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Flashcards in Pathologies of Bacterial Diseases Deck (109)
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1

Rank the following causes of morbidity in the Philippines
A. Acute Respiratory Infection
B. Pneumonia
C. Bronchitis

ABC

2

Give the ranking of the ff top ten leading causes of mortality in the Philippines
a. Diseases of the Heart and Vascular System
b. Pneumonia
c. Malignant Neoplasms
d. TB

a. 1 and 2
b. 4
c. 3
d.6

3

Three most common infectious causes of morbidity

Schistosoma
Malaria
TB

4

Two related aspects in studying disease

Pathogenicity
host response

5

4 aspects to be considered in Pathology

Etiologic agent
Pathogenesis
Morphology
Clinical significance

6

When can you say that there is a disease based on the antibody titre?

when there's a 4x rise

7

Bacterial Virulence is characterized by ability to

ADHERE to host cells
INVADE cells and tissue
deliver TOXIC moieties

8

[Virulence gene:induction]
Vibrio cholerae adherence toxin genes:________
Salmonella genes:_________

induced by iron deprivation
induced by acidic environment

9

What is Cag?

Virulence gene converting H. pylori to gastritis producing pathogen

10

[Bacterial adhesin: Gram stain]
Fibrillae:_______
Fimbriae or pili:______

Gram (+) Cocci
Gram (-) Cocci and rods

11

The following infect macrophages EXCEPT
a. M. tuberculosis
b. E. coli
c. Shigella
d. S. typhi,
e. all except a

E

12

What is responsible for most biologic activities of LPS? e.g. feer, macrophage activation, B cell mitogenicity, all cytokine mediated)

Lipid A (+ sugar)

13

What is used to serotype bacteria?

O antigen

14

Which definitely has endotoxin?
a. Gram -
b. Gram +

A

15

The ff. are exotoxins EXCEPT
a. diphtheria txin
b. alpha toxin of C. pefringens
c. anthrax toxin
d. AOTA
e. NOTA

E

16

[Identify Diagnostic Technique to be used]
Most bacteria (except M.
tuberculosis)

Gram stain

17

[Identify Diagnostic Technique to be used]
Mycobacteria, nocardiae

Acid fast stain

18

[Identify Diagnostic Technique to be used]
Fungi, legionellae,
pneumocystis

Silver stains

19

[Identify Diagnostic Technique to be used]
Fungi, amebae

Periodic AcidSchiff

20

[Identify Diagnostic Technique to be used]
Cryptococci

Mucicarmine

21

[Identify Diagnostic Technique to be used]
Campylobacteria, leishmaniae,
malaria parasites, herpes

Giemsa

22

[Identify Diagnostic Technique to be used]
Viruses, rickettsiae
(done using ELISA)

Antibody probes
(most important)

23

[Identify Diagnostic Technique to be used]
All classes (~90%)
*others more difficult to culture
(e.g. Salmonella typhi)

Culture (can be
used for anything

24

[Identify Diagnostic Technique to be used]
Viruses, bacteria, protozoa

DNA probes

25

neutrophilic attraction to the site of infection in response to chemoattractants (In blood, neutrophilia is indicative of
bacteria even w/o Gram staining)
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation

A

26

cell-mediated response of the host -- lymphocytes and
macrophages; viruses, intracellular bacteria and arasites, spirochetes and helminths. → TB
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation

D

27

absent host inflammatory response, virus-mediated
damage to host cells
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation

E

28

Various classes of organisms with powerful toxins that cause extensive tissue damage(abcess). This also indicates destruction of the underlying tissues. → severe form of suppurative inflammation
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation

C

29

end stage of many infections
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation

B

30

characterized by antibody production and excretion of leptospires in the urine, intense jaundice; 2nd week of illness
a. Acute septicemic phase
b. Immune Phase

B

31

How long does leptospirosis acute septicemic phase last?

1 week

32

in leptospirosis, antibodies appear during

1st week - anicteric syndrome/acute septicemic phase

33

What is the coagulase reaction for?

To test for Staphylococcus

34

Which Staph virulence factor is responsible for degrading lipids on skin surface allowing quick abcess formation

lipase

35

Which Staph virulence factor binds with FC portion of immunoglobulins to escape antibody-mediated killing?

Protein A

36

Which Staph virulence factor attacks desmosomes, which cause keratinocytes to detach → barrier
function of skin lost?

Exfoliative toxin A and B

37

[Which Staph clinical feature?]
Focal suppurative inflammation of the skin and subcutaneous tissue; solitary or
multiple, or recurrent in successive crops; most frequent in moist hairy areas; from a single hair
follicle --> deepening abscess --> thinning and rupture of skin

Furuncle or boil

38

[Which Staph clinical feature?]
Deeper suppuration  spread laterally beneath the deep subcutaneous fascia  erupt
in multiple adjacent skin sinuses; found typically in fascial planes favoring their spread (skin of upper
back and posterior neck)

Carbuncle

39

[Which Staph clinical feature?]
small red raised lesions, each associated with a hair follicle

Folliculitis

40

[Which Staph clinical feature?]
persistent abscess formation of the apocrine glands, often in the axilla; furuncle

Hydradenitis suppurativa

41

[Which Staph clinical feature?]
lesions on finger and wrist usually found in children
o Impetigo- often characterized by yellow to brown crusts; restricted to the superficial epidermis
(fingers, wrist, face, scalp)

Bullous impetigo

42

[Which Staph clinical feature?]
nail bed infection

Paronychia

43

[Which Staph clinical feature?]
Infection on the palmar sides of the fingertips\

Felon

44

[Which Staph clinical feature?]
often characterized by yellow to brown crusts; restricted to the superficial epidermis(fingers, wrist, face, scalp)

Impetigo

45

[Identify]
o caused by the exfoliative A and B toxins
o an exfoliative dermatitis that most frequently occur
in children with Staphylococcal infections of the
nasopharynx or skin
o rash, bullae, partial or total skin loss
o skin is split in the granulose laye

Staphylococcal Scalded Skin Syndrome a.k.a Ritter disease

46

[Identify]
Staphylococcal infection Secondary to drug hypersensitivity, characterized by Desquamation of the skin at the epidermal-dermal junction

Lyell's Disease a.k.a Toxic Epidermal Necrolysis

47

[Identify]
o mediated by one or more of the exotoxins produced by S. aureus
o occurs predominantly in menstruating females using tampons (the Staphylococcus colonizes the
vagina or cervix - the tampon probably promotes superficial ulceration and easy entry for the toxin)
o rash is a diffuse, blanching, macular erythema particularly affecting the hands and feet, which
desquamates 1-2 weeks after it appears.

TSS

48

What mediates methicillin resistance of MRSA? what genes carry it?

mecA carried by Staphylococcal cassete chromosome (SCCmec)

49

MRSA a.k.a "________ eating bacteria"

flesh eating bacteria

50

Gram positive, B-hemolytic, facultative anaerobic cocci
a. Streptococcus
b. Staphylococcus
c. Diplococcis
d. Gonococcus

A

51

T/F patients with S. aureus usually have brain abcesses

T

52

[Identify pathogen]
Symptoms: chills, headache, myalgia, abdominal pain, conjunctival suffusion, a transient skin rash (<24
hrs, if present)

Leptospira sp.

53

Gram positive non-motile cocci with a large number of plasmids
a. Streptococcus
b. Staphylococcus
c. Diplococcis
d. Gonococcus

B

54

What do Streptococci have that allows them to avoid phagocytosis?

M protein

55

C5a
a. degrades chemotactic peptide
b. allows adhesion
c. prevents bacteria from being recognized by the immune system
d. NOTA
e. AOTA

A

56

Which makes more damage to tissues and more pronounced abcesses?
a. Staph
b. Strep

A

57

[Identify]
Occurs when Group A streptococci infection spreads
through the epidermis to cause `punched out' ulcers
that extend into the dermis

Ecthyma

58

[Identify]
o Spreading superficial infection of the skin occuring at
any age
o often develops abrupt onset of malaise, fever, chills and headache and the involved skin becomes tender, red, warm and swollen
o occasionally bullous; inflammation spreads with poorly
defined margins (as compared to erysipelas)
o found in lower extremitie

Cellulitis

59

[Identify]
o a characteristic variant of cellulitis, almost
always caused exclusively by S. Pyogenes
o painful, bright red, shiny lesion with a raised,
sharply demarcated, advancing edge (“butterfly-wing
rash” with erythema and induration)
o common in the legs and face

Erysipelas

60

[Which Streptococcus strain?]
Pharyngitis, scarlet fever, erysipelas, impetigo, rheumatic fever, TSS, and glomerulonephritis.

S. pyogenes (Group A)

61

[Which Streptococcus strain?]
o Colonizes the female genital tract
o Sepsis and meningitis in neonates, chorioamnionitis in pregnancy.

S. agalactiae (Group B)

62

[Which Streptococcus strain?]
o Community-acquired pneumonia and meningitis in adults
o Pneumolysin – inserts into host cell membranes and lyses them

S. pneumonia

63

[Which Streptococcus strain?]
o Dental caries
o Metabolizes sucrose to lactic acid → demineralization of tooth enamel
o Glucans – promote aggregation of bacteria and plaque

S. mutans

64

[Which Streptococcus strain?]
Endocarditis

Viridans group streptococci

65

[Which Pathogen?]
 Aerobic, non-spore forming, non-motile bacilli with a waxy coat that causes retention of the red dye in
acid treatment of acid-fast stains.
 20-100x slower growth than most bacteria

M. tuberculosis

66

[Which Pathogen?]
 Gram negative, pleiomorphic
 Encapsulated and unencapsulated forms
 Capsule prevents opsonization
 Pili mediate adherence to respiratory epithelium, also a factor that disorganizes ciliary beating, protease
that degrades IgA, capsule

H. influenza

67

[Which Pathogen?]
 Acid fast obligate intracellular organism that grows very poorly in culture but can be propagated in
armadillo
 Slender, aerobic rods that grow in straight or branching chains
 Affects skin and peripheral nerves and results in disabling deformities

M. leprae

68

What can H. influenza cause?

LRTI and meningitis in young children

69

What is the great triad symptoms of pneumonia?

fever, cough, dyspnea

70

In meningitis caused by H. influenza, what causes inflammation and what causes blood brain barrier disruption?

endotoxin causes inflammation, cell wall peptidoglycan damages endothelium

71

Which H. influenza serotype is the most usual cause of disease?

serotype B

72

Why is M. tuberculosis destructive?

Escapes killing by macrophage + induce type IV hypersensitivity

73

Unique waxy cell wall of M. tuberculosis is composed of mycolic acid and contains

Cord factor
Lipoarabinomannan
complement
HSPs

74

M. tuberculosis surface glycolipid causing it to grow in serpentine cords in vitro

Cord factor

75

M. tuberculosis lipopolysaccharide, inhibits macrophage activation by interferon gamma and induces macrophages to secrete IFN gamma and IL10

Lipoarabinomannan

76

component of M. tuberculosis that opsonizes the organism & facilitates its uptake by the macrophage complement
receptor

Complement

77

Component of M. tuberculosis that induce autoimmune reactions

HSPs

78

What forms caseation in TB?

lysed macrophages

79

What test shows resistance to M. tuberculosis?

Tuberculin test; Positive

80

What causes hemoptysis in lung TB?

caseous necrosis and cavities rupture into blood vessels

81

Miliary TB occurence favors the ff EXCEPT
a. bone marrow
b. liver
c. lung
d. spleen
e. retina

C

82

TB of the skin is called

lupus vulgaris

83

TB of the skin, characterized by an indolent, slowly spreading, reddish-brown plaque-like lesion
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy

A

84

regarded as allergic reactions to tuberculosis elsewhere in the body

tuberculids

85

involves the skin, peripheral nerves, anterior chamber of the eye, upper airways, testes, hands, & feet; contain large aggregates of lipid-laden macrophages often filled with masses of acid-fast bacilli
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy

C

86

begins with localized flat, red skin lesion that enlarge and develop irregular shapes with indurated, elevated, hyperpigmented margins, & depressed pale centers (central healing)
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy

B

87

anesthetic, dry, scaly skin lesions; asymptomatic involvement of large peripheral nerves, T-cell mediated immune response, with granuloma formation. Damage to
peripheral nerves is mediated by DTH reactions to mycobacterial antigens in the sheaths and fibers.
Nerves of predilection- ulnar, median, radial, lateral popliteal, great auricular
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy

B

88

diffuse lesions containing foamy macrophages teeming with mycobacteria, includes symmetric skin thickening & nodules; called anergic leprosy because of unresponsiveness of the host immune system. There could be numerous nodular skin lesions and
thickening of the pinna. Loss of eyebrows, atrophic rhinitis, testicular atrophy, & ocular damage are
common as well.
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy

C

89

More severe
a. Tuberculoid leprosy
b. lepromatous leprosy

B

90

What determines whether individual has tuberculoid or lepromatous leprosy?

T helper cell lymphocyte response to M. leprae

91

CD8+ suppressor T cells at the margins of lepromatous lesions secrete

IL-10,IL-4

92

inhibit helper T cells and mediate the anergy seen in lepromatous leprosy

IL-10

93

induces antibody production by B cells, these are not protective, but rather form antigen antibody complexes that lead to erythema nodosum leprosum, life-threatening vasculitis and glomerulonephritis

IL-4

94

How can you differentiate Borderline tuberculoid leprosy from fungal infection?

BT leprosy is anesthetic

95

T/F leprosy is highly communicable

F

96

Leonine facies is found in
a. lepromatous leprosy
b. tuberculoid leprosy

A

97

T/F M. leprae usually found in nasal passages because they prefer cool areas

T

98

Shigella is
a. Gram negative facultative anaerobe
b. Gram positive anaerobe
c. Gram negative anaerobe
d. Gram positive facultative anaerobe

A

99

Escapes from phagolysosome
a. M. tuberculosis
b. Shigella
c. both
d. neither

C

100

diarrhea with blood or mucoid stool with fresh blood
a. Reiter syndrome
b. Bacillary dysentery

B

101

chronic arthritis in HLA-B27 individuals due to S. flexneri, bacterial antigen reacts with the HLA-B27 protein
a. Reiter syndrome
b. Bacillary dysentery

A

102

How do you differentiate shigellosis from infection with Entamoeba histolytica?

The pseudomembrane and long segment are apparent in shigellosis while Entamoeba histolytica
infections have focal lesions.

103

[Which pathogen?]
 Gram negative
 Comma-shaped, flagellated
 Flagella for penetrating mucus
covering of epithelial surfaces
 From contaminated food especially
undercooked meat and
unpasteurized milk
 Can be caused by contact with
infected dogs

Campylobacter jejuni

104

acute inflammatory demyelinating polyneuropathy that results as a post-infectious complication of Campylobacter jejuni

Guillain-Barre syndrome

105

[Which pathogen?]
 Gram-negative, facultative
 Intracellular
 Affects distal ileum and colon, pharynx and tonsils
 Intestinal ulcers, diffuse enteritis with villus shortening
 crypt hyperplasia, microabscesses in mucosa and submucosa
 Hyperplasia of lymphoid tissue in terminal ileum

Yersinia

106

[Which Pathogen?]
 Gram-negative
 Comma-shaped
 cholera causing

Vibrio cholerae

107

[Which Pathogen?]
 Gram-negative
 Flagellated
 Invasion of epithelial cells and macrophages by invasion genes induced by low oxygen tension in the
gut
 Typhoid-causing

Salmonella (S. typhii)

108

S. typhi shed in the ff EXCEPT
a. urine
b. vomittus
c. oral secretions
d. NOTA
e. AOTA

D

109

T/F S. typhii infect chickens

F; they only infect humans. only non-typhi Salmonella infect chickens