microbio exam 5

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microbio exam 5
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  1. vaccine interference
    vaccinate to early, before 8 weeks, Ab from mom = useless with vaccine
  2. injection of Ab from outside source 
    ex: snake bite antivenom

    what type of immunity
    arrtifiically acquired passive immunity 
  3. what determines class  of Ab?
    constant portion 
  4. how classes of Ab/Ig and what are they?
    • 5
    • GMADE
  5. % IgG in serum?
    80-85
  6. IgG helps prevent against ? (3)
    • 1. neutralizes bacterial toxins
    • 2. bacteria/virus in blood (protection)
    • 3. enhances phagocytic/ white blood cells (more aggresive)
  7. IgG found in? (3)
    • blood
    • lymph fluid
    • large conc. in intestines 
  8. IgG structure
    allows for what? (2)
    • monomer unit
    • 1. cross blood vessel walls and enter tissue fluids and travel to other body parts
    • 3. cross placental barrier (placental transfer)
  9. IgM % in serum?
    5-10%
  10. IgM structure? and what joins the monmers? size limitations?
    • M=macro!
    • Pentamer structure, joined by J-chain
    • only effective in blood and lymph 
  11. IgM functions (3)
    • assist in clumping cells and viruses (easier immune system clean up)
    • FIRST Ab to arrive at infection site  (IgG is 2nd)
    • enhance phagocytic cells
  12. most prevelant Ab in body?
    • IgA DIMER
    • dimer form much more effective than monomer form
  13. IgA monomer % in serum?
    10-15%
  14. wher is IgA dimer most prevelant?
     mucus secretions (mucus, saliva, tears, breast milk)
  15. where is IgA monomer found
    bloodstream
  16. primary function on IgA?
    coats surface of Ag and helps prevent it from attaching to host tissues
  17. IgD % in serum
    0.2%
  18. IgD structure? found where? limitation?
    • monomer unit
    • found in blood/lymp fluid, attached to B cell surface
    • too big to cross placental barrier & blood vessel walls (even tho monomer)
  19. IgE % in serum? binds where and function?
    • 0.002%
    • binds to surface of mast cells and basophils (white blood cells in allergic reaction)
    • stimulates them to release histamine => allergic rxn

    higher conc of IgE in ppl w/ seasonal allergies
  20. B cells, T cells and macrophages 
    produced by what and from what?
    • by bone marrow 
    • from stem cells

    • B cells ->produce Antibodies
    • T cells pass through thymus
  21. effector t cell tbat attaches to target cell(Ag)  and  release perforins
    T cytotoxic cells / CD8+
  22. believed to be effective against eukaryotic parasites
    T cytotoxic cells / CD8+
  23. T cytotoxic cells / CD8+ helps prevent? (3)
    • cancer
    • transplanted tissue/blood
    • intracellular bacteria and viruses 
  24. helps macrophages recognize antigen and activate macrophages
    Helper T Cells CD4+
  25. when activated undergoes 2-3 reproductive cycles to produce cytokines
    Helper T Cells CD4+
  26. CD4+ = cytokines
    TH1 function?
    • activate macrophages and natural killer cells (white blood cells)
    • assist cytotoxic t cells
  27. CD4+ = cytokines
    TH2  function?
    • assist B cells  in Ab mcl production
    • with IgE = responsible for postive TB skin test
  28. T regulatory / suppressor cells 
    subset of?
    function?
    • subset of CD4+
    • shut down immune response (dysfuntion -> autoummunity)
    • believed to play role in preventing fetus rejection in pregnancy
  29. believed to play role in preventing fetus rejection in pregnancy
    Treg Cells
  30. dental carries are?
    tooth decay
  31. the bug that causes cavites and plaque on teeth
    • streptococcus mutans (gram + cocci) 
    • est along gum line, produce dextran -> ferments to produce acid
  32. plaque composition? if untreated leads to?
    • streptococcus mutans + dextran + metabolic waste product
    • doesnt dissolve in saliva
    • acid/plaque pockets break down teeth, may lead to tooth canal
    • Untreated: lead to peridontal disease
  33. peridontal disease 
    • general term for many conditions w:
    • inflammation & degeneration of gums, supporting bone and ligament
  34. microbes cause peridontal disease? (4)
    • actinomycete
    • corynebacterium
    • fusobacterium
    • nocardia
  35. peridontal disease prevented by? treated with?
    • prevented by brush, floss, professional cleaning
    • tx: penicillin or tetracycline(not for kids, blackening)
  36. diseases of digestive system
    intoxication?
    • ingestion of a pre-formed TOXIN
    • ex: staphylococcal food poisoning
  37. diseases of digestive system
    infection?
    • PATHOGEN enter and multiply in GI tract
    • usually delay btwn infection and symptoms
    • ex: salmonellosis
  38. diseases of digestive system
    toxico-infection?
    • results from combo of intoxication and infection 
    • usually fecal contamination
    • ex: cholera
  39. staphlococcal food poisoning 
    bug? bug produces?
    staphylococcus aureus produces enterotoxin

    heat stable toxin, tolerate 30 min boiling, reheating kill bug but not toxin

    staphylococcus aureus can withstand higher osmotic pressure than most other microbes, can live in custard or cream pies
  40. staphlococcal food poisoning 
    symptoms (3)
    • nausea
    • vomiting
    • diarrhea (1-6 hrs after eating)

    • symptoms usually disappear in 24 hr
    • causes ~25% of food poisoning cases
  41. staphlococcal food poisoning 
    treatment?
    ride it out, replace loss fluids
  42. Salmonellosis (salmonella gastroenteritis) 

    bug? incubation?
    • caused by several species of Salmonella, infection delay
    • time: 12 hours to 2 wks (avg 12-36hrs) - depends on contamination level
  43. Salmonellosis (salmonella gastroenteritis) 

    symptoms? (5)
    • fever
    • nausea
    • abdominal pain and cramps
    • diarrhea
    • vomiting
  44. Salmonellosis (salmonella gastroenteritis) 

    recovery time and mortality rate?
    • recovery: only few days and complete
    • mort rate: LOW, <1% - if death usually due to septicemia
  45. Salmonellosis (salmonella gastroenteritis) 

    prevention?
    meat particulary susceptible to contamination especially poultry, eggs

    • proper cooking of food 
    • good sanitary practices
  46. Salmonellosis (salmonella gastroenteritis) 

    treatment?
    • replace fluids lost through diarrhea
    • antibiotics not usually useful
  47. botulism (intoxication) 

    bug? gram? found where?
    • clostridium botulinum
    • gram +, endospore-forming, obligate anaerobe
    • found in soil or in the sediment of fresh water
  48. botulism (intoxication) 

    toxin?
    • Exotoxin
    • acts as neurotoxin
    • associated w/ nonacidic foods, not formed w/ pH < 4.7
  49. botulism (intoxication) 

    associated with? geo location?
    • associated with home canning, esp green beans and honey
    • rare in USA, still common in underdeveloped countries
  50. botulism (intoxication) 

    symptoms?
    usually takes 2 days to begin

    • nausea, blurred vision, difficulty swallowing 
    • flaccid paralysis (1-10days) - pt may die due to respiratory and cardiac failure
  51. botulism (intoxication) 

    Type A
    • most virulent, most heat resistance, most often seen type in US
    • possible death from just tasting food, not even eating
    • w/o tx: mort rate = 60-70%
  52. botulism (intoxication) 

    Type B
    • europe and US
    • mort rate 25% w/o tx
  53. botulism (intoxication) 

    Type E
    • associated w/ seafood 
    • less heat resistant endospores
  54. botulism (intoxication) 

    Type  C&D
    in grazing animals 
  55. botulism (intoxication) 

    treatment
    • Antibotics useless- b/c toxin not organism
    • use ABE antitoxin
    • respiratory & cardiac assistance may necessary
    • nerve damage may persist for months
  56. cholera (toxico-infection)

    bug? incubation?
    • vibrio cholerae - flagellated, gram negative vibrio
    • -associated commonly w/ fecal contam water

    • incubation - 24-48 hours
    • outbreaks sporadic and relatively uncommon
  57. cholera (toxico-infection)

    symptoms
    • bugs colonize GI tract, produce toxin
    • SEVERE diarrhea leading to dehydration
    • Stools have HUGE # of vibrios, mucus and epothelial cells = "Rice - Water Stools"

    DANGER of Dealth if loss fluids not replaced
  58. cholera (toxico-infection)

    treatment
    • replace fluids&electrolytes
    • up to 25liters/day alkaline-saline soln w/ bicarb and lactate (oral/IV)

    • w/ tx: mort 1%
    • w/o tx: mort 50%
    • antibiotics not effective
  59. Shigellosis or Bacillary Dysentery 

    bug? (2)
    gram - bacilli

    • shigella dysenteriae - causes severe dysentary in tropical countries 
    • shigella sonnei - causes 70% of cases in US
  60. Shigellosis or Bacillary Dysentery 

    infection by? 5f's of transmission
    ingestion of feces contaminated food/water

    Food, Feces, Fomites, Fingers, Flies
  61. Shigellosis or Bacillary Dysentery 

    symptoms (3)
    • initial: cramps & diarrhea in ~12hours after infection
    • 1-4 days after infection: inflammation of mucosa, ulcers, blood, and stool mucus = dysentery
    • disease serious, debilitating but usually self-limiting
  62. Shigellosis or Bacillary Dysentery 

    epidemiology?
    most common in children less than 10 yrs old
  63. diseases of upper respiratory system (3)
    • many normal flora, mostly gram +
    • 1. diphheria
    • 2. streptococcal pharyngitis
    • 3. scarlet fever
  64. diseases of lower respiratory system (6)
    • 1. pertussis (whooping cough)
    • 2. TB
    • 3. pneumonia by Streptococcus pneumoniae
    • 4. atypical(walking) pneumonia by Mycoplasma pneumoniae
    • 5. pneumonia by Klebsiella pneumoniae
    • 6. Legionella (Legionnaire's Disease)
  65. most common type of infection?
    upper respiratory system
  66. Diphtheria

    bug? 
    • Corynebacterium diphtheria
    • gram + pleomorphic baccillus
    • lysogenic conversion: bug gains ability to produce toxin that causes Diphtheria
  67. lysogenic conversion
    bacterium infected w/ particular virus = new abilites
  68. Diphtheria

    transmission
    respiratory secretions ( cough/sneeze produced droplets(inhale) + fomites)
  69. Diphtheria
    incubation?
    • range 1-10 days
    • avg 2-5 days
  70. Diphtheria

    symptoms?
    • slight fever, fatique, malaise, sore throat
    • very swollen neck = BULL NECK
    • formation of pseudomembrane over soft palate and tonsils

    important for quick diagnosis if NOT:progressive organ failure
  71. Diphtheria

    diagnosis
    based on bull neck and pseudomembrane
  72. Diphtheria

    tx?
    antibiotics + antitoxin

    • 1st choice = penicillian
    • 2nd = erythromycin
  73. Diphtheria

    control?
    easier to vaccinate than tx
  74. Diphtheria

    vaccination?
    • DPT
    • DTaP
    • (diptheria, pertussis, tetnus) 
  75. Streptococcal pharyngitis (strep throat) 

    bug?
    • Streptococcus pyogenes
    • gram + betahemolytic
  76. Streptococcal pharyngitis (strep throat) 

    transmission?
    respiratory secretions
  77. Streptococcal pharyngitis (strep throat) 

    incubation?
    2-5 days
  78. Streptococcal pharyngitis (strep throat) 

    symptoms? (5)
    • inflammed throat& tonsils
    • fever
    • pus pockers in back of throat
    • lymph nodes = swollen and tender
    • otitis media = middle ear infection
  79. Streptococcal pharyngitis (strep throat) 

    diagnosis?
    • Classic: swab throat, streak on BAP, betahemolysis = +
    • Modern: instant test, results in 5 min to 1 hr
  80. Streptococcal pharyngitis (strep throat) 

    treatment?
    • antibiotics
    • 1st choice: penicillian
    • 2nd: erythromycin
    • BAD choice: tetracycline bc strep resistance
  81. scarlet fever

    bug?
    • streptococcus pyogenes
    • bug virus infected= erythrogenic toxin "red causing"
  82. scarlet fever

    transmission? incubation?
    • same progression as strep throat
    • incubation: n/a
  83. scarlet fever

    symptoms
    • strep symptoms plus:
    • red skin rash, deep peel ~ Day 10
    • high fever
    • swollen and spotted tongue
    • possible deafness (progression of otits media)
  84. scarlet fever

    diagnosis?
    same as strep
  85. scarlet fever

    treatment?
    • 1st: pencillian
    • 2nd: erythromycin
  86. pertussis (whooping cough)

    bug? 
    • Bordetella pertussis
    • gram - coccobacillus
  87. pertussis (whooping cough)

    primarily seen in ?
    unimmunized infants
  88. pertussis (whooping cough)

    transmission
    • respiratory secretions
    • highly contagious
  89. pertussis (whooping cough)

    incubation
    10 days
  90. pertussis (whooping cough)

    symptoms
    • initial: mild cough, sneezing, inflammed throat
    • next 10-14 days: bug go to lower respiratory tract
    • severe next: severe cough up to 2 wks, so violent = pt will vomit, may break ribs, fluid in lungs may cause convusions 

    symp taper off over bext 2-3 wks
  91. pertussis (whooping cough)

    diagnosis
    whooping cough
  92. pertussis (whooping cough)

    tx
    • 1st: erythromycin
    • 2nd: ampicllian
  93. TB

    bug?
    • Mycobacterium tuberculosis
    • gram +, acid fast, bacillus
  94. TB

    transmission
    70% cases by inhalation
  95. TB

    Incubation
    2-6 weeks
  96. TB 

    diagnosis (3)
    • 1. PPD - purified protein derivative 
    • 2. Chest X ray
    • 3. Acid-fast stain sputum sample
  97. at one time, responsible for 25% deaths in Europe
    est. min over 20,000 new cases worldwide
    TB
  98. historically related to poverty, over crowd, poor hygiene
    now w/ AIDS
    TB
  99. + TB PDD skin test (3)
    • active case of TB
    • did have and spontaneous recovery
    • vaccinated against TB
  100. + chest x ray for TB
    • calcified lung tubercules
    • active case or old inactive case
  101. acid fast stain sputum sample for TB
    positve means
    active case
  102. TB primary infection
    • ~6 wks in, pt allerfic rxn & develops tubercules in lungs
    • digested by macrophages but survives and multiplies ->systematic
    • -self limiting if pt is healthy. multiplication stops, tubercules calcify but bug can still live
  103. Adult TB (reactivation)
    • mostly men (50+ yrs)
    • assoc. w/ malnutrition, alcoholism, diabetes, extreme stress
    • most often in lungs = tubercules reactivate, break open
    • leads to lung tissue necrosis
  104. Adult TB (reactivation)

    symptoms
    chronic blood tinged cough, chronic weight loss, severe night sweats, chronic fever

    necrosis of lungs
  105. TB

    Vaccine
    • BCG vaccine (bacilli Calmette Guerin)
    • used routinely worldwide except N.Amer to prevent child TB
  106. TB

    Treatment
    • highly drug resistant
    • Isoniazid, rifampin, ethambutol
    • pt given at least 2, tx 6-9 months to 2 yrs
    • compliance problems = drug resistance
  107. Pneumonia caused by Streptococcus pneumoniae

    bug
    • gram + alpha hemolytic strep
    • causes 70% of bacterial pneumonia cases
  108. Pneumonia caused by Streptococcus pneumoniae

    vaccine
    • pneumococcal polysaccharide vaccine, made from bacteria capsules
    • generally give to elderly(70+)
  109. Pneumonia caused by Streptococcus pneumoniae

    transmission
    normal upper respiratory flora that becomes opportunistic
  110. Pneumonia caused by Streptococcus pneumoniae

    incubation
    unknown
  111. Pneumonia caused by Streptococcus pneumoniae

    symptoms
    • fever
    • edema of lungs
  112. Pneumonia caused by Streptococcus pneumoniae

    treatment
    penicillan or erythromycin
  113. Pneumonia caused by Streptococcus pneumoniae

    recovery time and rate
    about 70% ppl = spontaneous recover in 5-7 days
  114. Atypical (walking) pneumonia

    bug
    • Mycoplasma pneumoniae
    • -no gram bc no cell wall
  115. Atypical (walking) pneumonia by Mycoplasma pneumoniae

    transmission 
    • inhalation of cough/sneeze droplets
    • outbreak in close social groups (daycares, families)
  116. Atypical (walking) pneumonia by Mycoplasma pneumoniae

    symptoms
    • cough
    • fever 
    • malaise
    • generally self limiting but no immunity afer recovery 
  117. Atypical (walking) pneumonia by Mycoplasma pneumoniae

    incubation
    2-3 weeks
  118. Atypical (walking) pneumonia by Mycoplasma pneumoniae

    diagnosis
    • presumptive diagnosis bc cant grow bacteria on media 
    • 5-10 days to isolate but pt high chance of recovery by then
  119. Atypical (walking) pneumonia by Mycoplasma pneumoniae

    treatment
    erythromycin or tetracycline
  120. Pneumonia by Klebsiella pneumoniae

    bug?
    • gram - capsule forming bacillis 
    • common in nature, found in moist soil, aquatic environments
    • can be normal flora of human GI, even upper resp. tract
  121. Pneumonia by Klebsiella pneumoniae

    symptoms
    • fever
    • pulmonary edema
  122. Pneumonia by Klebsiella pneumoniae

    seen in?
    • immunocompromised patients
    • nosocomical infectious patient
  123. Pneumonia by Klebsiella pneumoniae

    treatment
    antibiotics as appropriate
  124. Legionella (Legionnaire's Disease)

    bug
    • Legionella pneumonia
    • gram - bacillus
    • aquatic environments
  125. Legionella by Legionella pneumonia

    transmission
    inhalation
  126. Legionella by Legionella pneumonia

    incubation
    10 days
  127. Legionella by Legionella pneumonia

    symptoms
    malaise, high fever, SOB, achy muscles, cough, diarrhea, headache, chest/abominal pain
  128. Legionella by Legionella pneumonia

    treatment
    • untreat: 15-30% mort by pneumonia then shock
    • treat: 1-2 wk hospitalization. erythromycin
  129. very common std, over 300,000 cases/yr in US. acutal # may be 2-3x higher. no immunity
    gonorrhea
  130. gonorrhea

    bug? growth media in lab?
    • neisseria gonorrhoeae
    • gram - diplococcus
    • grown in chocolate agar in lab
  131. gonorrhea

    diagnosis
    • gram staining 
    • serological testing
  132. gonorrhea

    asymptomatic % by gender
    • female: 75% asymp for significant period time (months to yrs)
    • male: 10% or less for any period time
  133. gonorrhea

    transmission
    • sexual contact (symp and asymp carriers)
    • fomites unlikely
    • transmitted to infant by infected mom thru canal birth = ophthalmia neonatorum (infant blindness)
  134. gonorrhea : ophthalmia neonatorum (infant blindness)

    treatment
    • up to 1982 - Crede's solution (silver nitrate) in eyes
    • now - penicillin ointment. tetracycline or erythromycin (protects against Chlamydia too)
  135. gonorrhea

    incubation
    2-8 days
  136. gonorrhea

    male symptoms?
    if untreated?
    • fever, penis discharge, painful urination
    • untx:  ureathra inflammation,  possible scarring and inflammation of cas deferens -> may lead sterility
    • still untx: systemic, bone joints, arthritis, death
  137. gonorrhea

    female symptoms?
    if untreated?
    • vaginal discharge, fever, abdominal pain, burning urination
    • untx: fallopian tube and other repro organs = perm scarring
    • can lead to ectopic pregnancies
    • PID= pelvic inflammatory disease: infection of female repro organs
  138. gonorrhea

    treatment
    • cephalosporins 
    • previousl penicillin but now resistant
  139. Syphilis

    bug?
    • treponema pallidum
    • gram - spirochete
    • contagious in first 2 stages
    • susceptible to drying, fomites not likely
    • doesnt grow on artificial media
  140. Syphilis -treponema pallidum

    transmission
    • genital/ oral infection
    • formites unlikely
  141. Syphilis -treponema pallidum

    incubation
    10-90 days then Stage 1
  142. Syphilis -treponema pallidum

    Stage 1 symptoms and tx. % spon recovery
    • hard rubbery, not fluid filled chancre at inital infection site (genital/oral)
    • 2-6 wks in: systemic infection
    • 25% ppl spontaneously recover
    • tx: penicillin in buttocks
  143. Syphilis -treponema pallidum

    stage 2: time? symptoms? tx?
    • 6wks-6months after chance disappears
    • weeping rash anywhere (similiar to german measles)
    • white patches on mouth, tongue
    • body temp increase 1-2 deg

    • tx: penicillin, failure= stage 3
    • possible spon recovery, unlikely
  144. Syphilis -treponema pallidum

    congenital syphilis
    • stage 2 and 3
    • if fetus survives and infected = profound mental retardation
  145. Syphilis -treponema pallidum

    stage 3: time? symp? 
    • 5-40 yrs later
    • no longer contagious
    • no longer treatable
    • gummas ulcers, increase body system damage. overtime: blindness, deafness, liver damage, insanity, death
  146. Syphilis -treponema pallidum

    detection for stage 1, 2, 3?
    • S1 and S2: gram staining
    • S3: serological
  147. Lymphogranuloma venereum  

    bug?
    • chlamydia trachomatous
    • typically in tropics
  148. Lymphogranuloma venereum  by chlamydia trachomatous

    incubation
    3-30 days
  149. Lymphogranuloma venereum  by chlamydia trachomatous

    symptoms
    • painless genital lesions
    • fever, chills, headache, joint pain, anorexia
    • inflammation of lymph nodes of groin (male and female)
    • rarely fatal
  150. Lymphogranuloma venereum  by chlamydia trachomatous

    treatment
    • tetracycline (wks to months)
    • surgical drain of lymph fluid
    • difficult to treat
  151. nongonoccal urethritis NGU 

    bug?
    chlamydia trachomatous
  152. nongonoccal urethritis NGU by chlamydia trachomatous

    incubation
    1-3 weeks but may be as long as several months
  153. most common STD in US, but not reportable to CDC
    nongonoccal urethritis NGU by chlamydia trachomatous
  154. nongonoccal urethritis NGU by chlamydia trachomatous

    symptoms
    • primary: penis/vagina discharge
    • women usually asymp

    newborns commonly found w/ eye infection
  155. nongonoccal urethritis NGU by chlamydia trachomatous

    treatment
    tetracycline or erythromycin
  156. nongonoccal urethritis NGU by chlamydia trachomatous

    diagnosis
    • most reliable: culturing but take 24-72 hours
    • DNA amp tests available but expensive and special equipment
  157. Toxic shock syndrome (TSS)
    • 1979-80 inital outbreaks: 1000 cases
    • 99% females
    • 98% of them menstruating, most using super absorabant tampons + not changing enough
  158. Toxic shock syndrome (TSS)

    few cases seen in men and children, suspected cause?
    low magnesium levels
  159. Toxic shock syndrome (TSS)

    staphlyococcus aureus produces what toxin?
    TSST-1: toxic shock syndrome 1
  160. non menstrual TSS occurs when?
    • nasal surgery using absorbant packing 
    • surgical incisions
    • women who've just given birth
  161. Toxic shock syndrome (TSS)

    bug?
    staphlyococcus aureus
  162. TSS

    symptoms
    • fever, vomiting, rapid BP decrease -> shock. 
    • sunburn line rash w/ peeling
  163. TSS

    tx? incubation?
    hospitalization and antibiotics(clindamycin)

    incubation variable
  164. nosocomial infections

    def? percent?
    • infections from heath care facilities
    • 5-15% all patients in US hospitals get them
  165. nosocomial infections

    most commonn causing bug?
    staphylococcus aureus = MRSA
  166. causes burn and surgical site infections, septicemia and pneumonia
    pseudomonas aeruginosa
  167. etiology
    the cause of disease
  168. pathogenesis
    how disease develops

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