. genitalium causes:
Non-gonococcal urethritis (NGU)
97
How is M. genitalium transmitted?
Sexually
98
Mycoplasma hominis causes:
Pyelonephritis
99
Ureaplasma urealyticum causes:
- NGU
- Pyelonephritis
100
Mycoplasmas should be treated with:
Tetracyclines
101
____ grows well at 5-40 degrees celsius
Listeria monocytogenes
102
Listeria monocytogenes has a tropism for:
Fetus and placenta of most animals
103
Listeria outbreak usually occurs in:
Ready to eat meat and cheese
104
Listeria monocytogenes causes opportunistic infection in:
- Neonates
- Immunocompromised adults
- pregnant women
- diabetics
105
Transmission - Listeria can cross:
- intestine (**processed meat products**)
- **placenta**
- blood brain barrier
106
Listeriosis is often ____ in healthy adults
Asymptomatic
107
Clinical forms of Listeriosis
- Non-invasive
- Invasive
108
Non-invasive listeriosis can cause:
gastroenteritis
109
Invasive listeriosis can cause:
meningitis in neonates and older adults
110
________ is the leading cause of meningitis in cancer and renal transplant patients
Listeria monocytogenes
111
Listeria monocytogenes can be found in
CSF (facultative intracellular in monocytes, macrophages, and PMN)
| remember, it causes meningitis so makes sense it is in CSF
112
14% of listerosis cases occurs in:
pregnant women
| transplacental transmission results in miscarriage or stillbirth
113
Neonates can contract listeriosis at ___ and often causes ____
birth; meningitis (CNS most often affected)
114
What diseases can be caused by Chlamydia trachomatis?
- Chlamydia (sexually transmitted)
- ocular diseases
- lymphogranuloma venereum
115
Chlamydophila pneumoniae causes:
Bronchopneumonia
116
____ is clinically similar to Mycoplasma pneumonia
Chlamydophila pneumoniae
117
____ is linked to arteriosclerosis
Chlamydophila pneumoniae
118
Chlamydiaceae life cycle
1. Elementary bodies attach to cell receptors and gets internalized
2. Reticulate bodies (replicating form) form inclusion bodies; binary fission
3. Replication results in death of the cell (releases infectious EB)
119
Most commonly reported notifiable disease in the US
Chlamydia trachomatis
120
Most common bacterial STD in the US
Chlamydia trachomatis
121
Local Chlamydia trachomatis infection in men causes:
- conjunctivitis
- urethritis
122
Local Chlamydia trachomatis infection in women causes:
- conjunctivitis
- urethritis
- cervicitis
123
Infants infected with Chlamydia trachomatis can get infection of the conjunctiva known as:
Ophthalmia neonaturum (can cause blindness)
124
___ can experience sequelae from chlamydia infection, which include:
Women; infertility, ectopic pregnancy, chronic pelvic pain
125
_____ causes 15-40% of urethritis cases in the US
Chlamydia trachomatis
126
Trachoma
Chronic keratoconjunctivitis
127
Symptoms of trachoma
- cornea and conjunctiva inflammation
- inflamed granulation of inner surface of eyelids
128
Leading cause of preventable blindness globally
Trachoma
129
Trachoma is rare in:
developed countries (prevented by antibiotics)
130
Perinatal transmission of Chlamydia trachomatis to infant can result in infections of the:
- conjunctiva
- respiratory tract
- pneumonia
131
Children older than 1 year with signs of Chlamydia trachomatis serves as possible evidence of
Sexual abuse
132
Pap smear with cervicitis showing inclusion bodies indicates ____ infection
Chlamydia trachomatis
133
Venereal disease
lymphogranuloma venerum caused by Chlamydia trachomatis
134
Stages of venereal disease
First stage: small painless vesicular lesion at infection site
Second stage: 2-6 weeks later; **regional lymphadenopathy, draining buboes**
| sexually transmitted
135
Diagnosis of Chlamydia trachomatis
PCR
136
If a patient has chlamydia, also check for:
Gonorrhea
137
DOC for Chlamydia trachomatis
tetracyclines
138
Francisella tularensis causes ____ disease, also known as:
zoonotic; tularemia/rabbit fever
139
____ has many animal reservoirs
Francisella tularensis
140
____ has been weaponized and is referred to as Select Agent Tier 1
Francisella tularensis
141
_____ is highly infectious and can be used as a biological weapon
Francisella tularensis
142
Major clinical manifestations of tularemia
- acute pneumonia
- skin ulcers
- lymphadenopathy
143
Francisella tularensis acute pneumonia has ____ fatality
30-80%
144
____ reservoir is in cats (infects through bite or scratch)
Bartonella henselae
145
Cat Scratch Disease causes:
- chronic regional lymphadenopathy in children
- pustular lesion at scratch site
- spreads to adjacent **lymph** nodes
- fever. malaise
- disseminates to spleen, joints, CNS
146
Bacillary angiomatosis occurs in patients who have ____ due to infection via ____
late stage AIDS; Bartonella henselae
147
Bartonella henselae DOC
Azithromycin
148
Zoonotic infection by pasteurella multocida is often due to _____
cat or dog scratch, bite, lick
149
Pasteurella multocida often causes:
Cellulitis
150
Rocky mountain spotted fever is caused by
Rickettsia rickettsii
151
Most common rickettsial pathogen in the US
Rickettsia rickettsii
152
Typhus fever forms of Rickettsiaceae
- Rickettsia prowazekii
- Rickettsia typhi
| both now **rare**
153
Rickettsia rickettsii infects you via:
Infected ticks
154
Rickettsia rickettsii causes:
- **Vasculitis (leakage from blood vessels)**
- hypovolemia (decreased blood plasma)
- poor blood flow to organs
155
Most common rickettsial infection in the US
Rickettsia rickettsii
156
Most common vector-borne infection in the US
Rickettsia rickettsii
157
What tick is the most common source of Rickettsia rickettsii?
American dog tick (Eastern US)
158
Which tick is most commonly found in western parts of US?
Rocky mountain wood tick
159
There is an estimated ____ cases per year of Rocky Mountain Spotted Fever, but only ____ cases were reported
300,000; 30,000
160
Symptoms of Rocky Mountain Spotted fever
- **Severe myalgia**
- **high fever**
- headache
- **rash (including palms and soles)**
- cough
- confusion, ataxia
161
Mortality is ____ in Rocky Mountain Spotted fever if untreated
35%
162
Diagnosis of Rickettsia rickettsii
- Serology (**antibodies produced late**, < 8 weeks)
- **Microimmunofluorescence assay** (IFA) test for IgM, IgG
- **Skin biopsy (staining)**
163
Rickettsia rickettsii DOC
Tetracyclines (can **reduce mortality to 5%**)
164
How to remove tick
- Tweezers and pull upward with steady even pressure
- do not set tick on fire
- keep tick for 3 weeks for ID
