Final (lectures 22-36/cumulative) Flashcards
1
Q
What is broad spectrum?
A
Kills many different groups, is indiscriminate
2
Q
What is narrow spectrum?
A
Kills a specific group
3
Q
What Mode of Action targets penicillin-binding proteins, peptidoglycan subunits and peptidoglycan subunits transport?
A
Inhibiting Cell Wall Biosynthesis
4
Q
What Mode of Action has a drug class of β-lactams, which includes penicillins, cephalosporins, monobactams, carbapenems, glycopeptides, and bacitracin?
A
Inhibiting Cell Wall Biosynthesis
5
Q
What Mode of Action targets 30S ribosomal subunits?
A
Inhibiting biosynthesis of proteins
6
Q
What Mode of Action targets 50S ribosomal subunits?
A
Inhibiting biosynthesis of proteins
7
Q
Which inhibition of biosynthesis of proteins has a drug class containing aminoglycosides and tetracyclines?
A
30S ribosomal subunit
8
Q
Which inhibition of biosynthesis of proteins has a drug class containing macrolides, lincosamides, chloramphenicol, and oxazolidinones?
A
50S ribosomal subunit
9
Q
What Mode of Action targets lipopolysaccharide, inner and outer membranes?
A
Disrupting the membrane
10
Q
What Mode of Action has a drug class of polymyxin B, colistin, and daptomycin?
A
Disrupting the membrane
11
Q
What Mode of Action targets RNA?
A
Inhibiting nucleic acid synthesis
12
Q
What Mode of Action targets DNA?
A
Inhibiting nucleic acid synthesis
13
Q
Which inhibition of nucleic acid synthesis has a drug class containing rifamycin?
A
RNA
14
Q
Which inhibition of nucleic acid synthesis has a drug class containing fluoroquinolones?
A
DNA
15
Q
What Mode of Action targets folic acid synthesis enzyme?
A
Antimetabolites
16
Q
What Mode of Action targets mycolic acid synthesis enzyme?
A
Antimetabolites
17
Q
Which antimetabolite has a drug class containing sulfonamides and trimethoprim?
A
Folic acid synthesis enzyme
18
Q
Which antimetabolite has a drug class containing isonicotinic acid hydrazide?
A
Mycolic acid synthesis enzyme
19
Q
What Mode of Action targets mycobacterial ATP synthase?
A
Mycobacterial ATP synthase inhibitor
20
Q
What Mode of Action has a drug class containing Diarylquinoline?
A
Mycobacterial ATP synthase inhibitor
21
Q
? bind to the 50S ribosomal subunit, prevents peptide bond formation, and stops protein synthesis
A
Chloramphenicol, macrolides, and lincosamides
22
Q
________ bind to the 30S ribosomal subunit, and impair proofreading resulting in the production of faulty proteins
A
Aminoglycosides
23
Q
________ bind to the 30S ribosomal subunits, and block the binding of tRNAs, thereby inhibiting protein synthesis
A
Tetracyclines
24
Q
Sulfonamide, a structural analog of PABA, competitively inhibits the synthesis of ?
A
dihydrofolic acid
25
Trimethoprim, a structural analog of dihydrofolic acid, competitively inhibits the synthesis of ?
Tetrahydrofolic acid
25
Which mechanism of action in common antifungal drugs has drug classes including imidazoles, triazoles, and allylamines?
Inhibit ergosterol synthesis
26
What are the different drugs under Imidazoles?
Miconazole, ketoconazole, clotrimazole
27
What are the clinical uses of imidazoles?
Fungal skin infections and vaginal yeast infections
28
What is a specific drug of a triazole?
Fluconazole
29
What are the clinical uses of triazoles?
Systemic yeast infections, oral thrush, and cryptococcal meningitis
30
What is a drug under the drug class allylamines?
Terbinafine
31
What are the clinical uses of allylamines?
Dermatophytic skin infections, and infections of fingernails and toenails
32
Which mechanism of action in common antifungal drugs that has drug classes including polyenes?
Bind ergosterol in the cell membrane and create pores that disrupt the membrane
33
What is a drug under the drug class polyenes?
Nystatin and amphotericin B
34
What is the clinical use of nystatin?
Used topically for yeast infections of skin, mouth, and vagina; also used for fungal infections of the intestine
35
What is the clinical use of amphotericin B?
Variety systemic fungal infections
36
Which mechanism of action in common antifungal drugs has drug classes including echinocandins?
Inhibit cell wall synthesis
37
Which mechanism of action in common antifungal drugs has drugs including caspofugin and nikkomycin Z?
Inhibit cell wall synthesis
38
What is a specific drug from the drug class echinocandins?
Caspofugin
39
What is the clinical use of caspofugin?
Aspergillosis and systemic yeast infections
40
What is the clinical use of nikkomycin Z?
Valley Fever and yeast infections
41
Which mechanism of action in common antifungal drugs has drug including griseofulvin?
Inhibiting microtubules and cell division
42
What is the clinical use of griseofulvin?
Dermatophytic skin infections
43
Which mechanism of action in common antiviral drugs that has drugs including acyclovir, AZT, ribavirin, vidarabine, sofosbuvir?
Nucleoside analog inhibition of nucleic acid synthesis
44
What is the clinical use of acyclovir?
Herpes virus infections
45
What is the clinical use of AZT?
HIV infections
46
What is the clinical use of ribavirin?
Hepatitis C virus and respiratory syncytial virus infections
47
What is the clinical use of vidarabine?
Herpes virus infections
48
What is the clinical use of sofosbuvir?
Hepatitis C virus infections
49
Which mechanism of action in common antiviral drugs that has drugs including etravirine?
Non-nucleoside noncompetitive inhibition
50
What is the clinical use of etravirine?
HIV infections
51
Which mechanism of action in common antiviral drugs that has drugs including amantadine and rimantadine?
Inhibit escape of virus from endosomes
52
What are the clinical uses of amantadine and rimantadine?
Infections with influenze virus
53
Which mechanism of action in common antiviral drugs that has drugs including olsetamivir, zanamivir, peramivir?
Inhibit neuraminadase
54
What are the clinical uses of olsetamivir, zanamivir, and peramivir?
Infections with influenza virus
55
Which mechanism of action in common antiviral drugs that has drugs including pleconaril?
Inhibit viral uncoating
56
What are the clinical uses of pleconaril?
Serious enterovirus infections
57
Which mechanism of action in common antiviral drugs that has drugs including ritonavir and simeprevir?
Inhibition of protease
58
What is the clinical use of ritonavir?
HIV infections
59
What is the clinical use for simeprevir?
Hepatitis C virus infections
60
Which mechanism of action in common antiviral drugs that has drugs including raltegravir?
Inhibition of integrase
61
What is the clinical use of raltegreavir?
HIV infections
62
Which mechanism of action in common antiviral drugs that has drugs including enfuviritide?
Inhibition of membrane fusion
63
What is the clinical use for enfuviritide?
HIV infections
64
What is immunology?
the study of the immune system and
immunity
65
What are the 2 branches of immunity?
1. Innate immunity
2. Adaptive immunity
66
What is Innate immunity?
multifaceted system of defenses targeting
invading pathogens in a nonspecific manner.
67
What is Adaptive immunity?
Multifaceted system of defenses that
specifically targets invading pathogens and that develop
memory to the invading pathogens
68
______ immunity is non-inducible, non-specific, gives a quick response, with no previous exposure required, physical + chemical barriers, phagocytes, and inflammation
Innate
69
______ immunity is activated when the other fails, specific recognition of pathogens, slow process, develop memory, T-cell, and B-cells with antibodies
Adaptive
70
In innate immunity there are many physical barriers:
? deny entry, ? remove potential threats, and the _____
cellular barriers, mechanical defenses, microbiome
71
In innate immunity, what are the 5 chemical barriers?
Body fluids, antimicrobial components, complement systems, cytokines, mediators of inflammation
72
In innate immunity, the complement system has _____ _____ that have sequential interaction, enzymes, and the ? that all boost innate and adaptive responses
Plasma proteins, membrane attach complex (MAC)
73
______ are the molecular messenger of the immune system
Cytokines
74
______ binds to receptors, signaling cascade leading to transcription activator
Ctyokines
75
_____ are a sub-class of cytokines that recruit circulating immune cells to site of injury
Chemokines
76
_____ is the same cell secretes and receives cytokine signal
Autocrine
77
______: cytokine signal is secreted to a nearby cell
Paracrine
78
_______: cytokine signal secreted to the circulatory system; travels to distant cells
Endocrine
79
______ are a sub-class of cytokines that activate anti-viral response of nearby cells
Interferons
80
What are the 2 main systems of the immune system?
Blood and lymphatic
81
_____ dumps antibodies and immune cells into the blood, while the _____ allows circulation and distribution of immune cells
Lymph, blood
82
What are the 3 secondary lymphoid organs?
Lymph nodes, mucosa-associated lymphoid tissue (MALT), spleen
83
_______ to detect antigens or pathogens circulating in the lymphatic system
Leukocytes
84
Derived from pluripotent hematopoietic stem cells (HSCs) are 3 main cells in the immune system: ?
Erythrocytes (Red blood cells)
Leukocytes (White blood cells)
Platelets
85
______ are immature, but become mature and differentiate; while _____ have granules that can be stained, contain toxins and enzymes and can destroy their targets
Monocytes, granulocytes
86
What are the 3 main granulocytes?
Basophil, neutrophil, and eosinophil
87
What are the 2 differentiated cells of monocytes?
Macrophages and dendritic cells
88
? : antigenic-presenting cells (APCs) residing in the skin and mucous membranes
Dendric cells
89
? : APC residing in the tissues and organs (spleen, lymph nodes and MALT) and are the link to adaptive immunity
Macrophages
90
? : elimination and destruction of extracellular bacteria, are the blood and bone marrow
Neutrophils
91
? : protection against protozoa and helminths and role in allergies
Eosinophils
92
? : role in inflammation and allergic reactions; found in the blood
Basophils
93
? : role in inflammation and allergic reactions; found in tissues
Mast cells
94
? : kill virus-infected cells and cancerous cells
Natural killer cells
95
Tissue damage will activate tissue _______ (macrophages), which will release the _____ and _____. This then recruits _______ and ______. Neutrophils enter tissues by
sticking to capillary wall (_______), rolling and squeezing in the cellular junctions (_______)
phagocytes, cytokines, chemokines, Neutrophil, T-cells, margination, diapedesis
96
What are Pathogen-associated Molecular Pattern (PAMS)?
Unique microbe structures
97
What are Pattern Recognition Receptors (PRRs)?
Toll-like receptors (TLRs)
NOD-like receptors (NDRs)
98
Uptake of extracellular pathogen is done by a _______, and the purpose is to ______
Phagosome, destroy
99
Membrane-bound inclusions are called ______, which contain ______ substances, reactive _____ species, enzymes like lysozymes, proteases, etc
lysosomes, bactericidal, oxygen
100
When lysosomes fuse with phagosome it is called a ________
phagolysosome
101
What is inflammation?
Normal biological response to physical injury, toxins, and pathogens
102
Inflammation is characterized by ?
Redness, swelling, pain, and heat
103
What is the scientific name for redness caused from inflammation?
Erythema
104
What is the scientific name for swelling caused from inflammation?
Edema
105
Inflammation can be ____or _____, ____ or _____, and its promote healing
localized, systemic, acute, chronic
106
What is acute inflammation?
Production of activators and pro-inflammatory molecules, and has an influx of phagocytes
107
What is a fever?
Non-localized inflammatory
108
_____ will induce a fever and are considered endogenous pyrogens, while ____ will also induce fever and are considered exogenous pyrogens
Cytokines, LPS
109
What are exogenous pyrogens?
Substances which originate inside the body and which are capable of inducing fever
110
What are endogenous pyrogens?
Substances which originate inside the body and which are capable of inducing fever
111
Exogenous and endogenous pyrogens act on ________, which act on the _______
prostaglandins, hypothalamus
112
What is the main purpose of fever?
Limit growth of pathogens
113
What is the official name for uncontrolled inflammation?
Toxic/septic shock
114
What are the 3 main aspects of adaptive immunity?
Discriminate: distinguishing between specific foreign molecules
Diversify: recognize many possible foreign molecules
Memorize: remember foreign molecules after 1st expose
115
What are the 2 components of adaptive immunity?
1. Humoral immunity
2. Cell-mediated immunity
116
What is humoral immunity?
Antibodies produced by B-cells in response to antigens
117
What are B-cells?
Bone marrow lymphocytes
118
What is cell-mediated immunity?
Activation of T-cells to control intracellular microbes
119
What are T-cells?
Thymus lymphocytes
120
An _____ is a molecule/substance that interacts with antibodies or T Cell Receptor (TCR). Not all antigen induce an immune response
antigen
121
An _______ induces an immune response, used in conjugate vaccines
Immunogen
122
A _______ is a small molecules that binds to an antibody, does not induce an immune response, it needs a ______ to be an immunogen
Hapten, carrier
123
Immunogenicity is dependent on: ?
Complexity
Physical form and structural form
Dose
124
What are epitopes?
Sections or specific regions of an antigen that are recognized
125
Antibodies are also known as ______. They are considered ______ and are found in blood and tissue fluids. They are ______, and have __ protein chains held by disulfide bonds. It is __-shaped, with __ heavy chains + __ light chain. They also have 2 fragments: ? and ?
Immunoglobulin, glycoproteins, Monomers, 4, Y, 2, 2, fragment of antigen binding (Fab), fragment of crystallization (Fc)
126
What is the Fragment of antigen binding (Fab region)?
Variable: diversity and specificity
Provide function
127
What is the Fragment of crystallization (Fc region)?
Binds to complement and phagocyte
128
What are the 5 functions of antibodies?
1. Opsonization
2. Neutralization
3. Agglutination
4. Immune activation
5. Cell mediated cytotoxicity
129
What are the 5 immunoglobin classes?
1. IgA
2. IgD
3. IgE
4. IgG
5. IgM
130
What is the function, properties, and distribution of immunoglobin class IgA?
Function: neutralization
Properties: major secretory antibody
Distribution: dimer in secretions, monomer in blood
131
What is the function, properties, and distribution of immunoglobin class IgD?
Function: B-cell receptor
Properties: activate B-cells
Distribution: B-cell
132
What is the function, properties, and distribution of immunoglobin class IgE?
Function: Fc bind and activate mast cells and basophils
Properties: parasite immunity
Distribution: blood and lymph
133
What is the function, properties, and distribution of immunoglobin class IgG?
Function: neutralization, agglutination, complement activation, opsonization, cell-mediated cytotoxicity
Properties: major circulating antibody, Fc binds phagocytes, crosses placenta
Distribution: blood, lymph, and extracellular fluid
134
What is the function, properties, and distribution of immunoglobin class IgM?
Function: neutralization, agglutination, complement activation
Properties: first antibody to appear
Distribution: blood and lymph
135
What is the Major Histocompatibility Complex (MHC)?
Important for antigen presentation, Dimers, 2 classes: MHC I and MHC II
136
What is MHC I?
Found on all nucleated cells, present self antigens, present non-self antigens
137
What is MHC II?
Found on macrophages, dentritic cells and B cells, present non-self antigens
138
Each T Cell Receptor (TCR) binds a different _____, selection occurs in ______, and failure can lead to ________
antigen, thymus, autoimmunity
139
______ selection: TCR with weak interaction divide and grow. No interaction is death
Positive
140
_____ selection: TCR with strong interaction die
Negative
141
What are the 3 classes of T-cells?
1. Helper (Th)
2. Regulatory (Treg)
3. Cytotoxic
142
What is the activation of Helper T-cells?
APC with antigen + MHC II
143
What is the activation of Regulatory T-cells?
APC with antigen + MHC II
144
What is the activation of Cytotoxic T-cells?
APC or infected cell with antigen + MHC I
145
What are the 4 subclasses of Helper T cells?
1. Th1
2. Th2
3. Th17
4. Memory
146
What is the function and outcome of Th1 helper t-cells?
Function: Activation of cytotoxic T-cells, neutrophile, NK and macrophage
Outcome: Cell-mediated immunity
147
What is the function and outcome of Th2 helper t-cells?
Function: Activation of B-cells
Outcome: antibody-mediated immunity
148
What is the function and outcome of Th17 helper t-cells?
Function: Activation and recruitment of neutrophils
Outcome: Amplification of innate immunity
149
What is the function and outcome of Memory helper t-cells?
Function: Remember specific pathogen
Outcome: Strong secondary response
150
What is the function and outcome of regulatory t-cells?
Function: Tolerance and prevention of autoimmune response
Outcome: Control of Th immunity
151
What is the function and outcome of cytotoxic t-cells?
Function: Destroy cells with intracellular pathogen
Outcome: Cell-mediated immunity
152
What is the surface CD of helper T cells and regulatory T cells?
CD4
153
What is the surface CD of cytotoxic T cells?
CD8
154
___ binds MHC II, ____ binds MHC I
CD4, CD8
155
B Cell Receptor (BCR) recognize __ antigen. Diversity is achieved by different process – ______, ________. Selection occurs in ?
1, recombination, hypermutation, bone marrow
156
B-cell stimulation where it is t-cell _______, there is proliferation and differentiation into plasma cells. T-cell _____ are stronger and induce memory, and have the internalization of antigen.
independent, dependent
157
_____ produced during the secondary response are more effective and bind with higher affinity; while ? produced during secondary responses live longer and levels of antibody remain elevated for longer
Antibodies, plasma cells
158
What was Edward Jenner's contribution?
Pioneered the concept of vaccines and created the smallpox vaccine, the world's first vaccine
159
What is passive, naturally acquired immunity?
Immunity acquired from antibodies passed in breast milk or through placenta
160
What is passive, artificially acquired immunity?
Immunity gained through antibodies harvesting from another person or animal
161
What is active, naturally acquired immunity?
Immunity gained through illness and recovery
162
What is active, artificially acquired immunity?
Immunity acquired through a vaccine
163
Vaccines leverage _____ immunity
adaptive
164
What is herd immunity?
Occurs when a sufficient percentage of a population has become immune to an infection, whether through previous infections or vaccination
165
Vaccines can ?, ?, and ?
Prevent infections, limit infections, limit severe effects
166
What is a Live Attenuated vaccine, and what are the pros and cons?
Description: Non-pathogenic viable microbe
Pros: Mimic a “real” infection; Balanced immunity
Cons: Not safe for immunocompromised; Risk of reversion
167
What is a Whole Inactivated vaccine, and what are the pros and cons?
Description: Pathogen is dead
Pros: Entire microbe without risk of infection
Cons: Weaker immunity; Stronger dose + booster
168
What is a Sub-Units vaccine, and what are the pros and cons?
Description: Immunogenic piece(s) of microbe
Pros: Limited side effects
Cons: Booster needed; Limited longevity
169
What is a Sub-Unit toxoid vaccine, and what are the pros and cons?
Description: Inactivated toxin
Pros: Antibodies neutralize toxin
Cons: Does not prevent infection
170
What is a Sub-Unit conjugated vaccine, and what are the pros and cons?
Description: Low immunogenic antigen attached to an immunogen
Pros: Effective in younger kids
Cons: Costly; Interfere with other vaccines
171
What is a Sub-Unit viral-like particle vaccine, and what are the pros and cons?
Description: Proteins that assemble as a capsid
Pros: Mimic the virus
Cons: Low immunogenicity (adjuvant)
172
What is a Viral Vector vaccine, and what are the pros and cons?
Description: A virus expressing an antigen
Pros: Mimic natural infection
Cons: Risk of genomic integration; Natural immunity to vector
173
What is a RNA vaccine, and what are the pros and cons?
Description: RNA strand that can be translated
Pros: Highly adaptable; Strong cell-mediate immunity
Cons: Costly (Storage); Weak humoral immunity
174
What is a DNA vaccine, and what are the pros and cons?
Description: DNA strand can be transcribed
Pros: Highly adaptable
Cons: Risk of genomic integration
175
What are the 3 broad categories of disorders and deficiencies of the immune system?
1. Hypersensitivity
2. Immunodeficiency
3. Autoimmunity
176
What is hypersensitivity?
An over-active and harmful response to foreign antigens
177
What is Immunodeficiency?
Failure to mount an adequate immune response in the presence of danger
178
What is Autoimmunity?
Harmful response to “self” antigens
179
All sites on a human that contain microorganisms are part of a _____
microbiome
180
What is a microbiome?
A functional collection of different microbes in a particular environmental system
181
What is microbiota?
Describe all the microbes in a microhabitat
182
There are ~10^__ microbes in the human
microbiome living in complex communities
13
183
What is the most common bacteria found on the skin?
Propionibacterium
184
What is the most common bacteria found in the saliva?
Streptococcus
185
What is the most common bacteria found in the urogenital tract?
lactobacillus
186
What is the most common bacteria found in the gastrointestinal tract?
bacteroidetes
187
Humans are _____ and omnivorous
monogastric
188
What is the pH in the stomach?
2
188
Colonization of gut begins at ___
birth
189
What is the pH in the small intestine?
4-5
190
What is the pH in the large intestine?
7
191
Microbial populations in different areas of the GI tract are influenced by ____ and the ?
diet, physical conditions in the area
192
_______, _________, and _________ are common in the gastric fluid, while ________ and _______ are common in the mucus layer of the stomach
Firmicutes, Bacteroidetes, Actinobacteria, Firmicutes, Proteobacteria
193
When present, acid-resistant ? causes chronic and acute gastritis and leads to the formation of peptic ulcers which can now be cured with antibiotics
Helicobacter pylori
194
The _____ is essentially an in vivo fermentation vessel, with the microbiota using nutrients derived from the digestion of food
colon,
195
Most organisms are restricted to the ____ of the large intestine, while others are in the _______ layers
lumen, mucosal
196
The vast majority (~98%) of all human gut phylotypes fall into one of three major bacterial phyla: ?
Firmicutes, Bacteroidetes, and Proteobacteria
197
Individuals may have mostly ________, mostly _______, or a mix of the two. This may regulate metabolism and the host’s propensity for obesity
Firmicutes, Bacteriodetes
198
? : individuals vary in their gut microbiota, each individual has a relatively stable gut microbiota
Gut Enterotypes
199
Three basic gut enterotypes: ?
1. Bacteroides
2. Prevotella
3. Ruminococcus
200
Each basic gut enterotypes ______ and _________ distinct
functionally, phylogenetically
201
A person’s enterotype influences the response to ? and may contribute to ?
diet and drug therapy, health or disease status
202
Immune system does not properly develop in the absence of ? Exposure to a ____ of microorganisms soon after birth is essential for developing immune
tolerance of beneficial microorganisms and recognizing pathogens as foreign
microbial stimulation, variety
203
Obese mice have more ______ and a greater
number of methanogenic ____
Firmicutes, Archaea
204
Saliva contains antimicrobial _____, but high concentrations of nutrients near surfaces in the mouth promote ?
enzymes, localized microbial growth
205
Cells form a biofilm called dental plaque, which
has ______ and other fermenting bacteria. S. mutans a major contributor –generates ____ ____. These fermenters produce acid, which wears down the _____ ______. Periodontal disease is thought to contribute to
several systemic conditions, including ______ ______ and _____
Streptococcus, lactic acid, tooth enamel, cardiovascular disease, arthritis
206
Microbes thrive in the ____ respiratory tract, while the ____ respiratory tract has no normal microbiota in healthy adults
upper, lower
207
Most are trapped in the mucus of the nasal and oral passages and expelled with ? or swallowed and then ?
nasal secretions, killed in the stomach
208
Only particles smaller than about 10 millimeter in diameter reach the lungs, most notably certain bacteria and viruses that cause _____.
pneumonia
209
Altered ___ conditions can cause potential pathogens in the urethra. ? and ? frequently cause urinary tract infections, especially in women
pH, E. coli, P. mirabilis
210
The vagina of the adult female is weakly _____ and contains significant amounts of _____. Lactobacillus acidophilus, a resident organism in the vagina, ferments the glycogen, producing _____ ____, which maintains a local acidic environment
acidic, glycogen, lactic acid
211
The most abundant viruses in all body sites are not animal viruses but instead are ______
bacteriophages
212
Bacteriophages likely play a _______ role in human health, and can be a first line of defense against certain pathogens. This can be considered to have a symbiotic relationship with the human host and provide a form of ?
protective, host-independent immunity
213
What are pathogens?
Microbial parasites that cause disease or tissue damage in a host
214
What is pathogenicity?
The ability of a parasite to inflict damage on the host
215
What is virulence?
The relative ability of a pathogen to cause disease
216
What is an opportunistic pathogen?
Causes disease only in the absence of normal host resistance
217
What is an infection?
Situation in which a microorganism is established and growing in a host, whether or not the
host is harmed
218
What is a disease?
Damage or injury to the host that impairs host function
219
What is adherence?
The enhanced ability of microbes to attach to host tissues. It is necessary, but not sufficient, to start disease
220
Bacteria and viruses that initiate infection often adhere specifically to ______ cells
epithelial
221
Adhesins are ________ or _______ found on the pathogen’s surface that enable it to bind to host cells
glycoproteins, lipoproteins
222
Gram-positive pathogens such as Staphylococci, Streptococci, and Enterococci, contain _____ anchored to their cell walls
SdrG
223
The protein domain SdrG C terminal refers to
the ? of an adhesin found only on the cell walls of bacteria
C terminus domain
224
The capsule is both sticky and contains specific receptors to facilitate ?. Capsules, such as those found in Streptococcus pneumoniae, protect the bacteria from ingestion by ?
attachment on host tissues, white blood cells
225
Fimbriae, flagella, and pili are bacterial cell surface protein structures that function in ______
attachment
226
_______ is the growth of microorganisms after they’ve gained access to host tissues. Typically starts with ______ ______, or tightly packed epithelial cells coated in mucus, a thick liquid secretion of glycoproteins.
Colonization, mucous membranes
227
Dental caries, or cavities, are an oral microbial disease. After initial contact, _______ sobrinius and _______ mutans attach and reproduce and form a biofilm called _____
Streptococcus, Streptococcus, plaque
228
What is bacteremia?
The presence of bacteria in the bloodstream
229
What is septicemia?
Bloodborne systemic infection. Can lead to massive inflammation, septic shock and death
230
Pathogens produce various virulence factors that
enhance invasiveness, what are 2?
1. Enzymes that enhance virulence by breaking down or altering host tissue to provide access to nutrients
2. Protect the pathogen by interfering with normal host defense mechanisms such as clotting
231
Virulence factors are ____ or ______ substances produced by the pathogen that directly or indirectly enhance _______ and ___ _____ by facilitating and promoting infection
toxic, destructive, invasiveness, host damage
232
Virulence can be estimated from experimental studies of the ?
LD50 (lethal dose50)
233
What is LD50?
The amount of an agent that kills 50% of the animals in a test group
234
Highly virulent pathogens show _____ difference in the number of cells required to kill 100% of the population as compared to 50% of the population
little
235
What is toxicity?
organism produces a toxin that inhibits host cell
function or kills host cells
236
What is invasiveness?
Ability of a pathogen to grow in host tissue at
densities that inhibit host function, and can cause damage without producing a toxin
237
What is attenuation?
Decrease or loss of virulence
238
When pathogens are kept in laboratory culture rather than isolated from diseased animals, their virulence often ______, or may be completely ____
decreases, lost
239
Attenuated strains of various pathogens are valuable to clinical medicine because they are?
often used for the production of viral vaccines
240
Genes that direct invasion are clustered together on the chromosome as ______ ______
pathogenicity islands
241
S. enterica serovar typhimurium has 5 pathogenicity islands:
SPI1: ?
III secretion system
SPI2: ?
encodes proteins promoting invasion forming an injectisome type, genes that promote a more systemic disease
242
Salmonella also contains ______ plasmids (R plasmids)
resistance
243
_________ infections are those caused by organisms that do not cause disease in healthy hosts
Opportunistic
244
_______ requires a pathogen break down host
tissues. This is often done with enzymes that attack host cells.
Invasiveness
245
________ breaks down host tissues. _______ and _______ manipulate clotting: ______ forms clots, while _______ breaks them down
Hyaluronidase, Coagulase, streptokinase, coagulase, streptokinase
246
What are the 4 classes of exoenzymes?
1. Glycohydrolases
2. Nucleases
3. Phospholipases
4. Proteases
247
What is the function and an example of the exoenzyme glycohydrolase?
Function: degrades hyaluronic acid that cements cells together to promote spreading through tissues
Example: hyaluronidase
248
What is the function and an example of the exoenzyme nuclease?
Function: degrades DNA released by dying cells that can trap the bacteria, thus promoting spread
Example: DNAse
249
What is the function and an example of the exoenzyme phospholipase?
Function: degrades phospholipid bilayer of host cells, causing cellular lysis, and degrade membrane of phagosomes to enable escape into the cytoplasm
Example: phospholipase C
250
What is the function and an example of the exoenzyme protease?
Function: degrades collagen in connective tissue to promote spread
Example: collagenase
251
What are exotoxins?
Toxic proteins released from the pathogen as it grows
252
What are the 3 categories of exotoxins?
1. Cytolytic toxins
2. AB toxins
3. Superantigen toxins
253
What disease, toxin, and activity is caused by the organism Clostridium botulinum?
Disease: botulism
Toxin: botulinum toxin (AB)
Activity: causes flaccid paralysis
254
What disease, toxin, and activity is caused by the organism Clostridium tetani?
Disease: tetanus
Toxin: tetanospasmin (AB)
Activity: causes spastic paralysis
255
What is the first disease, toxin, and activity is caused by the organism Clostridium perfringens?
Disease: gas gangrene
Toxin: α, β, γ, δ toxins (AB)
Activity: hemolysis, lecithin destruction
256
What is the second disease, toxin, and activity is caused by the organism Clostridium botulinum?
Disease: food poisoning
Toxin: enterotoxin (CT)
Activity: alters intestinal tract permeability
257
What disease, toxin, and activity is caused by the organism Corynebacterium diphtheriae?
Disease: diphtheria
Toxin: diphtheria toxin (AB)
Activity: inhibits eukaryotic protein synthesis
258
What disease, toxin, and activity is caused by the organism Escherichia coli (enterotoxigenic strains only)?
Disease: gastroenteritis
Toxin: shiga-like toxin (AB)
Activity: inhibits protein synthesis, induces bloody diarrhea
259
What are AB exotoxins?
Consist of two subunits, A and B. Work by binding to host cell receptor (B subunit) and transferring damaging agent (A subunit) across the cell membrane
260
What is the difference between the mode of action of cytotoxins and AB toxins?
Cytolytic toxins enzymatically attack cell constituents, such as membrane phospholipids, causing lysis of host cells
AB endotoxins consist of two covalently bonded subunits, A and B
261
?, which leads to _____ toxin, causes the activation of adenylate cyclase in intestinal cells, causing increased levels of cyclic adenosine monophosphate (cAMP) and secretion of fluids and electrolytes out of cell, causing diarrhea
Vibrio cholerae, cholera
262
?, which leads to _____ toxin, inhibits the release of inhibitory neurotransmitters in the central nervous system, causing spastic paralysis
Clostridium tetani, tetanus
263
?, which leads to _____ toxin, inhibits the release of the neurotransmitter acetylcholine from neurons, resulting in flaccid paralysis
Clostridium botulinum, botulinum
264
?, which leads to _____ toxin causes the inhibition of protein synthesis, causing cellular death
Corynebacterium diphtheriae, diphtheria
265
Diphtheria Exotoxin is an AB toxin. The A domain prevents its function in ______. Is coded by a lysogenic phage: __
translation, β
266
What is phage conversion?
Conversion of nonpathogenic strains to toxigenic
and pathogenic by infections with β
267
Which of the relevant toxins are considered neurological exotoxins?
Clostridium tetani and Clostridium botulinum produce potent AB exotoxins that affect nervous tissue
268
_____ toxin consists of several related AB toxins that are the most potent biological toxins known
Botulinum
269
What is the mode of Action of Botulinum Toxin?
Flaccid Paralysis: blocks the release of acetylcholine, inhibiting muscle contraction
270
What is the mode of Action of Tetanus Toxin?
Tetanus toxin binds to inhibitory interneurons, preventing release of glycine and relaxation of muscle
271
What are enterotoxins?
Exotoxins whose activity affects the small intestine
272
_______ generally cause massive secretion of fluid into the intestinal lumen, resulting in vomiting and diarrhea
Enterotoxins
273
________ enterotoxin is an AB toxin, whose activity affects the small intestine
Cholera
274
What is the mode of action of cholera enterotoxin?
Generally cause massive secretion of fluid into the intestinal lumen, resulting in vomiting and diarrhea
275
What is the mode of action of cytolytic exotoxins?
Work by degrading cytoplasmic membrane integrity, causing cell lysis and death
276
What are hemolysis?
Toxins that lyse red blood cells
277
Staphylococcal α-toxin kills nucleated cells and lyses ?
erythrocytes
278
What are 3 membrane disrupting toxins whose mode of actions is via proteins that assemble into pores in cell membranes, disrupting their function and killing the cell?
1. Streptolysin - streptococcus pyogenes
2. Pneumolysin - streptococcus pneumoniae
3. α-toxin - staphylococcus aureus
279
What are 3 membrane disrupting toxins whose mode of actions is via phospholipases that degrade cell membrane phospholipids, disrupting membrane function and killing the cell?
1. α-toxin - clostridium perfringens
2. Phospholipase C - pseudomonas aeruginosa
3. β-toxin - staphylococcus aureus
280
True or False: all hemolysins are phospholipases?
False
281
What are superantigens?
Generally due to a localized infection, but with systemic effects
282
_______ stimulate excessive activation of immune system cells and release of cytokines from immune system cells. Life-threatening fever, inflammation, and shock are the result
superantigens
283
Gram-positive bacteria Staphylococcus _____ and Streptococcus ____ are major producers of exotoxin superantigens
aureus, pyogenes
284
Superantigen poisoning can be triggered by ?, ?, or by ?
food poisoning, by toxic shock syndrome, pyrogenic fever
285
What are endotoxins?
The lipopolysaccharide portion of the cell envelope of certain gram-negative Bacteria, which is a toxin when solubilized. Lipid A is toxic portion
286
______ (endo/exotoxins) are less toxic than _____ (endo/exotoxins), but under certain circumstances can cause death
endotoxins, exotoxins
287
The presence of endotoxin can be detected by the
? assay, where normal ameobocytes are lysed
Limulus amoebocyte lysate (LAL),
288
What are the chemical properties of exotoxins?
Proteins, secreted by certain Gram+ or Gram- bacteria; generally heat labile
289
What are the chemical properties of endotoxins?
Lipopolysaccharide-lipoprotein complexes, released on cell lysis as part of the outer membrane of Gram- bacteria; extremely heat stable
290
What is the mode of action/symptoms of exotoxins?
Specific; usually bind to specific cell receptors or structures; either cytotoxin, enterotoxin, or neurotoxin with defined, specific action on cells or tissues
291
What is the mode of action/symptoms of endotoxins?
General; fever, diarrhea, vomiting
292
What are the toxic properties of exotoxins?
Often highly toxic in picogram to microgram quantities; sometimes fatal
293
What are the toxic properties of endotoxins?
Moderately toxic in tens to hundreds of microgram amounts, rarely fatal
294
What are the immune responses of exotoxins?
Highly immunogenic; stimulate the production of neutralizing antibody (antitoxin)
295
What are the immune responses of endotoxins?
Relatively poor immunogens; immune response not sufficient to neutralize toxin
296
What are the toxoid potentials(a) of exotoxins?
Heat or chemical treatment may destroy toxicity, but treated toxin (toxoid) remains immunogenic
297
What are the toxoid potentials(a) of endotoxins?
None
298
What is the fever potential of exotoxins?
Nonpyrogenic; do not produce fever in the host
299
What is the fever potential of endotoxins?
Pyrogenic; often induce fever in the host
300
What is the genetic origin of exotoxins?
Often encoded on extrachromosomal elements or lysogenic bacteriophages
301
What is the genetic origin of endotoxins?
Encoded by chromosomal genes
302
What is clinical microbiology?
Subdiscipline of microbiology whose focus is diagnosing infectious diseases by identifying pathogenic microbes and advising medical providers on treatment
303
Laboratories are classified according to their containment potential, or ?, and
are designated as ____through ____
biosafety level (BSL), BSL-1, BSL-4
304
What is a nosocomial infection?
A local or systemic infection acquired at a healthcare
facility
305
Nosocomial infections are frequently resistant to ______
antibiotics
306
What are the 6 frequency categories of nosocomial infections?
21.8% - respiratory tract infections
21.8% - surgical site infections
17.1% - gastrointestinal infections
16.4% - other
12.9% - urinary tract infections
10.0% - bloodstream infections
307
Patient → _______ assay → _____ ____
immunological, blood sample
308
Patient → ______ assay → _______ → ________ biology or immunology → _____ assay or _____ assay
other, samples, molecular, antigen, molecular
309
Patient → ______ assay → _______ → _____-_______ biology → _______ → ________ →_______
other, samples, growth-dependent, enrichment, isolation, identification
310
_______ is the ability to recognize the target pathogen, minimizing false positives. _______ is the minimum amount of a pathogen needed for the test to detect it, minimizing false negatives.
Specificity, Sensitivity
311
One of several selective media used for primary isolation of Neisseria gonorrhoeae is modified ? agar
Thayer–Martin (MTM)
312
? media: support growth of most aerobic and facultatively aerobic organisms (e.g.,
blood agar; chocolate agar heated blood)
General-purpose
313
? media: contain specific growth factors that enhance growth of certain fastidious pathogens. Can often identify pathogens based on colony morphology on a particular agar
Enriched
314
? media: inhibits growth of some bacteria while inhibiting others. EMB agar (eosin methylene
blue) inhibits growth of Gram positive and supports
the growth of Gram negative organisms
Selective
315
? media: allow identification based on growth, colour and appearance. EMB - contains lactose to identify lactose fermenters. EMB is selective and differential
Differential
316
Blood cultures are the only immediate way of
isolating and identifying the causative agent of
_______. One bottle is cultured _____, while the other is cultured _______
septicemia, aerobically, anaerobically
317
Urinary tract pathogens can be cultured using ? media, _____ media, and additional _____ media.
Disease-causing agents are often _____ flora.
general-purpose, selective, differential, normal
318
_______ media incorporate biochemical tests to
measure the presence or absence of enzymes
involved in catabolism of specific substrate(s)
Differential
319
Infections associated with injuries are sampled to determine the ____ and ______ microbes in
the area.
relevant, irrelevant
320
______ agar media is a common selective and
differential medium. Colonies of MRSA on this agar medium appear pink, whereas colonies of other bacteria appear blue
Chromogenic
321
For anoxic incubation, agar plates are placed in a ______ ___, which is made anoxic
sealed jar
322
What is a Disc diffusion test?
Method for assessing antimicrobial susceptibility
(susceptible or resistant). Specified agar medium is
inoculated (spread evenly) with culture of bacteria
323
What is the Minimum Inhibitory Concentration (MIC)?
Antibiotic dilutions made in broth or agar. Wells containing serial dilutions of antibiotics are inoculated with a standard amount of a test organism. Examine for inhibited growth. These methods are automated for most microorganisms. NOT N. gonorrhoeae.
324
What is an Etest?
Non-diffusion-based antimicrobial susceptibility testing method that uses a preformed and predefined gradient of an antimicrobial agent immobilized on a plastic strip. MICs are ascertained. Expensive but handy
325
? : Uses pathogen-specific RNA to make cDNA. Quantitative real time, and uses fluorescently labeled (SYBR Green) product. Almost immediate results DNA extracted from a bacterium monitored for expression of 16s rRNA and a kanamycin resistance marker using gene specific primers.
RT-PCR
326
? : uses labeled hybridization primers that are incorporated into product of this reaction. Determines presence but not amount of pathogen DNA. After the cycle, each virus shows a
distinct DNA melting curve.
Qualitative PCR
327
What is Nucleic acid hybridization?
Involves the bonding of a short, complementary nucleic acid strand (probe) to a target sequence. The probe is generally labeled with a radioisotope or fluorescent molecule, and the target sequence is typically bound to a nylon membrane or other solid surface
328
What is serology?
The study of antigen–antibody reactions in vitro
329
Serological reactions used for many diagnostic immunology tests which have the following 3 reactions: ?
1. Neutralization
2. Precipitation
3. Agglutination
330
The usefulness of a serological test for diagnostic purposes is dependent on the test’s specificity and sensitivity: test _______ is the probability of having a positive test when the patient IS infected, but test ________ is the probability of having a negative test if the patient is NOT infected
sensitivity, specificity
331
________ use antibodies specific for pathogens or their products for in vitro tests designed to detect specific infectious agents
Immunoassays
332
The ? is a quantitative measure of antibody level and is defined as the highest dilution (lowest concentration) of serum at which an antigen–antibody reaction is observed
antibody titer
333
Serological reactions are used for many diagnostic
immunology tests and often use ?
monoclonal antibodies (mAbs)
334
Not all pathogens elicit an immune response that can be measured – e.g. ?
N. gonorrhoeae
335
An antibody binds to a specific region on an antigen called an _____.
epitope
336
Multiple antibodies may bind to such an antigen – _____ antibodies. ______ antibodies bind to a single epitope
polyclonal, Monoclonal
337
How many epitopes are on an antigen?
There are multiple epitopes on an antigen
338
What is a precipitin reaction?
Interaction of a soluble Ag and Ab. A visible antigen-antibody reaction
339
_____ reaction: as soluble antigen is slowly added to a solution containing a ______ amount of soluble antibody, the amount of precipitin _____ as the antibody-to antigen ratio approaches ______ and decreases once the proportion of antigen ?
Precipitin, constant, increases, equivalence, exceeds the optimal ratio
340
What is agglutination?
The visible clumping of a particulate antigen when mixed with antibodies specific for the particulate antigens
341
Agglutination tests are typically more sensitive
than ______ tests
precipitation
342
Standardized agglutination tests are used to
identify ? and many pathogens and pathogen products
blood group antigens
343
_____ agglutination: results when soluble antibody causes clumping due to interaction with an antigen that is an integral part of the surface of a cell or other insoluble particle
Direct
344
_____ agglutination: used for the classification of antigens found on the surface of red blood cells
Direct
345
_____ agglutination: the agglutination of soluble antigens or antibodies that have been adsorbed or chemically coupled to cells or insoluble particles
Passive
346
_____ agglutination: reactions can be up to five times more sensitive than direct agglutination tests
Passive
347
What is the serum for Blood Type O?
Anti A: no agglutination
Anti B: no agglutination
348
What is the serum for Blood Type A?
Anti A: agglutination
Anti B: no agglutination
349
What is the serum for Blood Type B?
Anti A: no agglutination
Anti B: agglutination
350
What is the serum for Blood Type AB?
Anti A: agglutination
Anti B: agglutination
351
_____ reactions can be up to 5X more sensitive than direct _____ tests
Indirect, agglutination
352
________: the interaction of antibody with antigen to block or distort the antigen sufficiently to reduce or
eliminate its biological activity. Reactions can
occur in vivo or in vitro
Neutralization
353
____ method: the antibody targeted against the surface antigen is covalently linked to the fluorescent dye
Direct
354
_____ method: the presence of a nonfluorescent antibody on the surface of a cell is detected by use of a fluorescent antibody directed against the nonfluorescent antibody
Indirect
355
What is immunofluorescence?
Antibodies can be chemically modified with fluorescent dyes to help detect antigens on intact cells
356
What are the two common fluorescent dyes used in immunofluorescence?
Rhodamine B (red)
Fluorescein isothiocyanate (yellow-green)
357
If the pathogen contains surface antigens reactive with the antibody, the pathogen cells _____
fluoresce
358
Fluorescent antibodies can be applied ______ to
infected host tissues, allowing for rapid diagnosis
directly
359
Fluorescent antibody assays are also used in the diagnosis of ?
noninfectious diseases (e.g., malignant cells)
360
What is an Immunoblot (western blot)?
Electrophoresis of proteins, followed by transfer to a membrane and detection by addition of specific antibodies
361
Immunoblot methods detect antibodies to specific antigens or the ?
antigens themselves
362
What are the 3 different enzyme immunoassays (EIA)?
1. Direct
2. Indirect
3. Sandwich
4. Bonus - combination
363
What is direct EIA?
Detection of antigen
364
What is indirect EIA?
Detection of antibody
365
What is sandwich EIA?
Detection of antibodies
366
What is an Enzyme-linked Immunosorbent Assay (ELISA)?
A technique to detect the presence of antigens in biological samples, relies on antibodies to detect a target antigen using highly specific antibody-antigen interactions.
367
ELISAs are very _____
sensitive
368
EIAs employ ______ bonded enzymes attached to antibody molecules
covalently
369
? are like EIAs except that results can often be reported within minutes instead of hour
Rapid tests
370
In rapid tests, the reagents are absorbed to support material, the body fluid is applied to the support ____ which contains a soluble antigen conjugated to a colored molecule (_______). Color forms when concentration of chromophore gets ____ enough.
matrix, chromophore, high
371
What is epidemiology?
The study of the occurrence, distribution, and determinants of health and disease in a population
372
What is Public Health?
The health of the population as a whole
373
Epidemiologists rely on _________: the observation, recognition, and reporting of diseases as they occur
surveillance
374
The _____ of a disease is the number of new cases of the disease in a given period of time
incidence
375
The ______ of a disease is the total number of new and existing cases in a population in a given time.
prevalence
376
A disease is an _____ when it occurs in a large number of people in a population at the same time
epidemic
377
A _______ is widespread, usually worldwide
pandemic
378
An ______ disease is constantly present in a population, usually at low incidences. Individuals that
are infected with a pathogen that causes endemic disease are called reservoirs. These reservoirs may be human or nonhuman animals.
endemic
379
A disease _____ occurs when a number of cases of a disease are reported in a short period of time
outbreak
380
Diseased individuals who show no or mild symptoms have _____ infections. These individuals are called _____
subclinical, carriers
381
_____ infections are where the host and pathogen survive, but ____ infections are where the pathogen can be selective force
Chronic, acute
382
What are the stages of diseases?
1. Infection
2. Incubation
3. Acute
4. Decline
5. Convalescent
383
What is the Infection stage?
The organism invades and colonizes the host
384
What is the Incubation stage?
The time between infection and onset of symptoms called prodromal in graphs
385
What is the Acute stage?
The disease is at its height (period of illness)
386
What is the Decline stage?
Disease symptoms are subsiding
387
What is the Convalescent stage?
Patient regains strength and returns to normal
388
What is Mortality?
The incidence of death in a population
389
What is Morbidity?
Refers to the incidence of disease, including fatal and nonfatal diseases
390
What is Disability-Adjusted Life Year (DALY)?
Quantitatively measures disease burden in terms of lost years due to the disease, disability due to disease, and premature death
391
Virulence of the parasite in host-to-host transmission diminishes, and resistance of the host _____
increases
392
If a pathogen does not rely on host-to-host transmission, it may remain extremely _____
virulent
393
What is herd immunity?
Defined as the resistance of a group to infection due to immunity of a high proportion of the group. If a high proportion of individuals are immune to an infection, then the whole population will be protected
394
What is direct host-to-host transmission?
Infected individual transmits a disease directly to a susceptible host without the assistance of an intermediary
395
What is indirect host-to-host transmission?
Occurs when transmission is facilitated by a living or nonliving agent
396
Living agents are called _____, while nonliving agents are called _____
vectors, fomites
397
What are the 3 modes of person to person transmission?
1. Direct contact –sexual contact/handshakes
2. Indirect contact – cups and other fomites
3. Airborne droplet – sneeze/cough/talk
398
What are the 4 modes of vehicle transmission?
1. Waterborne
2. Foodborne
3. Airborne - fungal spores
4. Soilborne - wound contamination
399
What are the 3 main modes of transmission?
1. Person-to-person
2. Vehicle
3. Vector
400
What is the main mode of vector transmission?
Arthropods/insects
401
What is an example of indirect contact mode of transmission?
Influenza, common cold
402
What is an example of airborne droplet mode of transmission?
influenza, TB
403
What is an example of the waterborne mode of transmission?
cholera
404
What is an example of the foodborne mode of transmission?
salmonellosis, staph food poisoning
405
What is an example of the airborne - fungal spores mode of transmission?
histoplasmosis
406
What is an example of the soilborne - wound contamination mode of transmission?
tetanus
407
What is an example of the arthropods/insects mode of transmission?
typhus, lyme disease, malaria
408
______ are sites in which infectious agents remain viable and from which individuals can become infected
Reservoirs
409
_____ is any disease that primarily infects animals but is occasionally transmitted to humans
Zoonosis
410
Major epidemics are usually classified as ? epidemics, which usually arises from contamination of water or food
common-source or host-to-host,
411
In a host-to-host epidemic, the disease shows a slow, progressive rise and a _____ decline
gradual
412
A propagated epidemic is where one or more of the first wave of cases serves as a source of infection for ______ cases and those subsequent cases, in turn, serve as sources for later cases. The shape of the curve usually contains a series of ?, which are one incubation apart in which an increasingly large number of cases caused by person-to-person contact, until the pool of susceptible is exhausted or control measures are implemented
subsequent, successively larger peaks
413
What is the basic reproduction number (R0)?
The R0 is the number of expected secondary cases of a given disease from each single case. The mathematical model assumes an entirely susceptible population. Different infectious diseases have
different R0
414
Basic Reproduction Number (R0) and Herd Immunity Necessary for ?
Community Protection From Selected Infectious Diseases
415
Gonorrhea, chlamydia and syphilis are considered ______ diseases
notifiable
416
_______ ______ can be resistant to traditional and currently recommended antibiotics used for treatment. There is no vaccine; obligate human pathogen
Neisseria gonorrhoeae
417
Gonorrhea is caused by Neisseria gonorrhoeae, which is an obligate human pathogen; Gram-_____ _______
negative, diplococcus
418
What are the 3 symptoms of Gonorrhea in females?
1. Characterized by a mild vaginitis that often goes unnoticed
2. Can lead to pelvic inflammatory disease, infertility, ectopic pregnancy
3. Can be passed from mother to child; was a leading cause of blindness
419
What are the 3 symptoms of Gonorrhea in males?
1. Urethral discharge
2. Painful infection of the urethral canal
3. Rare complications can arise
420
In gonorrhea infections, both sexes may have ______ and _____ infections
pharyngeal, rectal
421
What are the 3 steps in the diagnosis of N. gonorrhoeae?
1. Microscopy - Gram negative diplococci in PMNL
2. Culture - Growth on Thayer Martin medium, oxidase positive, other biochemical tests
3. Nucleic acid amplification tests
422
_____ can be caused by Treponema pallidum and may be transmitted with other STIs
Syphilis
423
T. pallidum can be transmitted from an infected woman to the fetus during pregnancy, causing ?
Congenital syphilis
424
Having syphilis can increase chances of acquiring an HIV infection by __-__x and HIV-positive people with syphilis can increase the risk of transmitting the virus.
3-5
425
Syphilis can also progress more quickly and be more difficult to treat in people who are HIV-_____.
positive
426
There are four stages of syphilis: ?
Primary, secondary, latent, and tertiary
427
What is the treatment of syphilis?
penicillin
428
What is considered early and late syphilis?
Early: <1 year
Late: >1 year
429
What are the symptoms in primary syphilis?
Chancres, which are painless ulcers
430
What are the symptoms in secondary syphilis?
Rash, if any. Usually from 1-12 months after the chancres appear, the rash will appear
431
What are the symptoms in latent syphilis?
Irreversible damage to the CNS and cardiovascular system, and there are no signs or symptoms. Typically cannot be transmitted at this point but a mother can pass it to her unborn child
432
What are the symptoms in tertiary syphilis?
Causes tissue and organ damage 10-20 years after the beginning of latent stage
433
______ cannot be cultivated on artificial media, but can be grown in rabbit testes
syphilis
434
You can identify _____ from lesions - microscopy, direct fluorescent antibody test, nucleic acid
amplification
syphilis
435
Blood tests such as agglutination assays, EIAs and other formats are also used in identifying _____
syphilis
436
In identifying ______, a number of different tests which look for anti-treponemal antibodies as well as non-treponemal antibodies (detect IgG and IgM in patients which react with a mixture of cardiolipin, lecithin and cholesteral. These materials are probably released by host cells early in infection. Are screening tests and become positive after 6 weeks)
syphilis
437
_____ is caused by C. trachomatis, it is the most prevalent STI worldwide
Chlamydia
438
_____ causes: Nongonococcal urethritis (NGU) and Lymphgranuloma venereum (LGV)
Chlamydia
439
? is nonmotile, gram negative, obligate intracellular pathogen and 0.3-1 µm in diameter
C. trachomatis
440
_____ has a unique and complex biphasic life cycle; infectious during only one life stage
Chlamydia
441
In Chlamydia, the ______ body form adapted for extracellular survival; ______ body form involved in intracellular growth and replication
elementary, reticulate
442
In C. trachomatis, there are __ serovars; __ serovars cause trachoma, __ serovars cause lymphogranuloma venereum (LGV)
18, 4, 5
443
What is a serovar?
Distinct variation within a species of bacteria or virus or among immune cells of different individuals.
444
Is trachoma or lymphogranuloma a major cause of blindness?
Trachoma
445
Order these statements in accordance to the life cycle of chlamydia:
1. Multiplication of reticulate bodies
2. Elementary body attacks host cell
3.Conversion to reticulate body
4. Conversion to elementary bodies
5. Phagocytosis of elementary body
6. Release of elementary bodies
2, 5, 3, 1, 4, 6
446
Symptoms of a _____ infection include inflammation of the reproductive tract, urethritis,
proctitis, and epididymitis in men, while urethritis, endometritis, and cervicitis in women can lead to
cervical cancer
chlamydia
447
Symptoms of a _____ infections may be asymptomatic especially in women
chlamydia
448
An untreated infection of _______ can result in long-term complications such as pelvic inflammatory disease and infertility in women, epididymitis and possible infertility in men and reactive arthritis (Reiter’s syndrome) in both men and women.
chlamydia
449
Infection from _____ can be passed to newborns during childbirth resulting in conjunctivitis or pneumonia, and may result in pregnancy complications
chlamydia
450
What is the diagnosis process of C. trachomatis?
NAATs (Nucleic acid amplification tests) recommended;
Now combined with gonorrhea tests
Formerly tissue cultures, antigen detection assays, direct immunofluorescence assays, EIA
Some POC tests
451
What is the treatment for C. trachomatis?
Antibiotics: tetracycline, azithromycin.
No resistance detected resulting in treatment failure
452
Human immunodeficiency virus (HIV) is the causative agent for ____
AIDS
453
HIV is divided into two types:
HIV-1 is the more virulent type
HIV-2 is less virulent and causes a milder, AIDS-like disease
454
What is HIV-1?
The more virulent type
455
What is HIV-2?
Less virulent and causes a milder, AIDS-like disease
456
_______ infections are common in AIDS patients, with the most common is ________ caused by the protist Pneumocystis jiroveci
Opportunistic, pneumonia
457
A frequent non-microbial disease in AIDS patients is ? , an atypical cancer caused by co-infection of HIV and herpesvirus 8 (HHV-8)
Kaposi’s sarcoma
458
What are the 4 opportunistic pathogens associated with HIV/AIDS?
Protists, fungi, bacteria, and viruses
459
What is the general structure of a Retrovirus?
Spherical, consisting of an internal protein core surrounded by an envelope of glycoproteins embedded in a lipid bilayer. The core contains several copies of reverse transcriptase bound to two identical single-stranded RNA molecules.
460
HIV infects cells that contain the ___ cell surface protein. Most commonly infected are _____ and ?. HIV also interacts with co-receptors on _____ cells
CD4, macrophages, T-helper cells, target
461
Order these statements in accordance to the infection of a CD4 target cell (Macrophage) with HIV:
1. The nucleocapsid is inserted into the host cell, beginning the viral infection
2. Interaction of the virus with a receptor-coreceptor pair on the host cell
3. HIV gp120 protein binds CD4 receptor and CCR5 receptor
4. The viral envelope and host membrane coalesce
3, 2, 4, 1
462
HIV infection does not immediately ___ the host cell, but results in progressive ____ in CD4 cells. As the number of CD4 cells declines, _____ production falls, leading to reduction of the ?
kill, decline, cytokine, immune response
463
What are the 4 steps in diagnosis HIV?
1. ELISA
2. Western Blot
2. qPCR
4. Point of Care tests
464
What are the 4 classes of drugs that delay the symptoms of AIDS and prolong the life of those infected with HIV?
1. Nucleoside reverse transcriptase inhibitors (NRTI)
2. Nonnucleoside reverse transcriptase inhibitors (NNRTI)
3. Protease inhibitors (PI)
4. Integrase inhibitors (INSTI)
465
Is there an effective vaccine for HIV?
No
466
What is the main kind of chemotherapeutic drugs for HIV?
Antiretrovirales
467
? : infects the epithelial cells around the mouth and lips causing cold sores and may occasionally affect other body sites
Herpes simplex 1 virus (HSV-1)
468
There are 2 types of herpes simplex virus: ?
1 - above the waist
2 - below the waist
469
_____ is spread via direct contact or through
saliva
HSV
470
_____ lesions heal without treatment in 2 to 3
weeks
HSV
471
Being infected with ____ increases risk of HIV transmission
HSV
472
? infections are associated primarily with anogenital region, and it causes painful blisters on penis of male and cervix, vulva, or vagina of females
Herpes simplex 2 virus (HSV-2)
473
Herpes simplex 2 virus (HSV-2) is typically transmitted through sexual contact and most easily transmitted when ?
active blisters are present
474
Genital herpes (Herpes simplex 2 virus (HSV-2))are presently _____, however, a limited number of drugs (guanine analogue acyclovir) are successful in controlling the infectious blister stage and inhibit replication of the virus
incurable
475
What is the diagnosis for primary genital herpes?
If a lab test is used may comprise cytological examination of cells by staining or direct immunofluorescence; viral antigen detection tests (EIA)
476
What is the diagnosis for trichomoniasis?
Direct microscopic observation, cell culture, immunological techniques, PCR assay
477
What is the treatment for trichomoniasis?
Metronidazole can be administered orally or
intravenously, with cure rates of 85-95%
478
________ is caused by the protist Trichomonas vaginalis
Trichomoniasis
479
_______ is generally transmitted by sexual contact; may be transmitted by a contaminated toilet seats, paper towels, etc
Trichomoniasis
480
_________ infection has been associated with an
increased risk of human immunodeficiency syndrome in both sexes
Trichomoniasis
481
______ is typically asymptomatic in males but for females, infections are characterized by vaginal discharge, vaginitis, and painful urination
Trichomoniasis
482
? is a small icosahedral non-enveloped DS DNA virus, and can infect different parts of the body
Human Papillomavirus (HPV)
483
There are over 100 types of ____; some are primarily sexually transmitted causing anal and genital warts. Other types can lead to more serious consequences such as cervical, penile and anal cancers. Cancer a rare outcome of this common genital infection
HPV
484
Most ___ infections occur without any symptoms and go away without treatment. However, in some people the infections can persist
HPV
485
Immunization prior to sexual debut is effective in protecting against most sexually transmitted ___ infections
HPV
486
___ testing relies on molecular methods, and cannot be cultured using conventional tissue culture methods
HPV,
487
How many HPV vaccines are available in Canada?
2
488
Most pathogens survive poorly in air, thus, are effectively transmitted only over ____ distances
short
489
Respiratory infections colonize the respiratory tract at ____ levels, many are Gram _____ organisms, and are considered viruses
different, positive
490
Genus ______ is gram positive; phylum Firmicute. They generally grow in chains or pairs. Classified based on hemolytic properties
Streptococcus
491
_______ respiratory infections caused by S. pneumoniae or S. pyogenes are usually initiated due to a weakening of ?, as these organisms are normally found in the respiratory tract
Streptococcal, host defenses
492
Symptoms of _______ pharyngitis are sore throat, enlarged tonsils, mild fever, and general malaise
streptococcal
493
Prompt treatment is essential because encapsulated strains of S. pneumoniae are extremely invasive and resist _______
phagocytosis
494
_____ infections by either organism lead to serious complications (scarlet fever, rheumatic fever, bone infections, toxic shock syndrome, etc.)
Systemic
495
________ pneumoniae grow in pairs or short chains and causes pneumonia. Encapsulated strains are pathogenic and its virulence factor is its capsule
Streptococcus
496
What is the treatment for Streptococcus pneumoniae?
Vaccines available (mix of 23 capsular polysaccharides)
Treatment with penicillin. High percent resistant to
this antibiotic
497
Streptococcus pyogenes is in what group of streptococcus?
Group A; GAS
498
Streptococcus ______ is commonly found in low
numbers in the upper respiratory tract of healthy
individuals. Causes β hemolysis and pus-forming wounds
pyogenes
499
Streptococcus ____ is the causative agent of: “strep throat” – streptococcal pharyngitis; infections of the middle ear, mammary glands; infections of
superficial layers of skin - impetigo; acute skin infections – erysipelas; infections occur if host defenses are weakened or a new, highly virulent strain is introduced
pyogenes
500
? can cause sudden and severe invasive, systemic infections: cellulitis (subcutaneous skin
infection), necrotizing fasciitis (“flesh-eating
bacteria”), and pneumonia. It also can cause toxic shock, and invasive infections that are less common
S. pyogenes
501
___ may carry a lysogenic bacteriophage that encodes ________ ______ exotoxins (Spe A, B, C and F) that act as superantigens and are responsible for symptoms of toxic shock syndrome and scarlet fever (M antigen included as part of superantigen complex for toxic shock). Untreated or insufficiently treated infections can lead to other diseases such as rheumatic fever and glomerulonephritis
GAS, streptococcal pyrogenic
502
What is the diagnosis and treatment of Streptococcal Diseases?
Culture on blood agar followed by serology and other biochemical tests; antigen detection – rapid tests; and both GAS and S. pneumoniae treatable with
antibiotics
503
________ is a severe respiratory disease that typically infects children, and is caused by Corynebacterium diphtheriae, a bacterium that forms irregular rods during growth in the phylum: Actinobacteria
Diphtheria
504
? spreads by airborne droplets; enters body by respiratory route, it is preventable (vaccine) and treatable, and both previous infection or immunization provides resistance
C. diphtheriae
505
? : caused by the Gram-positive, aerobic, nonmotile bacterium which enters the body via the
respiratory route, lodging in the throat and tonsils
Diphtheria
506
Inflammatory response of throat tissues to C. diphtheriae results in a characteristic lesion called a
________, which may block the air passage and result in death
pseudomembrane
507
Some C. diphtheriae strains are lysogenized by bacteriophage β and produce a powerful exotoxin (______ toxin, which is an AB toxin and inhibits protein synthesis) but is vaccine preventable
diphtheria
508
Diphtheria toxin causes ? and ?
tissue death and the appearance of the
pseudomembrane in the patient’s throat
509
C. diphtheriae must be isolated from the _____; it is grown on ? with tellurite which inhibits other pathogens
throat, Blood agar
510
How do people die from diphtheria?
Death due to a combination of partial suffocation by the pseudomembrane and tissue destruction
511
How do we treat diphtheria?
Treatment includes antibiotics (penicillin, erythromycin, gentamicin)
512
? is an acute, highly infectious respiratory disease caused by Gram-negative, aerobic
coccobacillus B. pertussis in the phylum Proteobacteria
Pertussis (Whooping Cough)
513
______ is a recurrent, violent cough, and produces pertussis exotoxin (AB toxin) after attaching top
cells of upper respiratory tract. It then induces cAMP, and produces an _______. But it can be prevented by _______
Pertussis, endotoxin, immunization
514
Pertussis is more infectious than _______; a
higher percentage of vaccinated individuals is
required to achieve herd immunity.
diphtheria
515
What is the diagnosis and treatment of pertussis?
Diagnosis: fluorescent antibody staining of nasopharyngeal swab specimen and a culture of the organism
Treatment: vaccination soon after birth – DTaP vaccine, and antibiotics (ampicillin, tetracycline,
erythromycin)
516
All mycobacteria are ? due to the waxy mycolic acid content of their cell walls
acid-fast
517
_________ is caused by Mycobacterium tuberculosis in the phylum: Actinobacteria
Tuberculosis
518
? is caused by Mycobacterium leprae
Hansen’s disease (leprosy)
519
______ is transmitted by airborne droplets and is common co-infection with HIV
tuberculosis
520
_______ is classified as a primary (initial) infection or post-primary infection (reinfection)
Tuberculosis
521
What is a Primary Infection of tuberculosis?
Hypersensitizes the patient to the bacteria and alters the individual’s response to subsequent exposures. Hypersensitivity measured by a diagnostic skin test (tuberculin test)
522
What is a Postprimary Infection of tuberculosis?
Reinfection from bacteria dormant in lung
523
Chronic ______ often results in a gradual spread of tubercular lesions in the lungs. Aggregates of
activated macrophages
tuberculosis
524
The treatment of ______ includes: antimicrobial therapy with isoniazid and other antibiotics, usually multiple (e.g. rifampin). It usually requires a 9-month
regimen, and affects the synthesis of mycolic acid in mycobacteria
tuberculosis
525
Most serious form of ? is characterized by folded, bulblike lesions on the body. Pathogenicity caused by combination of delayed hypersensitivity and the
invasiveness of the organism. Transmission by both direct contact and respiratory routes. Incubation times vary from several weeks to years
Leprosy (Hansen's Disease)
526
_______: inflammation of the meninges, membranes that line the central nervous system, especially the spinal cord and brain. Can be caused by viral, bacterial, fungal, or protist infections
Meningitis
527
_______ ______, in the phylum proteobacteria, it is gram-negative, nonsporulating, obligately aerobic, oxidase-positive, encapsulated diplococcus
Neisseria meningitides
528
What is the diagnosis of Neisseria meningitides?
Like N. gonorrhoeae –Thayer Martin medium
529
Neisseria meningitides causes one type of infectious bacterial meningitis and a related infection, _________: a condition characterized by intravascular coagulation and tissue destruction, shock, and
death in over 10 percent of cases
meningococcemia
530
_________ meningitis is typically via airborne routes, mortality can be high. Treatment: penicillin iv
Meningococcal
531
What is the immune reactant of Type I hypersensitivity?
IgE
532
What is the immune reactant of Type II hypersensitivity?
IgG or IgM
533
What is the immune reactant of Type III hypersensitivity?
IgG and IgM
534
What is the immune reactant of Type IV hypersensitivity?
T cells
535
What is the antigen form of Type I hypersensitivity?
Soluble antigen
536
What is the antigen form of Type II hypersensitivity?
Cell-bound antigen
537
What is the antigen form of Type III hypersensitivity?
Soluble antigen
538
What is the antigen form of Type IV hypersensitivity?
Soluble or cell-bound antigen
539
______ __ hypersensitivity: allergen-specific IgE antibodies bind to mast cells via their Fc receptor. When the specific allergen binds to the IgE, cross-linking of IgE induces degranulation of mast cells
Type I
540
______ __ hypersensitivity: IgM or IgG antibody binds to cellular antigen, leading to complement activation and cell lysis. IgG can also mediate ADCC with cytotoxic T cells, natural killer cells, macrophages, and neutrophils
Type II
541
______ __ hypersensitivity: antigen-antibody complexes are deposited in tissues. Complement activation provides inflammatory mediators and recruits neutrophils. Enzyme released from neutrophils damage tissue
Type III
542
______ __ hypersensitivity: TH1 cells secrete cytokines, which activate macrophages and cytotoxic T cells
Type IV
543
______ __ hypersensitivity: local and systemic anaphylaxis, seasonal hay fever, food allergies, and drug allergies
Type I
544
______ __ hypersensitivity: red blood cell destruction after transfusion with mismatched blood types or during hemolytic disease of the newborn
Type II
545
______ __ hypersensitivity: post-streptococcal glomerulonephritis, rheumatoid arthritis, and systemic lupus erythematosus
Type III
546
______ __ hypersensitivity: contact dermatitis, type I diabetes mellitus, and multiple sclerosis
Type IV
547
_____ anaphylaxis: reaction only at side where allergen enters the body
Localized (atopic)
548
______ anaphylaxis: causes a reaction in entire body, massive release of histamine, and causes anaphylactic shock
Generalized (systemic)
549
What is the treatment for Atopic &/or mild systemic reactions (esp. respiratory allergies)?
Anti-histamines
Steroids and bronchodilators: reduce inflammation and open airways
Drugs targeting mast cells: prevent degranulation, or IgE binding
550
What is the treatment for Anaphylactic shock?
Epinephrine: relax smooth muscles, reduce vascular permeability
551
What are superantigens?
Proteins that over activate T cells. Mimicking normal activation and activate indiscriminately
