what characterizes the cell mediated immune response to HIV in a primary infection?

CD8+ T cells kill infected cells, which if most are CD4+, the pt will then be more susceptible to infection and CD8+s will not be activated easily/at all More test answers on https://studyhippo.com/hiv-ii-41254/

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Chapter 37: Management of Patients With HIV Infection and AIDS – Flashcards 117 terms

Paula Corcoran

117 terms

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Chapter 37: Management of Patients With HIV Infection and AIDS – Flashcards

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A patient with HIV develops a nonproductive cough, shortness of breath, a fever of 101°F and an O2 saturation of 92%. What infection caused by Pneumocystis jiroveci does the nurse know could occur with this patient? You selected: Pneumocystis pneumonia

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Which blood test confirms the presence of antibodies to HIV? You selected: Enzyme-linked immunoabsorbent assay (ELISA) Correct Explanation: ELISA, as well as Western blot assay, identifies and confirms the presence of antibodies to HIV. The ESR is an indicator of the presence of inflammation in the body. The p24 antigen is a blood test that measures viral core protein. Reverse transcriptase is not a blood test. Rather, it is an enzyme that transforms single-stranded RNA into a double-stranded DNA.

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The client comes to the clinic to obtain the results from the test to determine if he is infected with HIV. The physician informs the client that he has a CD4 cell count of 300 cells/mm3 and a high viral load. What does the nurse anticipate the physician will discuss with the client? You selected: The initiation of antiretroviral therapy Correct Explanation: Based on randomized trials, nonrandomized trials, and observational studies, the current guideline is to initiate treatment if the client has a CD4 T-cell count less than 350 to 500 cells/mm3,whereas others will begin treatment with a CD4 cell count over 500 cells/mm3 based on expert opinions. Prophylactic antibiotic and antifungal drug therapy is not warranted at this time and can cause drug resistance strains to emerge.

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The nurse completes a history and physical assessment on a patient with AIDS who was admitted to the hospital with respiratory complications. The nurse knows to assess for the most common infection in persons with AIDS (80% occurrence). This is: You selected: Pneumocystis pneumonia. Correct Explanation: Pneumocystic pneumonia (PCP) is one of the first and most common opportunistic infections associated with AIDS. It may be present despite the absence of crackles. If untreated, PCP progresses to cause significant pulmonary impairment and respiratory failure.

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(see full question) A client with acquired immunodeficiency syndrome is admitted with Pneumocystis carinii pneumonia. During a bath, the client begins to cry and says that most friends and relatives have stopped visiting and calling. What should the nurse do? You selected: Listen and show interest as the client expresses feelings. Correct Explanation: The nurse should listen actively and nonjudgmentally as the client expresses feelings. Telling the client not to worry would provide false reassurance. A psychiatric consultation would be appropriate only after further assessment. Stating that the client's friends aren't true friends would discount the client's feelings.

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The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? You selected: "The patient may have cryptococcal meningitis and will need to be evaluated by the physician." Correct Explanation: A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures.

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Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as containing the genetic viral material? You selected: Ribonucleic acid (RNA) Correct Explanation: HIV is a retrovirus that carries its genetic material in the form of RNA rather than DNA. HIV consists of a viral core containing the viral RNA, surrounded by an envelope consisting of protruding glycoproteins.

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The nurse teaches the patient that lowering his or her viral load will have what effect? You selected: A longer survival time Correct Explanation: The lower the patient's viral load, the longer the survival time.

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(see full question) A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in? You selected: Primary infection Correct Explanation: The period from infection with HIV to the development of HIV-specific antibodies is known as primary infection, or stage 1. Initially, there is a period during which those who are HIV positive test negative on the HIV antibody blood test, although they are infected and highly infectious, because their viral loads are very high.

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(see full question) A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action? You selected: Call the health care provider to report. Correct Explanation: Fever and a rash could be indicative of a hypersensitivity reaction. Hypersensitivity reactions are also known as anaphylactic reactions and often involve skin rashes, fever, and bronchopulmonary issues such as bronchial constriction. The health care provider should be notified immediately and the medication stopped. Interventions need to be taken to assure that the patient's airway is not compromised. Administering Tylenol and documentation and treating the rash are not the priority, and would be completed after the patient was stabilized.

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(see full question) A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. Which of the following would the nurse describe as the first step? You selected: Uncoating Incorrect Correct response: Attachment Explanation: Once HIV enters the host cell, attachment occurs in which the glycoproteins of HIV bind with the host's uninfected CD4+ receptor and chemokine coreceptors. This is followed by uncoating, in which HIV's viral core is emptied into the CD4+ T cell. Cleavage and budding occur as the last steps.

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(see full question) During assessment of a patient with Kaposi's sarcoma, the nurse knows to look for the initial sign of: You selected: Deep purple cutaneous lesions. Correct Explanation: Localized cutaneous lesions may be the first manifestation of this HIV-related malignancy, which appears in 90% of patients as immune function deteriorates. Other symptoms develop over time as the lesions increase in size and spread to other locations.

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(see full question) The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse? You selected: Report the incident to the supervisor Correct Explanation: Because post exposure protocols can reduce the risk of HIV infection if initiated promptly, nurses must immediately report any needlestick or sharp injury to a supervisor. Obtaining counseling will occur after all other procedures are adhered to. The lab will draw blood from the client if required for documentation and other blood transmitted disorders.

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(see full question) An older adult widowed woman informs the nurse that she notices vaginal dryness now that she has become sexually active again. She is not using barrier protection because it makes the dryness worse. What education should the nurse provide to the patient? You selected: Vaginal dryness is common in postmenopausal women, and there are creams that can be used, but she should use a latex condom. Correct Explanation: Other than abstinence, consistent and correct use of condoms (Chart 37-3) is the only effective method to decrease the risk of sexual transmission of HIV infection. When latex male condoms are used consistently and correctly during vaginal or anal intercourse, they are highly effective in preventing the sexual transmission of HIV (CDC, 2011d). Nonlatex condoms made of natural materials such as lambskin are available for people with latex allergy but will not protect against HIV infection

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A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find? You selected: Hypokalemia Correct Explanation: Electrolyte imbalances such as decreased sodium, potassium, calcium, magnesium, and chloride typically result from profuse diarrhea. A urine specific gravity of 1.010 would indicate dilute urine. The client with severe diarrhea most likely would be dehydrated, leading to a high urine specific gravity. Proteinuria may suggest renal dysfunction and would not be associated with severe diarrhea unless the client was developing renal failure.

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The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates? You selected: Candidiasis Correct Explanation: Candidiasis is a yeast infection caused by the Candida albicans microorganisms. It may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in folds of the skin. It is often called thrush when located in the mouth. Inspection of the mouth, throat, or vagina reveals areas of white plaque that may bleed when mobilized with a cotton-tipped swab. Kaposi's sarcoma is a purple lesion and is an opportunistic cancer. Hairy leukoplakia is also an indication of oral cancer. Coccidiomycosis causes diarrhea in the immunosuppressed client.

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A client diagnosed with HIV asks the nurse how the doctor can know what their viral load is. What should the nurse respond? Correct response: The doctor can have a polymerase chain reaction test run. Explanation: The p24 antigen test and polymerase chain reaction test measure viral loads. They are used to guide drug therapy and follow the progression of the disease.

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A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next? You selected: Western Blot Correct Explanation: The enzyme-linked immunosorbent assay (ELISA) test, an initial HIV screening test, is positive when there are sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. The test is repeated if results are positive. If results of a second ELISA test are positive, the Western blot is performed. A positive result on Western blot confirms the diagnosis; however, false-positive and false-negative results on both tests are possible. A polymerase chain reaction gives the viral load of the client. The T4/T8 ratio determines the status of T lymphocytes.

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(see full question) A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? Correct response: Risk for injury

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A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test? You selected: Western blot assay Correct Explanation: A positive EIA test indicates seropositivity. To confirm this, a Western blot assay would be done. The OraSure test uses saliva to perform an EIA test. The p24 antigen test and nucleic acid sequence-based amplification test are used to test viral load and evaluate response to treatment. However, the reverse transcriptase-polymerase chain reaction (RT-PCR) and nucleic acid sequence-based tests have replaced the p24 antigen test. The RT-PCR tests may be used to confirm a positive EIA result

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The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: You selected: Chronic diarrhea. Correct Explanation: Chronic diarrhea is believed related to the direct effect of HIV on cells lining the intestine. Although all gastrointestinal manifestations of AIDS can be debilitating, the most devastating is chronic diarrhea. It can cause profound weight loss and severe fluid and electrolyte imbalances.

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(see full question) A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? You selected: Trimethoprim-sulfamethoxazole (Bactrim, Septra) Correct Explanation: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.

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(see full question) A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action? You selected: Assess BUN and creatinine.

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A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? Correct response: AIDS dementia complex (ADC) Explanation: ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.

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The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply. You selected: • Blood • Semen • Vaginal secretions • Breast milk Correct Explanation: There are only four known body fluids through which HIV is transmitted:blood, semen, vaginal secretions, and breast milk. HIV may be present in saliva, tears, and conjunctival secretions, but transmission of HIV through these fluids has not been implicated, HIV is not found in urine, stool, vomit, or sweat.

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A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when he schedules a return visit for viral load testing at which time? You selected: 6 weeks Correct Explanation: Viral load tests are measured immediately before initiating antiretroviral therapy and then again in 2 to 8 weeks. In most clients, adherence to a regimen of potent antiretroviral agents should result in a large decrease in the viral load by 2 to 8 weeks. Therefore, a return visit at 6 weeks would be in this time frame. By 16 to 20 weeks, the viral load should continue to decline, dropping below detectable levels.

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(see full question) A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about? You selected: Reverse transcriptase inhibitors Correct Explanation: Reverse transcriptase inhibitors are drugs that interfere with the virus' ability to make a genetic blueprint. A protease inhibitor is a drug that inhibits the ability of virus particles to leave the host cell. The integrase inhibitors are a class of drug that prevents the incorporation of viral DNA into the host cell's DNA. Hydrea is a drug that is used as an adjunct therapy that tries to halt the progression of AIDS

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Which of the following options should the nurse encourage to replace fluid and electrolyte losses in a patient with AIDS? You selected: Liquids Correct Explanation: The nurse should encourage patients with AIDS to have liquids to help in replacing fluid and electrolyte losses. Gluten and sucrose may increase the complication of malabsorption. Large doses of iron and zinc should be avoided because they can impair immune function.

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(see full question) A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis? You selected: Stool specimen for ova and parasites Correct Explanation: A stool specimen for ova and parasites will give a definitive diagnosis. The organism is spread by the fecal-oral route from contaminated water, food, or human or animal waste. Those infected can lose from 10 to 20 L of fluid per day. Losing this magnitude of fluid quickly leads to dehydration and electrolyte imbalances.

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Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy? Correct response: CD4 counts Explanation: The most important consideration in decisions to initiate antiretroviral therapy is CD4 counts.

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A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often."What should the nurse consult with the physician regarding? You selected: Testing the client for the presence of HIV

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Diagnosis of Kaposi's sarcoma (KS) is made by which of the following? You selected: Biopsy Correct Explanation: Diagnosis of KS is made by biopsy of the suspected lesions. Prognosis depends on the extent of the tumor, the presence of other symptoms of HIV infection, and the CD4+ count.

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Which of the following indicates that a client with HIV has developed AIDS? You selected: Herpes simplex ulcer persisting for 2 months Correct Explanation: A diagnosis of AIDS cannot be made until the person with HIV meets case criteria established by the Centers for Disease Control and Prevention. The immune system becomes compromised. The CD4 T-cell count drops below 200 cells and develops one of the opportunistic diseases, such as Pneumocystis carinii pneumonia, candidiasis, cytomegalovirus, or herpes simplex.

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A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay with positive results twice. What is the next step for the nurse to explain to the patient for confirmation of the diagnosis? You selected: Perform a Western blot test for confirmation of diagnosis.

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(see full question) A patient is diagnosed with pneumocystis pneumonia (PCP). What medication does the nurse anticipate educating the patient about for treatment? Correct response: TMP-SMZ (Bactrim) Explanation: TMP-SMZ (Bactrim, Cotrim, Septra) is the treatment of choice for PCP; it is as effective as parenteral pentamidine isethionate (Pentacarinat) and more effective than other regimens.

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Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? Correct response: CDC category A: HIV asymptomatic Explanation: More than 500 CD4+ T lymphocytes/mmindicates CDC category A: HIV asymptomatic. The period from infection with HIV to the development of antibodies to HIV is known as primary infection and 200 to 499 CD4+ T lymphocytes/mm indicates CDC category B:

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The development of a positive HIV antibody test following initial infection generally occurs in which timeframe? You selected: 6 weeks Incorrect Correct response: 4 weeks Explanation: Development of a positive HIV antibody test generally occurs within 4 weeks and with few exceptions by 6 months

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A patient taking amprenavir (APV, Agenerase) complains of "getting fat." What is the nurse's best action? Correct response: Teach the patient about medication side effects. Explanation: The patient needs to be aware of the potential for fat redistribution. Exercise, diet, and counseling will not change the outcome of this side effect.

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A patient is infected with HIV after sharing needles with another intravenous (IV) drug abuser. Upon infection with HIV, the immune system responds by making antibodies against the virus, usually within how many weeks after infection? You selected: 1 to 2 weeks Incorrect Correct response: 3 to 12 weeks Explanation: When a person is infected with HIV, the immune system responds by producing antibodies against the virus, usually within 3 to 12 weeks after infection.

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A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? You selected: Amphotericin B (Fungizone) Incorrect Correct response: Trimethoprim-sulfamethoxazole (Bactrim, Septra) Explanation: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.

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The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care? You selected: Assist with chest physiotherapy every 2 to 4 hours. Correct Explanation: The nurse should include interventions such as assisting with and/or performing chest physiotherapy every 2 to 4 hours to prevent stasis of secretions, assist the client to attain the semi- or high Fowler's position to facilitate breathing and airway clearance, allow for frequent rest periods to prevent excessive fatigue, and maintain a fluid intake of at least 3 liters per day unless contraindicated

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(see full question) A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? You selected: Using volume expanders in case blood is needed. Incorrect Correct response: Bank autologous blood. Explanation: Signing the refusal form does not give the client any information about the options that are available and place the client at risk. Banking autologous blood that is self-donated is the safest option for the client. Directed donor blood may be no safer than blood collected from public donors. Those who support this belief say that directed donors may not reveal their high-risk behaviors that put the potential recipient at risk for blood-borne pathogens such as HIV.

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When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____. You selected: HIV-1 is more prevalent than HIV-2 subtypes Correct Explanation: Two HIV subtypes have been identified: HIV-1 and HIV-2. HIV-1 mutates easily and frequently, producing multiple substrains that are identified by letters from A through O. HIV-2 is less transmittable, and the interval between initial infection with HIV-2 and development of AIDS is longer. HIV-1 is more prevalent in the United States and in the rest of the world. Western Africa is the primary site of infection with HIV-2. There is no cure for HIV/AIDS; hence, no cure rate. The virus is thought to be a mutation of a simian virus. Transmission of the virus is not a characteristic.

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(see full question) When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following? Correct response: Antibodies to HIV are not present in his blood. Explanation: A negative test result indicates that antibodies to HIV are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which take from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to HIV are detected in the blood, the test is interpreted as positive.

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The term used to define the balance between the amount of HIV in the body and the immune response is which of the following? Correct response: Viral set point

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(see full question) The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count? You selected: Greater than 500/mm3 Correct Explanation: A client is classified as HIV asymptomatic when the CD4+ T lymphocyte count is greater than 500/mm3. A person is considered HIV symptomatic when the CD4+ count is 200 to 499/mm3. A person is considered to have aquired immunodeficiency syndrome (AIDS) when the CD4+ count is less than 200/mm3.

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(see full question) A patient presents to a clinic on May 1 and tells the nurse practitioner that he had a 1-month sexual relationship with a friend who did not disclose that he was HIV positive. The relationship ended last week. The nurse tells the patient that after infection with HIV, the immune system responds by making antibodies against the virus; therefore the patient should expect this to happen by: You selected: June 5

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) A client who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that and arms. The client states, "I'm thinking the side effects of the drug are worse than the disease. Look what's happening to me." The nurse would most likely identify which nursing diagnosis as the priority? Correct response: Disturbed body image related to loss of fat in the face and arms Explanation: The client is experiencing lipoatrophy, which results in a localized loss of subcutaneous fat in the face (manifested as sinking of the cheeks, eyes, and temples), arms, legs, and buttocks. These changes as well as his statement about the side effects of the drug being worse than the disease indicate that he is concerned about how he appears to others. Therefore, the nursing diagnosis of disturbed body image would be the priority. Deficient knowledge, risk for infection, and risk for impaired liver function may be applicable; however, they are not concerns at this time.

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(see full question) A patient is on ART for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year? You selected: 50 mm3 to 150 mm3 Correct Explanation: An adequate CD4 response for most patients on ART is an increase in CD4 count in the range of 50 mm3 to 150 mm3 per year, generally with an accelerated response in the first 3 months

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A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy? You selected: Viral load and T4-cell counts will be performed every 2 to 3 months

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The period from infection with HIV to the development of antibodies to HIV is known as which of the following? Correct response: Primary infection Explanation: Primary infection is the period from the infection with HIV to the development of antibodies to HIV. The viral load test measures plasma HIV RNA levels. Viral set point is the balance between the amount of HIV in the body and the immune response. Anergy is the absence of an immune response

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(see full question) A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? You selected: AIDS dementia complex (ADC) Correct Explanation: ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.

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When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that Correct response: his body has not produced antibodies to the AIDS virus. Explanation: A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.

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When do most perinatal HIV infections occur? You selected: After exposure during delivery Correct Explanation: Mother-to-child transmission of HIV-1 may occur in utero or through breastfeeding, but most perinatal infections are thought to occur after exposure during delivery.

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(see full question) A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurse's best action? You selected: Ask his family to bring in food that he enjoys. Incorrect Correct response: Administer megestrol acetate (Megace). Explanation: Appetite stimulants are successfully used in patients with AIDS-related anorexia. The anorexia is compounded by medications that cause nausea and vomiting. The anorexia has a physiologic cause, and this must be addressed. Bringing in favorite foods or making favorite foods may have little or no effect on the patient's appetite; it is physiologically rather than psychologically based.

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Which of the following is an early manifestation of HIV encephalopathy? You selected: Headache Correct Explanation: An early manifestation of HIV encephalopathy is a headache. Later stages include hyperreflexia, a vacant stare, and hallucinations.

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(see full question) A public health nurse is giving an informational presentation on HIV/AIDS at a nearby college. How would the nurse best define AIDS? You selected: Acquired immunodeficiency syndrome is a fatal infection that profoundly weakens the immune system. Correct Explanation: Acquired immunodeficiency syndrome (AIDS) is an infectious and eventually fatal disorder that profoundly weakens the immune system.

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(see full question) A client diagnosed with HIV asks the nurse how the doctor can know what their viral load is. What should the nurse respond? You selected: The doctor can have a polymerase chain reaction test run. Correct Explanation: The p24 antigen test and polymerase chain reaction test measure viral loads. They are used to guide drug therapy and follow the progression of the disease.

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(see full question) Postexposure prophylaxis (PEP) medications should be started within __________ after exposure, but no longer than __________, to offer any benefit. It must be taken for __________. You selected: 1 hour; 72 hours; 4 weeks Correct Explanation: Prophylaxis needs to start immediately after exposure. After 72 hours, no benefit is offered because of the rapid increases in viral load upon initial infection

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Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy? You selected: CD4 counts Correct Explanation: The most important consideration in decisions to initiate antiretroviral therapy is CD4 counts.

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(see full question) A client with AIDS comes to the clinic reporting difficulty swallowing. He says, "It hurts so much when I swallow." Inspection reveals creamy white patches in the client's mouth. Which of the following would the nurse suspect? You selected: Candidiasis Correct Explanation: The client's complaints and physical examination suggest oral candidiasis. Wasting syndrome involves involuntary weight loss greater than 10% of the client's baseline body weight and either chronic diarrhea for more than 10 days or chronic weakness and documented intermittent or constant fever in the absence of any concurrent illness that could explain these findings. Cryptococcus neoformans is a fungal infection that affects the neurologic system. Clostridium difficile is a common cause of chronic diarrhea in clients with AIDS.

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The nurse advises a patient who has received a negative test result from his HIV antibody test that he: You selected: Does not have the infection. Incorrect Correct response: May be infected but antibodies are not currently present. Explanation: A negative test result indicates that antibodies to HIV are not present in the blood at the time of the testing. This means either the patient has not been infected or, if infected, that the body has not yet produced antibodies. Refer to Box 37-5 in the text

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(see full question) A client receiving atazanavir (ATV, Reyataz) requires what priority intervention? You selected: Increased fluids Incorrect Correct response: Cardiac assessment Explanation: This medication may cause prolongation of the PR interval and first degree AV block. Patients with underlying conduction deficits may develop problems. A cardiac assessment will assist in determining if the patient has underlying problems that could be exacerbated by this drug therapy.

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A client on antiretroviral drug therapy is discussing with the nurse that sometimes he "forgets to take his meds for a few days." What should the nurse inform the client can occur when the medications are not taken as prescribed? You selected: The client is risking the development of drug resistance and drug failure. Correct Explanation: Clients who neglect to take antiretroviral drugs as prescribed risk development of drug resistance. When drug levels are not adequately maintained, viral replication and mutations increase.

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A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? You selected: Risk for injury

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A patient taking amprenavir (APV, Agenerase) complains of "getting fat." What is the nurse's best action? You selected: Teach the patient about medication side effects. Correct Explanation: The patient needs to be aware of the potential for fat redistribution. Exercise, diet, and counseling will not change the outcome of this side effect.

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emale client with human immunodeficiency virus (HIV) receives family-planning counseling. Which statement about safer sex practices for persons with HIV is accurate? You selected: A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse. Correct Explanation: A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse.

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A patient with HIV has been on antiretroviral therapy (ART) for 6 months. The patient comes to the clinic with home medications and the nurse observes that there are too many pills in the container. What does the nurse know about the factors associated with nonadherence to ART? • Active substance abuse • Depression • Lack of social support

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(see full question) Which of the following has not been implicated as a factor for noncompliance with antiretroviral treatment? Correct response: Past substance abuse Explanation: Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment. Factors associated with nonadherence include active substance abuse, depression, and lack of social support.

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When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means? Correct response: His body has not produced antibodies to the AIDS virus. Explanation: A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that, if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged.

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There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS? You selected: Caring for a client with an infectious terminal disease Incorrect Correct response: Disclosure of the client's condition Explanation: Despite HIV-specific confidentiality laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. Since healthcare providers do not share a client's diagnosis with a support group, option A is incorrect. Caring for a client with an infectious terminal illness that can be transmitted to other people is a concern for healthcare providers but it is not an ethical issue

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Question 13: (see full question) A nurse is working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress? You selected: Following safer-sex practices Correct Explanation: It's essential for clients with AIDS to follow safer-sex practices to prevent transmission of the human immunodeficiency virus. Although it's helpful if clients with AIDS avoid using recreational drugs and alcohol, it's more important that I.V. drug users use clean needles and dispose of used needles for purposes of avoiding transmission. Whether the client with AIDS chooses to tell anyone about the diagnosis is his decision; there is no legal obligation to do so.

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(see full question) Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? You selected: Primary infection (acute HIV infection or acute HIV syndrome) Incorrect Correct response: CDC category A: HIV asymptomatic Explanation: More than 500 CD4+ T lymphocytes/mmindicates CDC category A: HIV asymptomatic. The period from infection with HIV to the development of antibodies to HIV is known as primary infection and 200 to 499 CD4+ T lymphocytes/mm indicates CDC category B: HIV symptomatic. Less than 200 CD4+ T lymphocytes/mm3 indicates CDC category C: AIDS

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Question 15: (see full question) A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? You selected: Bank autologous blood. Correct Explanation: Signing the refusal form does not give the client any information about the options that are available and place the client at risk. Banking autologous blood that is self-donated is the safest option for the client.

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(see full question) You are caring for a client who has a diagnosis of HIV. Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications? You selected: Side effects of drug therapy

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(see full question) A client who is HIV positive has been prescribed antiretroviral drugs. The nurse explains the action of each antiretroviral drug and develops a schedule for the client's self-administration, including strong emphasis about rigidly adhering to the dosage, time and frequency of the administration of the drugs. Why is it important to adhere to the schedule of drug dosing developed for this client? You selected: To avoid resistance to the drugs

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Which of the following are antidepressants used in the treatment of AIDS? Select all that apply. Correct response: • Tofranil • Norpramin • Prozac Explanation: Antidepressants such as Tofranil, Norpramin, and Prozac may be used, because these medications also alleviate the fatigue and lethargy that are associated with depression.

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(see full question) The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? Correct response: "The patient may have cryptococcal meningitis and will need to be evaluated by the physician." Explanation: A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures

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(see full question) A nurse is preparing a presentation about HIV for a local community group. Which of the following would the nurse include in the presentation about HIV transmission? Select all that apply. Correct response: • The risk of acquiring HIV through the transfusion of blood products is almost nonexistent. • The amount of HIV contained in body fluids on exposure is associated with the risk for infection. • HIV can be found in seminal fluid, vaginal secretions, and breast milk. • Sharing of infected equipment used to inject drugs increases the risk for infection. Explanation: HIV-1 is transmitted in body fluids that contain free virons and infected CD+4 T cells. These fluids include blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk. The amount of HIV and infected cells in the body fluid is associated with the probability that the exposure will result in infection. Blood and blood products can transmit HIV to recipients; however, the risk associated with transfusions have been virtually eliminated as the result of intensive donor screening. Mother-to-child transmission may occur in utero, at the time of delivery, or through breastfeeding. Most perinatal infections are thought to occur during delivery. Sharing infected equipment during drug injections increases a person's risk for acquiring HIV.

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Question 7: (see full question) A client with AIDS is experiencing pain secondary to Kaposi's sarcoma. The nurse would most likely expect the client to describe the pain as which of the following? You selected: Crushing, widespread pressure Incorrect Correct response: Sharp, throbbing pressure Explanation: The pain associated with Kaposi's sarcoma is typically described as sharp, throbbing pressure and heaviness. Pain related to peripheral neuropathy frequently is described as burning, numbness, and "pins and needles." Dull, cramping pain and crushing widespread pressure are not associated with Kaposi's sarcoma.

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(see full question) A nurse is preparing to administer an antiretroviral medication to a client who is positive for HIV. The nurse identifies the drug as a nucleoside reverse transcriptase inhibitor (NRTI). Which drug might this be? You selected: Delavirdine (Rescriptor) Incorrect Correct response: Lamivudine (Epivir) Explanation: Lamivudine (Epivir) is an antiretroviral agent that belongs to the class of NRTIs. Delavirdine (Rescriptor), etravirine (Intelence), and nevirapine (Viramune) are examples of non-nucleoside reverse transcriptase inhibitors (NNRTIs).

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(see full question) A client with human immunodeficiency virus undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. The most accurate conclusion the nurse can make is: You selected: the client has antibodies to the antigens. Incorrect Correct response: the client is immunodeficient and won't have a skin response. Explanation: Anergy testing determines the level of immune response an individual has to common microbes. A normal response is a local skin reaction to all the antigens injected intradermally. Absence of a response within 3 days suggests the individual is immunodeficient and can't produce a normal immune response. It doesn't imply nonexposure to the antigens, which are environmentally prevalent. A positive skin reaction demonstrates presence of antibodies to the antigens. An expected reaction to the antigens isn't considered an allergic or hypersensitive reaction

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(see full question) A client who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face and arms. The client states, "I'm thinking the side effects of the drug are worse than the disease. Look what's happening to me." The nurse would most likely identify which nursing diagnosis as the priority? Correct response: Disturbed body image related to loss of fat in the face and arms Explanation: The client is experiencing lipoatrophy, which results in a localized loss of subcutaneous fat in the face (manifested as sinking of the cheeks, eyes, and temples), arms, legs, and buttocks. These changes as well as his statement about the side effects of the drug being worse than the disease indicate that he is concerned about how he appears to others. Therefore, the nursing diagnosis of disturbed body image would be the priority. Deficient knowledge, risk for infection, and risk for impaired liver function may be applicable; however, they are not concerns at this time.

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(see full question) A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action? Correct respons (see full question) The term used to define the balance between the amount of HIV in the body and the immune response is You selected: viral set point. Correct Explanation: The viral set point is the balance between the amount of HIV in the body and the immune response. During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearancee: Assess BUN and creatinine.

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(see full question) The term used to define the balance between the amount of HIV in the body and the immune response is You selected: viral set point. Correct Explanation: The viral set point is the balance between the amount of HIV in the body and the immune response. During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearance

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What test will the nurse assess to determine the patient's response to antiretroviral therapy? You selected: Viral load

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HIV is harbored within which type of cell? You selected: Lymphocyte

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Which assessment finding is not likely to cause noncompliance with antiretroviral treatment? You selected: Lack of social support Incorrect Correct response: Past substance abuse

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Question 3: (see full question) A client is prescribed didanosine (Videx) as part of his highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? You selected: "Be sure to take this drug about 1/2 hour before or 2 hours after you eat." Correct Explanation: Didanosine should be taken 30 to 60 minutes before or 2 hours after meals. Other antiretroviral agents, such as abacavir, emtricitabine, or lamivudine can be taken without regard to meals. High-fat meals should be avoided when taking amprenavir. Atazanavir should be taken with food and not with antacids.

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(see full question) A patient is administered foscarnet to treat a case of cytomegalovirus (CMV) retinitis. Which of the following adverse effects should the nurse closely monitor in the patient? You selected: Electrolyte imbalances

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(see full question) A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often."What should the nurse consult with the physician regarding? You selected: Having the client abstain from sexual activity for 6 weeks while the medication is working Incorrect Correct response: Testing the client for the presence of HIV Explanation: Abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis also may correlate with HIV infection. Wearing cotton underwear can help with the prevention of candidiasis but does not address the recurrent vaginal infection that may not be caused by a fungus. Abstaining from sexual intercourse does not address the recurrent vaginal infection. A medicated douche can alter the normal flora of the vaginal wall.

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(see full question) A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV? You selected: Gynecologic problems Correct Explanation: In women with HIV, gynecologic problems, such as abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may be the focus of a majority of complaints. Acute retroviral syndrome (viremia) may be the chief complaint in one third to more than one half of those infected, not necessarily women. Its manifestations include rashes, muscle and joint pain, and weight loss.

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(see full question) There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS? You selected: Disclosure of the client's condition Correct Explanation: Despite HIV-specific confidentiality laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. Since healthcare providers do not share a client's diagnosis with a support group, option A is incorrect. Caring for a client with an infectious terminal illness that can be transmitted to other people is a concern for healthcare providers but it is not an ethical issue.

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(see full question) A patient in the clinic states, "My boyfriend told me he went to the clinic and was treated for gonorrhea." While testing for the sexually transmitted infection (STI), what else should be done for this patient? Correct response: Inform the patient that it would be beneficial to test for HIV. Explanation: HIV screening is recommended for all persons who seek evaluation and treatment for STIs. HIV testing must be voluntary and free of coercion. Patients must not be tested without their knowledge. HIV screening after notifying the patient that an HIV test will be performed (unless the patient declines) is recommended in all health care settings. Specific signed consent for HIV testing should not be required. In most settings, general informed consent for medical care is considered sufficient.

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(see full question) People have different levels of risk for becoming infected with HIV. Which client is more at risk of becoming infected with HIV? You selected: A person having casual intercourse with multiple partners Correct Explanation: People who have casual intercourse with multiple partners are at a greater risk of acquiring HIV. Women who have never had intercourse are at the least risk because HIV spreads through body fluids, such as semen, vaginal secretions, and blood. The risks of women who have had deliveries after the age of 40 or men who use sildenafil (Viagra) before having intercourse are yet to be established.

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Question 19: (see full question) A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find? You selected: Hypokalemia Correct Explanation: Electrolyte imbalances such as decreased sodium, potassium, calcium, magnesium, and chloride typically result from profuse diarrhea. A urine specific gravity of 1.010 would indicate dilute urine. The client with severe diarrhea most likely would be dehydrated, leading to a high urine specific gravity. Proteinuria may suggest renal dysfunction and would not be associated with severe diarrhea unless the client was developing renal failure.

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(see full question) Which of the following nursing actions is essential before an EIA test is performed? You selected: Obtaining a written consent from the patient Incorrect Correct response: Obtaining a general consent for medical care from the patient Explanation: Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing. The Western blot test is performed if the results of the EIA test are positive. A polymerase chain reaction test, which measures viral loads, is used if diagnosis is confirmed as positive

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Question 5: (see full question) The balance between the amount of HIV in the body and the immune response is the You selected: viral set point. Correct Explanation: The balance between the amount of HIV in the body and the immune response is the viral set point.A viral load test measures the quantity of HIV RNA in the blood. The window period is the time from infection with HIV until seroconversion detected on HIV antibody test. Anergy is the loss or weakening of the body's immunity to an irritating agent or antigen.

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Which of the following are modes of transmission for HIV? Select all that apply. Correct response: • Blood • Seminal fluid • Vaginal secretions • Amniotic fluid

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he nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? You selected: "The patient probably has pneumocystis pneumonia and will need to be evaluated by the physician." Incorrect Correct response: "The patient may have cryptococcal meningitis and will need to be evaluated by the physician." Explanation: A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures

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(see full question) A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action? You selected: Encourage the patient to drink more fluids. Incorrect Correct response: Assess BUN and creatinine.

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(see full question) Which of the following substances may be used to lubricate a condom? You selected: Baby oil Incorrect Correct response: K-Y jelly

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Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS? Cytomegalovirus

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(see full question) A client is given a nursing diagnosis of social isolation related to withdrawal of support systems and stigma associated with AIDS. Which outcomes would indicate that the nurse's plan of care was effective? Select all that apply. Correct response: • Client demonstrates beginning participation in events and activities. • Client identifies appropriate sources of assistance and support. • Client verbalizes feelings related to the changes imposed by the disease. Explanation: For the nursing diagnosis of social isolation, outcomes indicating effectiveness of care include demonstrating a beginning level of participation in activities and evenets, identifying appropriate sources for assistance and support, and verbalizing feelings related to the changes resulting from the disease. Demonstrating knowledge of safer sexual practices and practices to reduce transmission risk are more appopriate for a nursing diagnosis of deficient knowledge.

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A client is suspected of having an immune system disorder. The physician wants to perform a diagnostic test to confirm the diagnosis. What test might the physician order? You selected: T-and C-cell assays Incorrect Correct response: Enzyme-linked immunosorbent assay Explanation: T-cell and B-cell assays (or counts) and the enzyme-linked immunosorbent assay may be performed. A C-cell assay and plasmapherisis are distractors for this question. A complete chemistry panel is not a diagnostic test for an immune system disorder.

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Which category of HIV disease correlates with asymptomatic AIDS? You selected: A Correct Explanation: Each category denotes clinical progression of HIV infection in the patient from asymptomatic category A to "full-blown" AIDS category C

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A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurse's best action? You selected: Ask his family to bring in food that he enjoys. Incorrect Correct response: Administer megestrol acetate (Megace). Explanation: Appetite stimulants are successfully used in patients with AIDS-related anorexia. The anorexia is compounded by medications that cause nausea and vomiting. The anorexia has a physiologic cause, and this must be addressed. Bringing in favorite foods or making favorite foods may have little or no effect on the patient's appetite; it is physiologically rather than psychologically based.

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When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means? You selected: His body has not produced antibodies to the AIDS virus. Correct Explanation: A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that, if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.

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A nurse is caring for a client with human immunodeficiency virus (HIV). To determine the effectiveness of treatment the nurse expects the physician to order: You selected: enzyme-linked immunosorbent assay (ELISA). Incorrect Correct response: quantification of T-lymphocytes. Explanation: Quantification of T-lymphocytes is used to monitor the effectiveness of treatment for HIV. E-rosette immunofluorescence is used to detect viruses in general; it doesn't confirm HIV infection. The ELISA test detects HIV antibody particles but may yield inaccurate results; a positive ELISA result must be confirmed by the Western blot test. The Western blot test — electrophoresis of antibody proteins — detects HIV antibodies when used in conjunction with the ELISA. It isn't specific when used alone and doesn't monitor the effectiveness of treatment.

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(see full question) Which assessment finding is not likely to cause noncompliance with antiretroviral treatment? Correct response: Past substance abuse Explanation: Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment. Factors associated with nonadherence include active substance abuse, depression, and lack of social support.

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(see full question) A nurse is teaching high school students about transmission of the human immunodeficiency virus (HIV). Which comment by a student warrants clarification by the nurse? You selected: "I won't donate blood because I don't want to get AIDS." Correct Explanation: HIV is transmitted through infected blood, semen, and certain other body fluids. Although a transfusion with infected blood may cause HIV infection in the recipient, a person can't become infected by donating blood. The other options reflect accurate understanding of HIV transmission.

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What intervention is a priority when treating a patient with HIV /AIDS? You selected: Assessing fluid and electrolyte balance Correct Explanation: Fluid and electrolyte deficits are a priority in monitoring patients with HIV/AIDS. Assessment of fluid loss and electrolyte imbalance is essential. Skin integrity should be monitored, but is a lower priority. Neurologic and psychological status should also be monitored, but this is not as high a priority as fluid and electrolyte imbalance.

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STUDY

Cell Mediated Immune Response Fecal Oral Transmission Foundations Of Professional Nursing Nursing Priority Nursing Interventions Proton Pump Inhibitors

PrepU CH. 29 – Flashcards 83 terms

Elizabeth Hill

83 terms

Preview

PrepU CH. 29 – Flashcards

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A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:

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Surgery to release the bowel

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A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:

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Fistula formation

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The nurse is reviewing the medical history of four clients. The nurse determines that the client at greatest risk for developing peptic ulcer disease is:

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A client with a prior diagnosis of Helicobacter pylori and refused treatment

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Malabsorption syndrome results in loss of fat in the stool and failure to absorb fat-soluble vitamins.

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True

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After several months of persistent heartburn, a 57 year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem?

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Proton pump inhibitors; avoiding large meals; remaining upright after meals

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A male patient has just been diagnosed with esophageal cancer. He knew he was losing weight and fatigued most days, but he just attributed it to aging and working. The physician recommends chemotherapy and irradiation. However, the cancer has already metastasized. The patient asks the nurse what he can expect if he agrees to the treatments. The nurse responds:

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"The therapies may shrink the cancer in an effort to increase survival of the cancer."

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A patient has recently been diagnosed with H. pylori gastritis. The nurse knows that this form of gastritis is usually treated with a combination of an antibiotic and:

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Proton pump inhibitors.

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A 22 year-old student has developed a fever and diarrhea while on a backpacking trip in Southeast Asia. His oral temperature is 101.40 F. The diarrhea is bloody, frequent, and small in volume. These clinical manifestations are sufficiently distressing that he/she is visiting a local medical clinic in the area. Which of the following diagnoses best characterizes this health problem?

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Inflammatory diarrhea

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A 71 year-old male has been recently diagnosed with a stage III tumor of colorectal cancer, and is attempting to increase his knowledge base of his diagnosis. Which of the following statements about colorectal cancer demonstrates a sound understanding of the disease?

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"While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown."

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The nurse is teaching her patient with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?

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Fat

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In the balance of secretions in the gastric mucosa by the parietal cells, which of the following ions is produced to buffer the production of hydrochloric acid?

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HCO3-

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Symptoms of gastric cancer include vague epigastric pain, which makes early detection difficult. The nurse would expect a patient to undergo which of the following diagnostic examinations to determine the location of the gastric cancer?

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Barium x-ray

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Crohn's disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes which of the following?

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Fistula formation

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A patient with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which of the following problems?

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Obstruction

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The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which of the following reasons?

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Patients have few early symptoms of the disease.

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Crohn's disease is treated by several measures. Treatment with corticosteroids focuses on which of the following?

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Inflammatory suppression

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A patient is admitted with an intestinal obstruction with abdominal bloating. Which of the following types of treatment does the nurse know will help decompress the bowel?

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Nasogastric tube to suction

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Upon admission, a patient tells the nurse that he takes aspirin every 4 hours every day. The nurse determines that this patient is at risk for which of the following?

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Peptic ulcer

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Diverticulitis is the herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people over the age of 85. Diverticulitis is often asymptomatic, but when symptoms do occur, what is the most common complaint of the client?

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Lower left quadrant pain with nausea and vomiting

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After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to best address the woman's health problem?

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Proton pump inhibitors; avoiding large meals; remaining upright after meals

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A client who is diagnosed with Zollinger-Ellison syndrome will exhibit which symptoms?

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Diarrhea with fat deposits

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Select the client at greatest risk for developing colorectal cancer.

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A 64-year-old female whose mother had colorectal cancer

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A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of:

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Arthritis treated with high levels of nonsteroidal anti-inflammatory (NSAIDs) agents

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Parents of a 20-month-old infant report that he refuses food or eats poorly and that he grimaces when he swallows. He also is irritable and cries a lot. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which of the following health problems would the care team first suspect?

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Esophagitis from gastrointestinal reflux

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Which of the following clients is most clearly displaying the signs and symptoms of irritable bowel disease (IBD)?

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A 51 year-old male who states that his stomach pain is in his lower abdomen, "comes and goes" and "feels more like a cramp than a dull ache."

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A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called which of the following?

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Zollinger-Ellison syndrome

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Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn's disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn's disease and ulcerative colitis. Which of the following patterns describes Crohn's disease?

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Skip lesions

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Crohn's disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which of the following descriptions?

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Cobblestone

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The cause of gastric carcinomas has been influenced by which of the following factors? Select all that apply.

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Strain of Helicobacter pylori (H. pylori) • Environmental factors • Family history

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A patient diagnosed with ulcerative colitis has been experiencing more than six bloody stools daily with evidence of toxicity. The nurse should question which of the following orders from the physician?

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Colonoscopy

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An elderly patient has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which of the following potential problems would the nurse anticipate in this patient?

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Colonization of Clostridium difficile

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An elderly patient presents with loose mucousy stools. The nurse suspects the patient has Clostridium difficile. What is a priority assessment for the nurse?

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Ask the patient about his or her antibiotic use.

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Good hand-washing techniques are important in healthcare. The nurse knows that bacterial infections can be prevented by good hand-washing techniques. Which of the following routes of transmission is most common for Clostridium difficile?

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Fecal-oral transmission

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A nurse administering a patient's medication tells the patient that a proton pump inhibitor has been added. When the patient asks the purpose of the medication, the nurse responds that it is to prevent which of the following?

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Stress ulcer

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A nurse reading a sigmoidoscopy report notes that a patient was found to have skip lesions. The nurse interprets this as an indication of which of the following?

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Crohn's disease

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A nurse caring for a patient with an intestinal obstruction anticipates which of the following assessment findings? Select all that apply.

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Abdominal pain Abdominal distension Vomiting

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A client tells the doctor that every time he eats something made with wheat, barley, and/or rye, he gets sick. The doctors suspects the client has celiac sprue. The physician should further assess the client for: Select all that apply.

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Diarrhea Abdominal pain Iron deficiency

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Crohn disease is a recurrent inflammatory disease that can affect any area of the bowel. Characteristic of Crohn disease are granulomatous lesions that are sharply demarcated from the surrounding tissue. The nurse caring for a client with newly diagnosed Crohn disease would know to include what in the teaching?

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Information on sulfasalazine including dosage, route, frequency, and side effects of the drug

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A 68-year-old man who has smoked for at least 50 years reports that lately he feels as though food is "getting stuck" in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least five alcoholic beverages nearly every day. His problem is most likely:

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squamous cell carcinoma of the esophagus.

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A 79-year-old woman reports a recent onset of "nearly constant heartburn." During the assessment interview, she states that she has "lots of aches and pains." She states that she is not on any prescription medications but often takes aspirin for pain. The nurse should suspect what diagnosis?

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Acute gastritis

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A client has developed a ruptured appendix. The nurse is aware the client is at high risk for:

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Peritonitis

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Constipation is the infrequent or difficult passage of stools.

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True

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The nurse walks into a room and finds the patient forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term:

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Vomiting.

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A 28-year-old man presents with complaints of diarrhea, fecal urgency, and weight loss. His stool is light-colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and complains of pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which of the following diagnoses would his care team first suspect?

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Crohn disease

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A patient is admitted with a peptic ulcer. The nurse's priority on admission is to assess for which of the following? Select all that apply.

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Smoking history • Family history • Alcohol usage

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The most common forms of peptic ulcer are duodenal and gastric ulcers. Which of the following are the most common risk factors for peptic ulcer disease?

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The patient who has experienced third-degree burns is susceptible to which of the following specific types of gastrointestinal (GI) ulceration?

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Stress

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A nurse has just completed the assessment of a client diagnosed with inflammatory diarrhea who is having multiple small stools that are bloody and has a fever. The client asks the nurse what is causing the diarrhea. The best response by the nurse would be:

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C. difficile

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A client is admitted to the emergency department with early symptoms of appendicitis. The nurse would assess the client for:

answer

Vague pain that is referred to the epigastric or periumbilical area

question

A 43 year-old male client has presented to the emergency department with vomiting that he claims is of a sudden onset. The client also states that the emesis has often contained frank blood in the hours prior to admission. His vital signs are stable with temperature 98.30 F, pulse 88, BP 140/87, and respiratory rate 18. Which of the following potential contributing factors would the health care team suspect first?

answer

Alcohol consumption

question

A 20 year-old woman has visited her family physician due to occasional bouts of bloody diarrhea over the past several weeks, a phenomenon that she experienced two years prior as well. Her physician has diagnosed her with ulcerative colitis based on her history and visualization of the affected region by colonoscopy and sigmoidoscopy. Which of the following pathophysiological phenomena is most likely to underlie the client's health problem?

answer

Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated.

question

The nurse is caring for a patient with chronic diarrhea. She knows that this condition could be caused by which of the following? Select all that apply.

answer

Crohn disease, Ulcerative colitis, Lactase deficiency, and Fecal impaction.

question

Which symptom is often observed in cases of peritonitis?

answer

Abdominal rigidity

question

Treatment for Helicobacter pylori (H. pylori) requires combination therapy that includes which of the following medications? Select all that apply.

answer

Bismuth salts Omeprazole Amoxicillin

question

Crohn's disease not only affects adults but also can occur in children. The nurse assesses for which of the following major manifestations in children with Crohn's disease?

answer

Malnutrition

question

An older patient presents with a perforation of a peptic ulcer. The nurse will monitor for signs and symptoms of which of the following problems?

answer

Peritonitis

question

A patient is diagnosed with Crohn's disease. The nurse instructs the patient on which of the following types of dietary needs?

answer

High-calorie, vitamin, and protein diet

question

A patient complains of having bouts of diarrhea. The patient wants to know which antidiarrheal would be best to use. Which of the following antidiarrheals does the nurse know will help stimulate water and electrolyte absorption?

answer

Diphenoxylate (Lomotil)

question

A patient is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse's initial assessment, the patient is lying still and taking shallow breaths, with a rigid abdomen. Which of the following problems is the patient experiencing?

answer

Peritonitis

question

A patient is being screened for colorectal cancer with the fecal occult test. The nurse instructs the patient to avoid ingesting which of the following 3-7 days prior to the test? Select all that apply.

answer

Aspirin Citrus fruits Red meats

question

A patient is admitted with chronic gastritis. The nurse expects which of the following invasive tests to be performed to establish the presence of Helicobacter pylori (H. pylori)?

answer

Endoscopic biopsy

question

A nurse is completing a history and physical assessment on a patient admitted with ulcerative colitis. Which of the following symptoms would the nurse anticipate? Select all that apply.

answer

Diarrhea Rectal bleeding

question

The nurse is teaching the client about dietary factors that increase risks for colon cancer. The most important information for the nurse to include would be: Select all that apply.

answer

"Increasing your daily amount of sugar intake does influence your risk." "Decrease your daily intake of vitamins A and E."

question

Irritable bowel syndrome is thought to be present in 10% to 15% of the population in the United States. What is its hallmark symptom?

answer

Abdominal pain relieved by defecation with a change in consistency or frequency of stools

question

A 40-year-old man tells the nurse that his father died of gastric cancer and that he wants to do everything he can do to avoid the disease. Which recommendation should the physician provide?

answer

Avoid smoked and preserved foods

question

A young man presents reporting diarrhea, fecal urgency, and weight loss. His stool is light-coloured and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and reports pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect?

answer

Crohn disease

question

A stroke patient is having difficulty swallowing food and beverages. The patient complains that it feels like "the food is sticking to the back of their throat." Given this information, the priority nursing interventions would be to:

answer

Make the patient "nothing per os" (NPO) and call the physician.

question

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which of the following teaching points should his caregiver provide?

answer

"Your family history, your smoking history and NSAID use may all have contributed to this problem."

question

Parents have brought their seven year old child into the emergency room with abdominal pain. Which of the following clinical manifestations would lead the healthcare team to suspect the child has appendicitis? Select all that apply.

answer

Tenderness in right lower quadrant with palpation.• Rebound tenderness in inguinal areas with palpation.

question

The mother of a 19 week-old infant has brought her baby in for assessment to a pediatrician because of the baby's persistent weight loss and diarrhea. An intestinal biopsy has confirmed a diagnosis of celiac disease, and the child's mother is anxious to know what caused the disease. Which of the following aspects of the etiology of celiac disease would underlie the explanation that the physician provides?

answer

An inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response.

question

When comparing the symptomology of Crohn disease with that of ulcerative colitis, which symptoms are generally characteristic of only Crohn disease? Select all that apply.

answer

Fistulas. Perianal ulcers.

question

A patient presents with a perforated peptic ulcer. Which of the following complications would be a priority for the nurse?

answer

Assessment of a rigid, boardlike abdomen

question

Peptic ulcers can affect one or all layers of the stomach or duodenum. Ulcers that penetrate through the muscularis layer are classified as which of the following types of ulcer?

answer

Perforation

question

A patient is admitted to the medical surgical unit with a history of inflammatory bowel disease. The nurse knows that the clinical manifestations of both Crohn's disease and ulcerative colitis are the result of activation of which of the following cells?

answer

Inflammatory

question

A physician's orders for a patient to be started on total parenteral nutrition (TPN). The nurse knows that TPN is a hypertonic solution and must be administered in which of the following ways?

answer

Through a large diameter central line

question

Celiac disease commonly presents in infancy as failure to thrive. It is an inappropriate T-cell-mediated immune response, and there is no cure for it. What is the treatment of choice for celiac disease?

answer

Removal of gluten from the diet

question

A busy 45-year-old female executive has been diagnosed with diverticulitis. Her primary treatment is an increase in the fibre content of her diet. What effect will the fibre have on the diverticula?

answer

The fibre increases bulk, promotes regular defecation, and increases colonic contents and colon diameter, thereby decreasing intraluminal pressure.

question

The nurse has been providing dietary teaching to a client diagnosed with irritable bowel syndrome. The nurse determines that the teaching was effective when the client selects:

answer

A bran muffin, fruit, and orange juice.

question

The nurse is assessing a client who has just developed peritonitis. The nurse would expect the client to manifest:

answer

A board-like abdomen

question

The nurse is teaching an adult client about home treatment for uncomplicated diarrhea. The most appropriate information for the nurse to provide would be:

answer

Oral replacement therapy (ORT)

question

A number of clients on a geriatric subacute medical floor of a hospital have developed foul-smelling diarrhea over the last several days, and subsequent culture of stool samples has confirmed the presence of Clostridium difficile in each case. The care team on the unit would recognize that which of the following factors likely contributed to the health problem and would anticipate which of the following treatments?

answer

The use of broad spectrum antibiotics likely played a role in the developments of the infections, and most clients would likely receive metronidazole as a treatment.

question

A client has been admitted to the hospital with an exacerbation of peptic ulcer disease. The nurse is aware the client is at risk for: Select all that apply.

answer

Perforation • Hemorrhage • Obstruction

question

Diarrhea is described as a change in frequency of stool passage to a point where it is excessively frequent. Diarrhea can be acute or chronic, inflammatory, or noninflammatory. What are the symptoms of noninflammatory diarrhea? (Select all that apply.)

answer

Nonbloody stools, periumbilical cramps, and nausea and/or vomiting

STUDY

Advanced Pathophysiology Cell Mediated Immune Response Foundations Of Professional Nursing Nursing

Porth’s PrepU: Chapter 45: Disorder’s of GI Function – Flashcards 45 terms

Ruth Jones

45 terms

Preview

Porth’s PrepU: Chapter 45: Disorder’s of GI Function – Flashcards

question

The nurse has been providing dietary teaching to a client diagnosed with irritable bowel syndrome. The nurse determines that the teaching was effective when the client selects:

answer

A bran muffin, fruit, and orange juice.

question

A client has developed a ruptured appendix. The nurse is aware the client is at high risk for:

answer

Peritonitis

question

The nurse is reviewing the medical history of four clients. The nurse determines that the client at greatest risk for developing peptic ulcer disease is:

answer

A client with a prior diagnosis of Helicobacter pylori and refused treatment

question

Malabsorption syndrome results in loss of fat in the stool and failure to absorb fat-soluble vitamins.

answer

True

question

Crohn's disease not only affects adults but also can occur in children. The nurse assesses for which of the following major manifestations in children with Crohn's disease?

answer

Malnutrition

question

A patient is admitted with chronic gastritis. The nurse expects which of the following invasive tests to be performed to establish the presence of Helicobacter pylori (H. pylori)?

answer

Endoscopic biopsy

question

A nurse is completing an abdominal assessment on a patient suspected to have appendicitis. When the nurse applies and then releases pressure in the patient's right lower quadrant, the patient experiences tenderness. The nurse is documenting the presence of which of the following?

answer

Rebound tenderness

question

A nurse providing dietary guidance to a patient with celiac disease tells the patient that which of the following foods should be avoided?

answer

Wheat bread

question

A teenager who has a history of achalasia will likely complain of which of the following clinical manifestations?

answer

Feeling like there is food stuck in the back of the throat

question

Hiatal hernias can cause severe pain if the hernia is large. Gastroesophageal reflux is a common comorbidity of hiatal hernia, and, when this occurs, what might the hernia do?

answer

Retard esophageal acid clearance

question

A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:

answer

Surgery to release the bowel

question

A 60-year-old male client has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment?

answer

Inhibiting gastric acid production

question

A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the client's following statements demonstrates an accurate understanding of this diagnosis?

answer

"I suppose I should try to eat a bit more fiber in my diet."

question

An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis?

answer

Obstruction of the intestinal lumen

question

The nurse is teaching her patient with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?

answer

Fat

question

The most common forms of peptic ulcer are duodenal and gastric ulcers. Which of the following are the most common risk factors for peptic ulcer disease?

answer

Helicobacter pylori (H. pylori)

question

Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on which of the following?

answer

Eradicating Helicobacter pylori (H. pylori)

question

A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called which of the following?

answer

Zollinger-Ellison syndrome

question

answer

Cobblestone

question

answer

Fistula formation

question

answer

Patients have few early symptoms of the disease.

question

The cause of gastric carcinomas has been influenced by which of the following factors? Select all that apply.

answer

Strain of Helicobacter pylori (H. pylori) Environmental factors Family history

question

Crohn's disease is treated by several measures. Treatment with corticosteroids focuses on which of the following?

answer

Inflammatory suppression

question

In the treatment of Crohn's disease, many medications are used to mediate the inflammatory process. One specific medication that is used is infliximab, a monoclonal antibody. The nurse is aware that infliximab functions in which of the following ways?

answer

Targets destruction of tumor necrosis factor (TNF)

question

answer

Fecal-oral transmission

question

In patients with acute diarrhea, many require no treatment. However, the nurse knows the priority assessment in all patients with diarrhea is which of the following?

answer

Fluid and electrolyte status

question

Upon admission, a patient tells the nurse that he takes aspirin every 4 hours every day. The nurse determines that this patient is at risk for which of the following?

answer

Peptic ulcer

question

One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these tests, the nurse would instruct the client to do what?

answer

Avoid nonsteroidal anti-inflammatory drugs for 1 week prior to testing

question

answer

Proton pump inhibitors; avoiding large meals; remaining upright after meals

question

answer

squamous cell carcinoma of the esophagus

question

Select the client at greatest risk for developing colorectal cancer

answer

A 64-year-old female whose mother had colorectal cancer

question

A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:

answer

Fistula formation

question

The nurse is caring for a patient with chronic diarrhea. She knows that this condition could be caused by which of the following? Select all that apply.

answer

Crohn disease Ulcerative colitis Lactase deficiency Fecal impaction

question

In the balance of secretions in the gastric mucosa by the parietal cells, which of the following ions is produced to buffer the production of hydrochloric acid?

answer

HCO3-

question

answer

Barium x-ray

question

An elderly patient has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which of the following potential problems would the nurse anticipate in this patient?

answer

Colonization of Clostridium difficile

question

An elderly patient presents with loose mucousy stools. The nurse suspects the patient has Clostridium difficile. What is a priority assessment for the nurse?

answer

Ask the patient about his or her antibiotic use

question

answer

Stress ulcer

question

A nurse reading a sigmoidoscopy report notes that a patient was found to have skip lesions. The nurse interprets this as an indication of which of the following?

answer

Crohn's disease

question

A nurse caring for a patient who is vomiting assesses for accompanying signs and symptoms including which of the following? Select all that apply.

answer

Decreased blood pressure Dizziness Lightheadedness

question

Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis?

answer

A 79-year-old hospital client who is being treated with broad-spectrum antibiotics

question

An older patient presents with a perforation of a peptic ulcer. The nurse will monitor for signs and symptoms of which of the following problems?

answer

Peritonitis

question

answer

Peritonitis

question

Parents of a toddler report that he often refuses food and grimaces when he swallows. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which health problem would the care team first suspect?

answer

Gastrointestinal reflux

question

answer

Acute gastritis

STUDY

Advanced Pathophysiology Cell Mediated Immune Response Immunology Microbiology Pathophysiology

micr 12 – Flashcard 38 terms

Daniel Jimmerson

38 terms

Preview

micr 12 – Flashcard

question

Which of the following could result in a Type II Hypersensitivity?

answer

Both A and B

question

The symptoms of an immune complex reaction are due to ______.

answer

complement fixation

question

What is the hallmark of a conjugated vaccine?

answer

These vaccines contain weakly antigenic elements plus a more potent antigenic polysaccharide.

question

Which of the following may result from systemic anaphylaxis?

answer

Shock

question

When a person has previously been vaccinated against a viral pathogen, which cells are activated if that same pathogen re-enters the host's cells months or years later?

answer

Memory cells

question

A healthy immune system destroys cancer cells with ____.

answer

NOT T Helper cells

question

What type of vaccine involves host synthesis of viral antigens?

answer

Nucleic acid vaccine

question

All of the following are considered examples of type I hypersensitivity except _____.

answer

NOT penicillin allergic reactions

question

Treatment with certain drugs to reduce transplant rejection can cause ____.

answer

Immunosuppression

question

Inhalation of an allergen often results in _____.

answer

NOT systemic anaphylaxis

question

An antigenic protein from B. pertussis, the causative agent for whooping cough, is an example of a(n) ____ vaccine.

answer

NOT attenuated whole-agent

question

Type IV Hypersensitivity is associated with _______.

answer

all of the above

question

When exposure to tetanus is suspected, the treatment involves injections of Human Tetanus Immunoglobulin. What does this do?

answer

NOT It stimulates the immune response in order to provide lasting protection against tetanus.

question

Which of the following is not an advantage of live attenuated vaccine?

answer

NOT They elicit lifelong immunity.

question

Hypersensitivity is due to _______.

answer

NOT immunity

question

What could a vaccine contain?

answer

Weakened or killed pathogen or parts of a pathogen

question

Which antibodies will be in the serum of a person with blood type B, Rh+?

answer

NOT anti-A, anti-Rh

question

A positive tuberculin skin test is an example of _____.

answer

delayed cell-mediated immunity

question

Why is cyclosporine the preferred drug to suppress the immune system?

answer

NOT It does not completely suppress the B and T cell responses, only enough to prevent a negative immune response.

question

All of the following are true of hypersensitivity except ______.

answer

NOT it requires previous exposure to an antigen

question

All of the following are considered examples of type I hypersensitivity except _____.

answer

transplant rejections

question

The process of desensitization to prevent allergies involves the injection of increasing amounts of _____.

answer

NOT IgE

question

Which of the following utilizes a combination of monoclonal antitumor antibody and immunotoxin?

answer

Immunotherapy

question

Which antibodies will be in the serum of a person with blood type B, Rh+?

answer

NOT anti-B

question

Toxoid vaccines such as the vaccines against diphtheria and tetanus elicit a(n) ______.

answer

Antibody response against these bacterial toxins

question

All of the following are generally used in active vaccinations except _______.

answer

antibodies

question

All of the following are true of hypersensitivity except ______.

answer

NOT it is synonymous with allergy

question

Allergic contact dermatitis is due to ______.

answer

sensitized T cells

question

A healthy immune system destroys cancer cells with ____.

answer

CTLs

question

Anaphylaxis is the term for reactions caused when certain antigens combine with ____.

answer

IgE antibodies

question

All of the following lead to drug-induced thrombocytopenic purpura. Which occurs first?

answer

Drug binds to platelets.

question

A patient shows the presence of antibodies against diphtheria toxin. Which of the following statements is FALSE?

answer

NOT The patient may have been vaccinated.

question

Transplant rejection is an example of _____.

answer

NOT Type II hypersensitivity

question

Immunodeficiencies are a result of all of the following except ____.

answer

autoimmune diseases

question

What is the primary benefit of vaccination?

answer

An immune response will occur quicker upon future exposure to the pathogen.

question

Hemolytic disease of the newborn can result from an _____.

answer

Rh- mother with an Rh+ fetus.

question

An antigenic protein from B. pertussis, the causative agent for whooping cough, is an example of a(n) ____ vaccine.

answer

NOT inactivated whole-agent

question

Inactivated tetanus toxin is a(n) ____.

answer

Toxoid vaccine

STUDY

Cell Mediated Immune Response Microbiology Rna Dependent Rna Polymerase Rolling Circle Replication Virology

micro4 – Flashcard 390 terms

Kenneth Miller

390 terms

Preview

micro4 – Flashcard

question

Most RNA viruses replicate

answer

in cytoplasm; flu uses nucleus extensively. poxvirus is in cytoplasm

question

nucleocapsid

answer

R/Dna+structural proteins+NABP/enzymes= nucleocapsid

question

enveloped virus

answer

nucleocapsid+GPs+memb=enveloped virus

question

all picornaviruses

answer

plus sense. virion genome can be used as message. so is ~ to rna

question

flu

answer

orthomyxoviridae=type A B C. genome is in pieces. mutates v fast=reassortment. is negative sense= meaningless to cell=need own RNA dep RNA polym.

question

only virus with SSDNA

answer

parvovirus

question

DNA vs RNA virus location

answer

DNA- nuc. RNA- cytoplasm

question

for virus to make mRNA, needs

answer

polyA tail and cap

question

EBV cell rec

answer

cd21

question

herpes simplex cell rec

answer

nectin 1

question

rhino cell rec

answer

ICAM1

question

rabies cell rec

answer

ACh

question

flu and paramyxovirus cell rec

answer

sialic acid

question

polio cell rec

answer

IgG

question

HIV cell rec

answer

CD4 + CXCR4 TCells and CCR5 mphage

question

polio rec

answer

only in primates. rec in nasopharynx, gut, anterior horn cells

question

measles tropism

answer

everywhere

question

picorna virus

answer

translate- polyprotein- structural capside proteins, proteases. RNADRNAP.

question

poliomyelitis

answer

inc. in upper classes and older ppl

question

coxksacie A

answer

a picornavirus- forms vesicles of virus particles- herpangina

question

EV71

answer

~ to cocksackie. ras. encephalitis. hand, foot, mouth disease

question

toga virus

answer

RNA SS + enveloped. budding. mosquto vector

question

toga and rubella

answer

same structure

question

paramyxo and rhabdo virus

answer

neg sense RNA SS-> forms helical nuclear capsids with rna. enters cells via vesicles. nucles not involved. budding

question

RSV

answer

paroxymyxovirus, SS, neg, enveloped. nuvleus not involved. have fusion protein. glycoproteins and budding.

question

measles kopliks spots

answer

spots full of viruses. shows before rash does. very transmissible

question

influenza

answer

rna SS neg, genome in pieces, enveloped. involves nucleus- rna need to be spliced. steals host cell caps on mrna

question

bunyavirus

answer

rna ss +/- genome in pieces mosutios. #1 cause viral encehpalitis

question

reovirus

answer

human rotavirus. non enveloped icosahedral segmented DS RNA. G.I.P.

question

rotavirus

answer

DS ~ to reovirus replication strategy. nucleus not involved.

question

parvovirus

answer

SSDNA only in cells mitotically active. has DS intermediate. proteins made in cytoplasm.

question

herpes virs stages

answer

DS 1). envelope so do fusion of envelope w PM-> attachment and penetration. 2. targets nucleus-release DNA- IM/early stage. 3. replicate genome. virus polymerase and cell polymerase-> make more genome- early stage. 4. make structural proteins- late stage. 5. nuc memb modified by viral GPs, genome encapsidated, budding out from Nuc membrane. 2* membr-exocytosis. 6. can also lyse

question

herpes 1* and 2* memb

answer

1* from nuclear memb. 2* for PM.

question

poxviruses replicate

answer

all in cytoplasm, fast. DSDNA. lipid envelope, no budding out.

question

retrovirus

answer

diploid, 2 SSRNAs, positive, but need DNA IM. needs a RT.

question

viral protease

answer

clips up proteins, makes correct nuclear capsid particles.

question

Hep B is

answer

has RNA to DNA step. exists outside cell as wild state. antivirals to retroviruses work on HepB too. envelopes, buds.

question

Herpes

answer

DS DNA virus. icosahedral. lipid bilayer envelope

question

Herpes and GPs

answer

use to bud thru membrane and attach to host cell rec

question

alpha herpes

answer

type 1, type 2, varicellazoster 3

question

alpha herpes treatm

answer

acyclovir

question

herpes 1

answer

cold sore, some genital herpes

question

herpes 2

answer

genital herpes

question

herpes 3

answer

varicella- chickenpox. zoster-shingles

question

beta herpes

answer

cmv 5, human herpes virus 6 roseola, human herpes virus 7 roseola (6+7 inc in AIDS)

question

gamma herpes

answer

EBV 4, kaposi sarcoma 8

question

all herpes have latent stage

answer

alpha- in neurons. beta- in mono/lymphocytes, gamma- in B cells. so if ur infected- infected for life, reactive if stress/infection.UV

question

herpes envelope

answer

has envelope so enters via fusion

question

early herpes life cycle

answer

make mRNA, go to cytoplasm, proteins MUST be made in cytoplasm w nuclear localization signals-> return to nucleus-> more more proteins and replicate genome

question

herpes late stage life cycle

answer

actual viral capsids, make final virus, carbs via golgi, exit via budding/lyses/exocytosis.

question

herpes latency

answer

replicate in sensory neuron, travels up neuron->ganglions, it is making LAT (latency associated transcript). virus moves along Microtubules

question

LAT

answer

latency associated transcript from herpes

question

herpes spread

answer

via saliva vesicle fluid/saliva/vagina

question

herpes cell cell spread

answer

can avoid IS, need cell mediated immunity to resolve

question

herpes and IFN

answer

herpes -/-IFN inhibition of viral synthesis

question

TAP

answer

herpes has protein to plug transporter associated w AG processing channel (TAP) that inhibs delivery of peptides to ER

question

herpes and cell recog

answer

herpes blocks association w MHCI, prevents CD8Tcell recog

question

herpes infected cells express

answer

Fc rec and comp rec

question

herpes shedding

answer

virus can ->asymp shedding. no

question

herpes vaccine

answer

none but for chickenpox

question

herpes type 1

answer

90% asym, 9% minor, 1% disease. 1* herpes- gingivostomatitis - v painful, latent cold sores. hepatic whitlow- digits.

question

herpes type 2

answer

genital herpes. sex. 1 wk incub. long period malaise tender LNs. virus shed, not so bad...

question

herpes 1* vs 2*

answer

1* prominent vesicles w virus. 2* smaller vesicles, less pain.

question

neonatal herpes 2

answer

during birth canal passage. neonates dont have CMI.

question

herpes type 2 progression neonates

answer

->CNS->v bad. prevent via Csection.

question

V-Z spread

answer

via droplets, contact. respir tract-> other organs. viremia. ex if u see rash on skin

question

VZ and CMI

answer

CMI needed for viral clear, can escape ABs.

question

chickenpox

answer

less bad young. if YA, severe, pnuemonia.

question

chickenpox progression

answer

droplets-respir-lymphatics-retic system- viremia (fever malaise HA)- mucus memb and skin latency in neuron.

question

VZ vesicle progression

answer

macule- papule- vesicle- pustule- crust

question

chickenpox vs smallpox

answer

cpox- rash perfuse on trunk, sparse distal. smallpox- rash perfuse on face, sparse on trunk, profuse distally

question

VZ vaccine

answer

live virus vaccine- monovalent, also quadravalent- MMRV.

question

EBV

answer

mono- coated tongue. virus in saliva- kissing disease. get HSM. Bcell prolif. TCell response (lymphocytosis)-> infectious mono. see atypical lymphocytes

question

EBV associated w

answer

HL, lymphomas if IS, african kids in malarial regions (burkitts), nasopharyngeal carcinoma

question

EBV shed

answer

lifelong shed virus. kids asymp. no antiviral or vacine

question

CMV

answer

blood tissue, secretions. semen is most. -/-epithel cells.

question

CMV latent

answer

in T cells, mphages, others. need CMI, not much AB help.

question

CMV is generally

answer

asymp. can ->"heterophile neg" infecitous mono can infect in utero. 4k/yr. opportunistc. anti virals exist but are toxic. no vaccine

question

CMV and evade CMI

answer

imp. evade via prevent AG presentation by inhib MHC1. inhib w CK induced expression of MHC2 on APCs. inhib NKs. encodes IC-10 analogs that inhibit TH1.

question

Herpes 6+7

answer

v infectious 100%. rapid onset, fever ,rash 1-4d. CMI. after 4 days, recovery w out complications.

question

2 grps of papoviruses

answer

papillomavirus and polyomavirus. small, nonenveloped circular DSDNA.

question

papillomavirus

answer

larger than polyomavirus. more complex genome. trophic for skin/muc membrane epithel cells. warts cervical cancer CVD

question

papillomavirus early proteins

answer

E6+E7 are made in cancer tissues

question

answer

targets p53

question

answer

targets Rb

question

HPV dx

answer

dna typing. dna, pcr, stain, papsmear

question

HPV types

answer

100 types-> 16 grps based on DNA. are cutaneous or mucosal HPV.

question

HPV early/late genes

answer

early: E1-E8. late: L1-L2

question

HPV infects

answer

in sq. epithel of skin (wart) and muc. memb (genital, oral, conjunctival papilloma)

question

HPV structure

answer

5 pt star shaped capsomere in icosadeltahedral structure.

question

HPV type 16

answer

CCancer. see late L1,L2 (structural capside genes) and early E6,E7

question

HPV and CCancer

answer

linked to ecro endocervical squamocolumnar junction. mostly types 16,18. integrate into genome

question

epidermodysplasia verruci formis

answer

from HPV-> pruritic itchy pupules, erythematous. via HPV 5,8,17,20,36

question

papsmear

answer

exfoliated cervicovag sq. epithel cells 2 perinuclear cytoplasmic vaculization- koilocytosis . see large sq cells w hyper chrom. nucleus

question

koilocytosis

answer

The appearance of a cell in which the nucleus becomes large and swollen or contracted and wrinkled and is often surrounded by a "halo" of cytoplasmic clearing. PAP SMEAR hpv

question

hpv infects via

answer

direct contact breaks in skin/mucus, sex, birth canal, chew wart

question

hpv treatm

answer

surgery, electro, laser. Salicylic acid w LA, formaldehyde, bleomycin, imiquimod, IFN, cidofovir

question

gardasil

answer

inhibs hpv 6,11 (genital warts), 16,18 (CCancer)

question

polymavirus early late regions

answer

early- w large T(transforming) and small T AGs. late- 3 viral capside proteins

question

polymavirus

answer

~ Viral infection capable of inducing tumor ~Viral agents of leukoencephalopathy (JC virus) and renal transplant complication (BK virus) ~Primary infections target cells producing giant swollen nucleus ~symptoms are asymptomatic or mild ~ transmission through urine and respiratory secretions ~treatment: interferon

question

BK and JC viruses

answer

are types of polyomavirus esp in IC. both make T AGs ~ to SV40. new forms are Wu and Ki

question

answer

from brains of pats w progressive multifocal leukoencephalopathy.

question

SV40

answer

DNA virus that pirates the DNA replication machinery from the host cell replicating its genome- rate determining factor is the helicase (only mechanism it uses it's own of). Large T AG and Small T Ag are made. also viral proteins VP1,2,3

question

Merkel cell carcinoma

answer

Rare, aggressive and life-threatening neuroendocrine carcinoma of the skin located at head or neck of patient associated with sunlight and immunocompromised that's usually (>80%) caused by Merkel cell polyomavirus

question

JC and BK viruses happen

answer

by 15 yo. spread via respir. latent reactive via IC, preg, tplant, AIDS. no treatm.

question

adenovirus

answer

medium non envelped icosadeltahedral dna virus. 35 kb linear DSdna. has fiber projection from each of 12 vertices/bases. capsid -240 capsomeres of hexons and pentons. 11 viron proteins->serotyping

question

adenovirus grouping

answer

grps A-F, 47 serotypes. in same grp have same fiber length, DNA homology, GC content, woldwide, tumor transforming, agglutinate RCs

question

adenovirus reservoirs

answer

lung and brain via in situ hybrid+PCR. other reservoirs? lymph kid livr. can be reactivated in BMT

question

adenovirus attachment

answer

to host cell via interaction penton w cell integrins-> uncoating in cytosol- cell nucleus as nucleoprotein complex

question

adenovirus early events before viral dna syn

answer

induce cell->S phase for replciation and protect cell from host defense mechs. make viral proteins for viral DNA replic. make 20 E proteins- EIA- activate CCycle, EIB protec from apot, they interact w p105 Rb and p53

question

adenovirus late events

answer

terminal protein primes viral dna syn. major late promoter "L". complex of EIB+E4-> support transport of viral transcripts. make capsomers in cytosol-> nucleus beocmes empty capsids-> load w dna- primed to maturity

question

adenovirus inhib host defense via

answer

RNA blocks activation of PKinase R which inhibs PS by -/- eIF2. EIA inhibs IFN inducible genes. E3 inhibs MHC1 so cant do CTL lysis.

question

adenovirus pathogensis

answer

1. entery @ eyes nose moth 2. conjunctivitis/pharyngitis/gastroenteritis 3 exit via eye mouth anal. also cause dis in liver lung cns/ur bladder/ nail bed/hep/cervix

question

adenovirus can infect...

answer

water supply- conjunctivitis

question

adenovirus big 3 sx

answer

conjunctivitis, pharyngitis, gastroenteritis

question

adenovirus eye/GI dis

answer

eye infections via grp B type 3,7. GI dis via grp F type 40-42.

question

adenovirus 5

answer

hepatitis

question

adenovirus 35

answer

cystitis/nephritis/colitis

question

adenovirus time course

answer

21d

question

adenovirus histo

answer

dark basophillic nuclear inclusion bodies w dna/proteins/capsids

question

adenovirus DX

answer

long lasting immunity. DNA/elisa/serology

question

adenovirus spread

answer

feco oral, swimming polls, infect w type 1 2 5 6 in first yr of life. chlorinate h20!

question

adenovirus vector

answer

can use as vector for GT

question

poxvirus

answer

largest virus. envelpe, oval/brick. linear DSDNA. inverted terminal repeats w hairpin loops. multiples of enzymes/transcription. 8 genera.

question

poxvirus that afect ppl

answer

1. orthopox (cow monkey pox, vaccinia, variola- smallpox). 2. parapoxvirus- rare, localized lesions. 3. yatapoxvirus- rare, localized. tanapox inc. in skin infections in africa. 4. molluscipoxvirus- beign skin nodules via contact

question

pseudocowpox

answer

orf lesion on finger

question

molluscipoxvirus

answer

skin lesion and epidermis w molluscum bodies. BENIGN

question

poxvirus replication

answer

unique among DNA virus- happens entirely in cytoplasm!!!!!. only animal virus uncoating step needs new virus encoded protein uncoatase. viral core released to cytoplasm- virons intitiate transcription. uncoatase releases DNA. DNA and protein-cores. virions bud thhru PM, released via lysis. 10k viral particles per cell

question

poxvirus steps

answer

1. attach 2 entry 3 early mrna and early enzymes 4. uncoatase releases dna 5 replication 2-5hr 6. IM mrna and late TFs 7. late mrna 8. assembly 9. golgi for maturation 10. release via dissrupt/exocytosis

question

poxvirus prodrome

answer

up to day 7 (see slide 16)

question

poxvirus dx

answer

via serology, polypeptide map/

question

poxvirus autoinnoculate

answer

via scratch vaccine area and rub eye- live virus. can have progressive vaccina (vaccina necrosum). rare SE- evzema vaccinatum

question

vaccina

answer

a local infection induced in humans by innoculation with the virus causing cowpox in order to confer resistance to smallpox. levaes pitted scar

question

vaccinia virus

answer

large DS DNA. can use for GT.

question

parvovirus

answer

small non enveloped linear SSDNA. virus have 1 major, 1 or 2 minor coat proteins. human b19.

question

b19 goes to

answer

trophic for erythroid cells based on distrib of rec for b19 (blood grp P (D?) pathogen)

question

b19 lysis

answer

anemia, aplastic crisis.

question

fifth disease

answer

a type of maculopapular rash disease of the skin; also known as Erythema infectiosum; caused by Parvovirus B19; caTACuses "slapped cheek" syndrome in children and very contagious. arthlagia. 4-14d incub. 1). viremia flu like, detect IgM parvovirus immune complex. 2). 2*phase after 17d-erythmous facial rash, lace like rash on limbs trunk fades 2-3d. 3). joint pain

question

B19 TAC

answer

transient aplastic crisis-> loss of RCs cu of erythroid precursors, bad if u have SS, thal. fetal deatl 10%, 1* maternal infection.

question

b19 timecourse

answer

1. initial lytic- flu like 7d incub, dec Hb, viremia, dec. reticulocyte. 2. non infectious stage immunologic stage- rash arth fifth disease. v hard to isolate virus. have specfiic IgG Ab.

question

BK virus

answer

Cause of hematuria, hemorrhagic cystitis, or ureteric stenosis, or interstitial nephritis in a severly immunocompromised pat.Polyoma virus. dsDNA, naked, icosahedral renal disease in AIDS patients

question

b19 dx

answer

dna, igm (2-3mo), igG (years)

question

b19 widespread

answer

60% adults, 90% old have it

question

b19 treatm

answer

no vacine for fith dis/TAC- treat symp.

question

Slow disease

answer

viruses ex rabies. kuru and cjd

question

prions

answer

Prp->dis. products of gene on 1 exon on Chrom 20. have long incub pds. w neuronal loss-> coordination loss.

question

human/animal prion dis

answer

human- kuru, cjd, gss, fatal familial insom, cgdv. animal- chronic wasting dis, scrapie, bse

question

slow diseases from viruses

answer

progressive multifocal leukoencephalopathy- jc virus. subacute sclerosing panencephalitis (SSPE)- measles 1-10 yrs later. progresive rubella panencephalitis- rubella. rabies

question

prion disease

answer

only in CNS. 1-30 yr incub. show progressive ftal course. mad cow- vaculation of neurons. R to UV/Rad, proteases, disinfectant, digestion. rod like. kill via autoclave, no treatm

question

prions and plaque

answer

cause amyloid plaque? form plaque-cerebellum- smaller plaques in granular and molecular layer.

question

cjd vs vcjd

answer

older- cjd. younger- vcjd.

question

PRP types

answer

PRPnormal- alpha helix. happy. protease sensit. PRPsc- mut- Bsheets- bad, protease R>

question

prion transmit via

answer

infect, tplant, cannibal, food, cwd- infected deer

question

prion time course

answer

1-30 yr incub, 3.5 month prodrome, 4 mo dementia/myoclonic stage- death

question

prion dx

answer

no EM, AB or NA prob. no serology. DX w neuro symp

question

viral gastroenteritis

answer

rota and norovirus

question

reoviridae

answer

8 genera including rotavirus (#1 cause of severe diarrhea of kids under 5). 500k d/yr. 2d incub. vomit, watery diarrhea 3-8d

question

rotavirus

answer

reovirus. fatal dehydratation. non enveloped, icosahedral, double capsid, wheel w spokes. DS RNA in 11 segments. separate via PAGE.

question

rotavirus proteolysis->

answer

core particle and infectious subviral particle (ISVP)-> have v imp role in replication

question

rotavirus stripping

answer

NEED stripping of envelope for virus to be infecious in gut

question

rotavirus structural proteins

answer

outer VP7+VP4-> viral HA-spikes. inner core-VP1,2,3,6- AG determinant.

question

rotavirus targets

answer

B adrenergic rec in host.

question

rotavirus grps

answer

A-F via Ags. D,E,F not in ppl. A- mostly yung ppl in US. B- China. C- sporadic.

question

rotavirus serotypes

answer

15 total. 6=P type, ABs to VP7. 9=G type, ABs to VP4. Grp A- 4 serotypes. define w AG diffrences in VP6

question

rotavirus epid

answer

500 k d/yr. 95% kids infected by 3-5 yr. fecooral route or fomites. max shedding 2-5d after diarrhea. communicable 2d before, 10 d after onset. most infants have AB by 3yo. most severe 3-24 mo old. 5-10% all cases of gastroent. <5yo.

question

rotavirus clinical

answer

1-3 incub, fever, n/v/d. severe diarrhea no blood 3-9 d. neonates- hemorrhagic. dehydration, metab. acidosis, 2* malab of lactose, fats, chronic diarrhea

question

rotavirus RFs

answer

daycare, hospital, caretakers, immune SCID, HIV, BMT

question

rotavirus replicate

answer

. virion proteolysis-> ISVP or else wont infect

question

rotavirus DX

answer

EIA, latext agglut, viral AG detect, ELISA, cultures, gel electrophoresis.

question

rotavirus vaccine

answer

rotashellX. rotarix, rotateq

question

other gastroent viruses

answer

small round RNA viruses. 1). structured- SRSV- norovirus, Astrovirus, calcivirus (astro and calci can culture). 2). unstructured: wollan and ditchling

question

calcivirus

answer

non enveloped SS, pos sense, RNA, round, icosahedral, 1 capsid 32 cups-chalice. ~ to norov. 5AG types. worldwide, young kids, fecaloral, osters and shellfish. 1-4da incub, most asymp. d/v. anorexia, fever. 1/3 respir probs ~ flu. elisa, RIA

question

norwalk

answer

bind carbs of A, B,O blood Ags. nonevelope, SS RNA. 1 capsid. 23 mil gastroent cases/yr in us. 24 hr incub, 3 d illness. nvd cramps, ha, fever, malaise. inc. in daycare, SHIPS. fecal oral. serology, EIA, RTPCR.

question

astrovirus

answer

small ssrna, no envelope, 6 pt star. unbroken surface 7 serotypes. nvd, ha, fever. <7yo, fecaloral. food. EM useful- inc. shed in stool

question

adenovirus and entero probs

answer

grp F 40-42-> gastroent. diarrhea <4yo, 5-12d. DNA VIRUS. fecaloral. respir tract infections. 8-10d incub. latex agglut, EM, elisa, PCR, probes

question

other reoviruses

answer

are NOT gastroent. coltivirus and orbivurs

question

coltivirus

answer

colorado tick fever- disphasic, HA, muscle pain, erthralgia. kids- hemorrhage, encephal.

question

orbivirus

answer

animals, sheep, hourse, deer

question

orbi and colti replic

answer

same as rotovirus, but takes place in arthropod and verteb host. need to remove shell- activate RNA dep. RNA Polym.

question

Colorado tick fever

answer

coltivirus. dermacantor andersoni- ppl- BM cells, inhib Blood cell production -> thrombo cytopenia. can - CNS, encephal, CSF. 3-6d incub, fever, chill, HA, arthralg, photophobia, biphasic fever, conjunctivitis, LAD, rash

question

flu reassort

answer

via segmented genomes.

question

flu AG shift vs drift

answer

shift- introduce nu HA or NA-> pandemic. drift- accumulate muts in HA or NA->epidemic (seasonal flu). FLU A- SHIFT +DRIFT. B- just drift

question

HA and NA

answer

HA-surface glycoprotein spike, also has lipid bilayer.

question

flu vaccine and HA

answer

vaccine targets HA via neut ABs.

question

antiviral flu target NA

answer

antivirals target NA (tamiflu, relenza), prevent cell spread of virus.

question

M2 ion channel

answer

for Flu A-> amantadine and rimantadine.

question

flu

answer

RNA SS negative sense, helical, enveloped, segmented genome-reassort- nu viruses

question

flu proteins

answer

polymerase- made of PA, PB1, PB2. NSP: NS1 inhibs IFN, NS2 is nuc. export protein, M1 is matrix protein, M2 is ion channel, BP is nucleoprotein

question

answer

fuses w memb of endocytic vesicle

question

flu replication

answer

most RNA virus in cytoplasm, but flu in nucleus. 6-8hr. has RDRP in 8 segments. nucleocapsids. enter via endocytic vesicle, fusion, release the 8 segments- nucleus- steal host message caps (7methyl G caps taken up by PB2

question

how quantify flu

answer

HA titer- agglut of RCs. NA activity assay. plaque titration. cythopathic assay. elisa, trfia. rtcpr

question

H3N2v

answer

SOIV- 2011 county fair flu- picked up 09 H1N1 pandemic gene

question

virus and respir tract

answer

virus-> cilated mucosal cells of RT- denudes it->no protection- 2* bact infection

question

flu acute adults

answer

fever, coryza, HA, malaise, myalgia, sore throat, non productive coff

question

flu acute kids

answer

~ adults, but worse fever, GI probs, otitis media, myositis, croup

question

flu complications

answer

myositis, cardiac, GBS, Reye's, encephal

question

flu 2* bacterial

answer

spneu, mrsa, gas, hi

question

flu vaccine

answer

takes 10 d, dead or alive (nose spray). -> AB and CMI. get viral infections, not disease. dont give for preg or IS

question

MMR up/down

answer

measles, rubella dec, mumps inc

question

paramyxovirus

answer

SS rna, nonseg, neg polarity, RDRP, helical neucleocapsid. little AG variation, M protein matrix, F gp spikes

question

paramyxovirus fusion protein

answer

key to pathogenesis. class 1 fusion protein. ABs to FP neutaralize infection (if not, v bad)

question

class 1 fusion proteins

answer

flu HA, HIV gp120, paramyxovirus FProtein, ebola

question

RSV CPE (characteristic cytopathic effect)

answer

large multinucleate synctial cells.

question

measles

answer

paramyxovirus. RNA, HA, one AG type, inhib by heat and lite. reservoir = ppl, airborne, inc. in winter/spring. spread 4d before/4d after rash. 8-12 d incub.

question

measles clinical

answer

prodrome- fever, malaise, 4 Cs coff coryza, conjunctiv, Koplick spots on tongue. maculopapular erythamotous rash= morbilli form. otitis pneu, croup, diarr, encephal. lifelong immunity

question

4 Cs of measles

answer

coff coryza conjunctiv koplick

question

measles rec

answer

uses SLAM cd150 rec on mononuclear cells

question

measles timecourse

answer

get 4 Cs day 10-13. febrile prodrome. after 13, viremia ends, rash starts. D0: mucus memb. D2: LNs D4: blood 1* viremia fever D6: liver/spleen. D10: 2* viremia. D12- rash, focal infection.

question

measles pathology

answer

GC formation, vasculitis, lymphocytic infiltrate

question

mumps

answer

paramyxovirus. rubulavin family. RNA. one AG type, bilateral. spread 1-2d before, 5d after swelling. 16 d swelling

question

mumps tropism

answer

salivary gland stensons duct

question

mumps clinical

answer

prodrome fever, HA, malasie, myalgia. 20% asym. parotitis. 50% cns pleiocytosis. 10% cns. LRT, illness. renal 60%. abn ekg 10%. oophoritis, orchitis

question

parainfluenza

answer

laryngotracheobronchitis. croup, barking honking coff. DEX clears airways.

question

croup

answer

STEEPLE sign on XR- upper airway narrowing. croup coff- STRIDOR, retractions, use accessory muscles to breathe. give cold moist air. self limited, lasts 72H.

question

RSV bronchiolitis

answer

acute viral infection. LRT young kids. obstruction, wheeze, rales, hypoxemia, hear on inspiration.

question

RSV

answer

respir/fomites. communicable whole time u have it. bronchiolitis

question

RSV pathogenesis - bronchiolitis

answer

replicate in URT, spreads to LRT. infalmm bronch and epithel. narrow airway, mucus plugs. R to flow, abn ventil perfusion, hyperreactive airways, IgE hypersensit

question

RSV and bronchiolitis

answer

50% have asthma

question

types of parainflu

answer

1- croup. 3- bronchiolitis. 4- benign.

question

croup vs broncholitis

answer

broncholitis hear on EXPIR (LRT???) Croup hear on INSPIR (URT??)

question

ribavarin

answer

aerosol treatm of RSV. treats HCV. teratogenic

question

synagis

answer

for RSV for preemis and babies w chronic lung dis and CHD- palivizumab ab for FP.

question

human meta pneumovirus

answer

~ RSV. cytopathic effect. GCs fuse.

question

infants cant coff

answer

-> vomit- post tussive emesis

question

TORCH

answer

vertical. toxo, other (syph, b19, varicella), rub, cmv, herpes/hiv/hep.

question

TORCH RFs

answer

intimate relation of mom and fetus, organ systems are in early develop, inc. susceptible of placenta to microbes, pass thru birth canal, IS is immature.

question

type 1 vertical transmission

answer

transplacental/early 1* trimester- toxo, syph, rub, cmv, varicella. major impact on growth organ develop, MR>

question

type 2 vert transmission

answer

perinatal/late- via passage of birth canal or in labor- hep B, chlam, gonhorrea, HSV, HIV, GBS. effect in neonate pd or later in life.

question

1st trimester infecions result in

answer

deaf, HD, cns, neonatal purpura (blueberry), cataract, glaucoma.

question

sources of maternal infection

answer

STD, Pets, food, blood IUDA

question

TORCH infections w NO prevention

answer

cmv, hepC, B19, enterovirus

question

TORCH can result in

answer

IUGD, rash, vasculitis, petechiae, thrombocytopenia, HSM, CNS

question

rubella

answer

togavirus. SS + RNA. icosahedral, HA. fever, LAD, conjunct, maculopap rash. 3 d rash exanthem, encephal, arth, arthralg. life long immunity.2-3wk incub. respir spread.

question

rubella vs measles

answer

rub rash not as extensive, discrete, maculopapular erymathous rash. rub=LAD and malaise, no fever til day 4-5, fever <101, no coff.

question

rubella replicates in

answer

nasopharynx, regional LNs viremia after 5-7d-> placenta and fetus.

question

rubella timecourse

answer

Igm at d 10, [email protected] d14 when fever start. virus shed d8-22. lad d8-28.

question

congenital rubella

answer

85% infections first 4 weeks of gestation. dec. % later on. transmit @ viremic stage. can inhib via immuniz

question

mom baby rubella ABs

answer

mom w rub-> IgG-> infant gets maternal igg, makes igm and g and a

question

congenital rub syndrome

answer

deaf, cataracts, heart, microcephaly, MR, bone alter. HSM, preemie, IUGR rash PDA. bony lucencies- celaray stalk

question

congenital rub syndrome eye probs

answer

cataracts, glaucoma, strabismus, nystagmus, micropthalmia, iris dysplasia.

question

mom -/+ abs in rubella

answer

mom -- G+M is susceptible if gets rub. Mom M-,G+- is protected. mom M+G+/- ->autoinfection - manage the baby.

question

congen rubella baby AGs

answer

if baby G+ abs are from mom or baby. if M or A +, from infant- infected.

question

congenital CMV

answer

10% symp @ birth, 15% later. most common congenital infection in US- hearing loss, MR, palsy, viz, leading cause of hearing loss and brain damage.

question

cmv

answer

ds dna envelope B herpes family icosahedral. inclusions. surrounding tegument outer memb GPs. inc. liver fnctions, hyperbili, tcp, inc. csf protein- seeding ing meninges w cmv

question

congen cmv leads to

answer

petechiae, purpura jaundice HSM. microcephaly, IUGR, calcif intracranial, choriorentitis

question

cmv long term

answer

hearing loss, mr, neuro probs w inc. igm

question

congen toxo

answer

hydrocephaly, intracranial calcif, bony abnormal. cateracts, microopthalmia. hemat spread of tackys to fetus. 1*trimester TORCH 2/3* silent.

question

congen syphillis

answer

bony probs, rash is not blueberry, weepy, mucus, periostitis, hsm, penum, desquam

question

chronic hep progression

answer

normal- chronic inflamm- fibrosis- bridging/septal fibrosis- HCC

question

hepA

answer

30d incub, inc. jaundice w age, fulminant encephal, cholestatic, relapsing hep. AI disease.

question

hepA clinical

answer

inc ALT, jaundice, fecal shedding, IgM anti HAV. inc. in young kids (contact, food, blood).

question

hepA vacc

answer

esp if traveler, gay, drugs, chronic liver dis, Nat Ams

question

Hep A post exposure

answer

give Ig in 14d

question

HepB replication

answer

in nuc. no cure. has covalently closed circular DNA- is reservoir to make new virons

question

HepB

answer

no cytopathic- dont kill liver cells- immune response is what does. younger pat- higher risk of chronicity. can -> cirrhosis and cancer

question

hepB and babies vs adults

answer

babies- weak IS, dec. symptomatic infection, inc. chronicity. adults- strong IS, so inc. symptomatic infection, inc jaundice, dec chronicity

question

IgM anti HBC

answer

marker of acute infection. IgG/total anti HBC= past marker of remote infection

question

how tell someone vaccinated to HepB

answer

if not have AB to core, but have HBs+

question

4 phaes chronic hep B

answer

1. immune tolerance phase: HBeAg+, high HBV-DNA, normal ALT. 2). immune clearence phase: + HBeAg, high HBV-DNA, high ALT. 3). non replication: --, low, normal. 4). HBeAg-/chronic hepatitis: --, high high (active inflamm)

question

HepB variants

answer

HBeAg+= WT. inc. viral load, inc infectivity. HBeAg- is mutation @ core promoter, poor respons to therapy

question

hepb drugs

answer

1* tenofovir and entecavir inhib replication, dec. R. first drug was Lamivudine, high R.

question

HepD

answer

needs HbsAg to survive. only get if 1). coinfect with HepB acute not chronic, or 2). in a chronic hep B superinfection carrier

question

HepC

answer

replicates competely in cytoplasm, is curable. 6-7 wk incub. dec. fatal. 75% chronic. 10% cirrhosis.

question

hep C markers

answer

anti HCV=marker of infection, not protective. can have reinfection. anti HCV and normal ALT and --HCV-> acute hepC, recovered, and is good

question

chronic HepC RFs

answer

>50, duration, Male, steatosis, alcohol, coinfect w hbv/hiv, ivdu, immigrate, tfusion. low risk are perinatal, piercing, hemodialysls, work, coke factors that are NOT RFs: HCV viral load, HCV genotype, ALT****. baby boomers high rates of hepc

question

hepc treatm

answer

IFNa (high SEs). 1. direct anti viral affect via 2'5' oligoadentylate synthetase. 2). immunomodulation. so big 2 drugs are PEG IFNa, Ribavarin. IFN- stage 1 decline rapid, inhibit viral replciation. stage 2 decline determines response- clearance of infected hepatocytes. good PEG IFN response if genotype 2,3, dec fibrosis, thin, white, non insulin R, il28b genotype

question

IL28b genotype

answer

wiht HepC- a snp- inc. clearence, inc. response, milder course.

question

Hep C types of ppl

answer

good if ur C/C, bad if T/C or T/T

question

Hep E

answer

fecal oral. 40d incub. fatal if preg. illness inc w age. inc. in TPlants

question

Hep types

answer

fecal oral- A,E. percutaneous- B,C,D. chronic B C D E. Acute A. Vaccine B E/

question

Hep drugs

answer

A- supportive/globulin/prophylaxis. B- PEG IFN, nucleoside inhibs. C- protease inhib. D- treat HepB. E- ribavarin

question

Hep A A's

answer

Acute, asymp, alone (no carriers.

question

Hep B B's

answer

Blood borne

question

Hep C C's

answer

chronic, cirrhosis, carcinoma, carriers.

question

Hep D D's

answer

defective, depend on HBV.

question

Hep E E's

answer

enteric, expectant moms, epidemics

question

viral v alcoholic hep

answer

viral- ALT> AST. alcoholic: AST> ALT

question

see bottom of last page hep lecture...

answer

...

question

answer

via spneu, HI, MCAT. give multiple ABs. chronic fluid collection in middle ear- conductive hearing loss-> get tympanostomy tube- clear out fluid. keep ear dry. can -> rupture, meningitis, mastoiditis, abscess, sigmoid sinus thrombus, facial nerve paralysis

question

otitis externa

answer

outer ear swollen, swimmers ear, pseudomonas. malig in diabetes- osteomyelitis of temporal bone

question

sinusitis

answer

blocked sinus w pus- spneu, HI, MCAT, mucor (if IC, get diab ketoacidosis, leuk, BMT) in frontal sinus: meningtis, brain abscess. in ethmoid sinus: orbital cellulitis. in sphenoid sinus: cavernous sinus thrombosis

question

foreign body kid

answer

kid w unilateral foul smelling pusy rhinorhrea

question

SAureus

answer

TSS. nasal packing like tampon-> exotoxin binds MHC2-PIL1+ IL2.

question

pharyngitis

answer

GAS, viruses, white on tonsils, abscess. viral- ebv mono +monospot test.

question

GAS

answer

RF, glomeruloneph, scarlet fever w strawberry tongue, rash.

question

ludwig angina

answer

disease of dental cavity, infection- cellulitis, inflamm of floor of mouth, submandiv space. polymicrobial w stap/strep/bacteroides- compress airway, pushes tongue up

question

epiglottitis

answer

HFlu type B, spneu, saureus, virus. hard to swallow, inc. on XR.

question

ramsey hunt syndrome

answer

herpes zooster orticus. 7,8* CN. facial palsy, auriciular vesicles, hearing loss, tinnitus, vertigo

question

HPV and head

answer

tonsil cancer type 16, recurrent respir papillomatosis- blocks airways.

question

HIV and head

answer

cervical LAD, cystic growths in parotid, thrush, kaposis, acute mono like HIV sero conversion syndrome.

question

neck mass

answer

suppuratve LAD- pus inside a LN. SA and GAS.

question

retropharyngeal abscess

answer

direct spread from tonsil/dental carries or TV/Potts disease. sore throat, fever, sneck, stridor, obstruct, mediastinitis, aspiration pneu, epidural abscess, jugular ven thromb, necrotiz fascitis, sepsis, carotid Art erosion.

question

bartonella neck mass

answer

not painful. IC, pleomorphic, G-, bacillus, wartin starry silver stain.

question

neck mass via mycobacteria

answer

MAC, kansasii, TB scrofula painless, firm, no pulm probs.

question

parotitis

answer

staph/mumps(also orchitis, pancreatitis, CNS)/HIV

question

J-H rxn

answer

syphillis- FTA-ABs is best for syph, VDRL not as good test

question

retrovirus GPs

answer

gp120 surface protein, gp41 transmemb gp- attach virus to cell. 41- fusion rec. 120-cd4rec.

question

GAG ENV POL

answer

gag- internal proteins. env- envelope glycoprotein. POL- RT polym, integrase, protease.

question

transecting proteins

answer

TAT for HIV for replication, TAX for HTLV.

question

HIV LTR

answer

-> TAR element. API. growth promoting, NFA, NFKB.

question

course outline M75 pg6

answer

see

question

ccr5, cxcr4...

answer

.........

question

HIV immunological changes

answer

dec CD4, dec IL2, inc CD8: cd4 ratio, inc CD8, inc. CD8 activation markers cd25and 38

question

hiv replication

answer

need primer trna- bind primer binding site, DNA hypbridze to RNA, neg strand made first, then + strand-> DS DNA w LTR, LTR has CA at both ends

question

HIV + ...

answer

+ECs-> kaposi. +Bcell->lymphoma. +Epithel cell-> carcinoma.

question

AZT

answer

~ T base- chain terminate . pyrimidine analog. inc. absorb- CNS oral toxic BM. dec viral loading by a log. good in combo therapy w RTIs and Protease inhibs is (P) in host compete w thymidine in DNA synthesis catalyzed by RT -> chain termination- use prophylaxis in babies. has a azido grp . inc. cd4 cells. nevirapine

question

HTLV

answer

TALL, myelopathy, inhib CD4 AND 8. TAX proteins- inc. IL2, IL2R, Tcell GFs. causes tropical spastic paraparesis in brain, TALL, leuk/lymphoma. give AZT, ifna.

question

toxoid vaccine used for

answer

dipth and tetanus

question

passive v active immun

answer

passive- immun serum globin, specific IG, monoclonal AB. active- inactivated (subunit/toxoid/peptide/plolysac/killed unit) or live (attenuated/hybrid/low virulent)

question

passive immun adv/disadv

answer

adv- inc amount of AB. dis- dec lifespan of ABs, hypersensit rxns, inc cost.

question

VZ IG

answer

igg to vz abs. prophylaxis for Tplant of kidney lung liver pancreas heart.

question

vaccina IG

answer

for smallpox w live virions. need to inhib infection if IC.

question

humanized monoclonal ABs

answer

for RSV, CMN, hep B

question

ribavarin

answer

for RSV. guanosine analogue.

question

mexlmusane c

answer

company- makes ig treatm for RSV. respigam, synagis (ABs to F protein) and numex no vaccine.

question

vaccines not to give in preg

answer

VZ/MMR- are alive, can pass to baby

question

non replicative vaccines

answer

no risk of infection. use w bact/virus. cant be attenuated, can -> recurrent ifnection, or are oncogenic.

question

adjuvants

answer

include alum and sqalene (HPV),

question

inactivated viral vaccines

answer

flu pollio hep A rabies

question

live vaccines

answer

polio MMRV adenovirus, yellow fever. orgs w limited ability to cause disease- avirulent and attentuated, get humoral and CMI. long lived immunity. are temp sensative can be hybrid. but dont give if pregnant, or can get interference.

question

vacine via recomb dna

answer

hepb, hpv.

question

PS vaccines to

answer

HI, spneu, n mening, only give if over 2. TCell indep, so no memory response which is via B cells, no anamnestic response either.

question

Dipth

answer

#1 choice to link to

question

mening vaccine

answer

has A C Y W 135 forms, no B form - xreact w self. but B is 50% of cases

question

polio vaccine sabin

answer

live oral not used in US local gut infection + inc. SIGA that inhib incoming WT polio. can infect if IS.

question

polio vaccine salk

answer

parenteral inactive dead. only inc. igG not IgA. if there was WT polio it could be amplified in gut and spread.

question

sabin vs salk

answer

sabin inhibs polio @ GI epithel via SIGA. salk inhib @ blood via igg.

question

flu mist

answer

dont use if IS or preg or under 2.

question

rotovirus vaccine

answer

live, intussception, has many serotypes

question

hpv vaccine

answer

L1 protein of HPV- marker. virus like particles + neutralizing epitopes. target hpv16,18. gardasil target hpv 6,11- genital warts.

question

structural analog AVs

answer

acyclovir, didanosine, ribavarin, ganciclovir.

question

acyclovir

answer

hsv 1,2. purine analog, requires viral coded posphokinase (Thymidine Kinase) to convert acyclovir mono(P). host converts to tri(P)-> is potent inhib of HSV DNA polym. and chain term.

question

gancyclovir

answer

cmv retinitis in AIDS. phosphorylated to active form by viral encoded PKinase. cmv dont encode TKinase. toxic.

question

ribavarin

answer

purine analog. RSV. measles mumps flu paraflu hepC, lassa. combo therapy w IFNa for hepC. Phosphoro to tri(P) via cell enzymes, inhibs GMP snythesis- inhibs R/DNA synthesis and mrna capping. is broad spectrum. looks like atp or gtp. also inc. toxicity! has lots of SEs.

question

nevirapine

answer

non nucleoside inhib of HIV RT. discovered by random binds to RT. inhibs catalytic site. no (P) needed. inc R.

question

protease inhibs

answer

end in AVIR. dec HIB burden. combo w AVs target RTs inhib cleavage of HIV proteins to produce mature HIV

question

ritonavir

answer

boosts other protease inhibs by inhib CYP3a3.

question

enfurvirtide

answer

fusion inhib- targets GP41

question

ccr5 antags

answer

marviroc and vicriviroc

question

raltegravir

answer

integrase inhibs

question

cidofivir

answer

nucleotide (Cytidine) analog attached P grp. in cells long time- inc. potent. for cmv Herpes poxvirus . inhib viral DNA polym, inhib growing dna chain

question

foscaret

answer

hiv, cmv. use w phosphonoacetic acid

question

arlidone

answer

fo picornavirus uncoating.

question

amantidine

answer

inhib uncoating and M2 ion channel- flu. inhib flu A not B. inc R best for prophylaxis. inhib disso c of M1 from nucleocapsid uncoating. inhb HA also

question

zanamivir

answer

inhaled- NA inhibs inhib release from host cell

question

oseltamivir

answer

oral- na inhibs inhib release from host cell

question

rifampin

answer

TB. also for poxovirus assembly

question

AV toxcity

answer

can be nonspecific, high toxic like ribavarin or v specific and low toxic like acyclovir.

question

IFN

answer

gp CKs from virus infected cells- metab response in uninfected cells which inhib viral infections in new cells. first line of defense. gives flu like symptoms while ur on it.

question

IFN inducers

answer

viruses, dsrna, rna analogues ( ssrna or ds dna or ssdna are NOT inducers), bacteria, endotoxin, mitogens.

question

IFN types

answer

alpha- made in leukocytes, 15 subtypes. beta- in fblasts. 1 subtype. ~ w alpha type. gamma- made in T cells response to mitogen=mphage activation factor. 1 subtype. inhib by acid, alpha and beta are stable.

question

IFN rec

answer

doest nee to enter cell, interacts w IFN rec on cell-> induces anti viral state.

question

iFN induces...

answer

2 enzymex are activated via DSRNA. 1. oligoadenylate synthase -> 2,5oligoA up to 10 residues from ATP, it activates endoribonuclease- egrade viral mrna. 2). PKinase-(P) and incatvates eukaryote eIF2.

question

gamma IFN

answer

inc. activity of NKs, cytotoxic T cells mphage phagocytic activity.

question

IFNs and MHC

answer

IFN inc MHC2 (gamma), MHC1 (alpha, beta, gamma). also transiet suppression of CMI.

question

alpha IFN does

answer

rhinovirus colds in nasal spray, laryngeal warts, hairy cell leuk, chronic hep B combi w lamivudine, chronic hep C combo w ribavarin, herpes keratitis, papilloma, hemorrhagic fever, rabies

question

IFNb does

answer

treat relapsing MSclerosis.

question

IFNg does

answer

CGD

question

IFN disadv

answer

need injection, SEs: fever, malaise, n, leukopenia, confusion, dep, hypoten, expensive

question

2 kinds STDs

answer

ulcerative (syph chancroid LVG, GI HSV), mucopurulent (Gon Chlam HSV)

question

neuro syph

answer

treatm ceftriaxone. meningovascular, parenchymous (paresis, argyll rob puil, optic atrophy), tabes dorsalis (ataxia, impotence, bladder, rombergs sign, CN2-7). gumma

question

ducreyi

answer

give azithromycin also cefriaxon, cipro, erythmomycin

question

LGV

answer

Buboe. small fleeting lesion, painless. LAD has groove sign painful . mostly unilateral. 2* stage systemic- fever chills HA mening, hepatitis, erythema nodosa, arthritis. give doxy erythromycin, drain.

question

answer

donavonosis. deep erosive lesion dont go away by self, get worse. bloody, painful, NO LAD. dx w wrights/giemsa stain- blue rods w polar granules w pink capsules in epithel cells (donovon bodies). doxy

question

tzanck

answer

herpes- multinucleate GCs.

question

gon/chlam

answer

puruent discharge, 4-14d after sex. ch less discharge than gon, more clear than yellow

question

gonhorr

answer

disseminates- tinosynovitis, ~ reiter syndrome in chlam. jt pain and swelling, opthalmitis. gam stain more specific in men. oral sex- gonococcal pharyngitis . chocolate agar

question

treat G+C

answer

azithro

question

chlamydia

answer

cervicitis, urethritis. treatm Doxy, not if preg, GI probs, also azithr.

question

other drip STDs

answer

itchy, cheesy- candida. white discarge, strawberry- trichomonas. mucopurulent- G+C. Clue cells- vaginosis

question

vaginitis

answer

mobi/uncus.

question

treatm for PID

answer

1). parenteral- cefoxitin/cefotetan and doxy. clinda and genta. amp and doxy. 2). oral- ceftriaxone, doxy, cefoxitin, metron, levofloxin

question

HPV treatm

answer

warts- give cryotherapy, imiquimid, polofilex

question

sensit/specific

answer

sensit: tp/tp+FN. specific: TN/TN+FP

question

aldehyde fuchsin dye for

answer

HBsAg

question

#1 cause liver tplant

answer

hepc

question

wnv

answer

flaviviridiae- enveloped SSRNA. mosquito bite- 3-14d. 1 wk sx. 80% mild (HA, n/v). <1% meningoencephal. see perivascular cuffing of inflam cells

question

cjd types

answer

sporadic, inherited, iatrogenic, variant- meat, tfuson

question

picornaviruses

answer

rhinoviruses and enteroviruses. naked small icosahedral capsid with SS + RNA

question

picornaviruses replication

answer

in cytoplasm, are cytolytic.

question

rhinovirus

answer

common cold. 100 serotypes. attach to ICAM-1. start in nose- sneezing, rhinorrhea sore throat HA malaise. peak 3 days, lasts 7 d. nasal SIGA transient, IgG lasts longer.

question

enterovirus

answer

R to environtal conditions, often asymp, via fecal oral, ingestion, fomites, inhale.

question

enterovirus grps

answer

poliovirus- 3 serotypes, 1+3 mostly. coxsackA. coxsackB. echovirus. enterovirus

question

poliovirus

answer

replicates in pharynx and lymphoid in SI. spread to blood and CNS. retrograde along nerves too. motor neurones ant. horn cells of SC. neuron death- paralysis. if brain stem, respir. paralysis (bulbar poliomyelitis)

question

typs of poliomyelitis

answer

90% asymp. 1). abortive- mild, febrile illness HA ST nv. 2. nonparalytic- aseptic, fever, HA, stuff neck, spont. resolution 3). paralytic- flacccid paralysis, brain stem, respir. possible

question

coxsack A

answer

herpangina w fever ST vesicles in oropharynx. H/F/Mouth dis

question

coxsack B

answer

pleurodynia- feer and pleuritic chest pain, myocarditis and pericarditis, pancreas probs

question

coxsack A+B cause

answer

aseptic mening, mild paresis, partial paralysism transient parlaysis. URT, minor febrile illness, rash

question

echoviris

answer

enteric cytopathic human orphan. -> aseptic mening, URT, febrile illness, rash, infant diarr, hemorrhagic conjunct. H/F/Mouth dis

question

Enterovirus 72

answer

IS HEPA.

STUDY

Cell Mediated Immune Response Life Threatening Conditions Low Grade Fever Pure Red Cell Aplasia

Med-Surg Nursing Ch. 27 (499-509) – Flashcards 98 terms

Candace Young

98 terms

Preview

Med-Surg Nursing Ch. 27 (499-509) – Flashcards

question

For the Trivalent Inactivated Influenza Vaccine, what it the route of administration, and what is the most common side effects?

answer

Given by injection IM Injection site reactions, pain, swelling, and redness

question

What is approved age for adminstrtion of the Inactivated Flu Vaccine?

answer

> 6 months old

question

The inactivated flu vaccine can be used in people that are at increased risk; these groups of people include?

answer

People at any age with chronic medical condition, residents of nursing homes and long-term care facilities, people who are immunocomprimised, Pregnant women

question

The live attenuated influenza vaccine is given by what route, and what are the most common side effects?

answer

Given by nasal spray runny nose, nasal congestion in all ages, fever in children ages 2-6 yr, and sore throat in adults

question

What age is the live attenuated influenza intended for?

answer

Approved for healthy people ages 2-49 yrs old

question

When is the live attenuated influenza vaccine contraindicated?

answer

Children 50 yr, Pregnant Women, Immunodefiency, Children adolescents receiving aspirin or other salicylates, medical conditions that place them at increased risk for complications from influenza (chronic cardiovascular, pulmonary, or neurologic diseases; diabetes mellitus, renal or hepatic dysfunction, hemoglobinopathies), HCP of high-risk patients because of risk of viral transmission from vaccine (should not care for patients for 7 days after vaccination)

question

What things would you teach your patient or caregiver regarding acute or chronic sinusitis?

answer

Get plenty of rest to promote recovery, keep well hydrated 6-8 glasses of water to loosen secretions, hot showers twice a day, use a steam inhaler 15 minutes of vaporization of boiled water, beside humidifier, or nasal saline spray to promote drainage, Apply warm damp towels around nose, cheeks, and eyes to ease facial pain, sleep with head elevated, follow precription regimen, analgesics for pain, decongestants/expectorants to releive swelling, antibiotics for infection, properly administer nasal sprays, perform large-volume nasal saline washes once or twice a day, do not smoke and avoid smoke exposure, if allergies predispose sinusitis, follow instructions regarding environmental control, drug therapy, immunotherapy to reduce inflammation and prevent sinusitis

question

When allergies predispose sinusitis, what would you teach the patient to help reduce sinus inflammation and infection?

answer

environmental control of allergens appropriate drug therapy

question

What is the initial treatment for sinusitis?

answer

symptom relief oral or topical decongestants to promote drainage, nasal corticostersteriods to decrease inflammation, analgesics for pain, and saline spray to relieve congestion

question

How long can you use a topical decongestant, and what might occur if you use it longer than the recommended timeframe?

answer

no longer than 3 days rebound congestion caused by vasodilation

question

What are saline irrigations use for?

answer

rinse the nasal passages, facilitate drainage, and decrease inflammation

question

Saline nasal spray is availble over the counter as a sterile solution in spray bottles, but can also be prepared at home using what method?

answer

1/4 teaspoon of salt dissolved in 8 ounces of tap water Patients may also add a pinch of baking soda to soften the effect of salt

question

How often should the nasal saline spray be administered?

answer

2 to 4 puffs at least 3 to 4 times a day

question

What is a alternative, more aggressive method in symptom relief of sinusitis?

answer

lavage with a squeeze bottle, neti pot, or syringe while leaning over the sink with mouth open Repeated full-syringe wash recommended at least once a day to wash out the secretions if they cannont be effectively removed with saline spray alone

question

When would antibiotics be prescribed for sinusitis?

answer

if symptoms worsen or persist longer than 10 days

question

What types of antibiotics are used for treatment of sinusitis?

answer

Amoxicillin as the first line drug of choice ir continued for 10 to 14 days to prevent the formation of antibiotic-resistant organisms. If symptoms do not resolve, antibiotic should be changed to a broader spectrum cephalosporin antibiotic.

question

How long would broad spectrum antibiotics be used for with sinusitis?

answer

4 to 6 weeks

question

Persistent and recurrent sinus complaints may require further treatment when medical therapy does not work. What is a more invasive method to corrent sinusitis?

answer

Nasal endoscopic surgery to relieve blockage caused by hypertrophy or septal deviation, which is an outpatient procedure perform using local anesthesia. Propel, a self expanding dissolvable implant, can be placed directly in the sinus during surgery to maintain postoperative patency and provide localized corticosteroid delivery directly to the sinus lining.

question

Nasal Fracture occurs as result of?

answer

Blunt trauma, icluding Automobile accidents, Falls, Sports injuries

question

Nasal Fractures can be prevented by?

answer

Protective equipment and protecting against falls

question

Complications assoicated with Nasal Fractures?

answer

Airway obstruction, Epistaxis, Meningeal tears causing cerebrospinal fluid (CSF) leakage, Septal hematoma, Cosmetic deformity

question

Two types of classifications of Nasal Fractures

answer

Simple Fractures and Complex Fractures

question

What type of nasal fracture is unilateral or bilateral and typically produces little to no displacement?

answer

Simple Fracture

question

What type of nasal fracture may involve subsequent damage to adjacent facial structures such as teeth, eyes, or other facial bones and may be seen with mid-facial trauma?

answer

Complex Fracture

question

Diagnosis of a Nasal Fracture is based on?

answer

Health history and Physical Exam

question

The clinical Manifestations of a Nasal Fracture include?

answer

Localized pain, Crepitus on palpation, Swelling, Ecchymosis, Cosmetic deformity, Epistaxis, Difficulty breathing out of nostrils, Facial deformity common, epistaxis may be the only initial sign

question

When inspecting the nose after nasal fracture, what would you need to note and assess?

answer

Patient's ability to breathe through each side of their nose Note any presence of edema, bleeding or hematoma Ecchymosis under the eyes, referred to as raccoon eyes, may suggest orbital or basilar skull fracture Inspect the nose for septal deviation, hemmorrhage, or clear fluid

question

What suggests that there is a CSF leakage after a nasal fracture, and what test is used to determine the presence of CSF fluid?

answer

Clear, pink-tinged, or persistant drainage after control of epistaxis suggest CSF leak Perform quick test near bedside to determine if glucose is present

question

When might you have to wait to repair a nasal fracture?

answer

when there is extensive swelling or until edema subsides, which may be 5 to 10 days

question

What are the goals of nursing management for nasal fractures?

answer

Maintain airway, keep pt in upright position Reduce Edema, apply ice to face/nose in 10 to 20 min intervals Reduce Pain, administer analgesics, acetaminophen if preferred over nonsterodial anti-inflammatory drugs NSAID or acetylsalicyclic acid aspirin for first 48 hrs to avoid prolonging clotting time Prevent Complications, nasal decongestants, saline sprays, humidifier can releive nasal stiffness, and encourage patient to quite smoking to maximize healing time Provide emotional support

question

When the nasal fracture is confirmed what are the methods to correct the issue?

answer

Goal is to realign the fracture using closed or open reduction and to ensure that a septal hematoma does not develop, since this increases the patient's risk for infection. Surgical procedure provides adequate airway and function of nose, and reestablishes the cosmetic appearance.

question

When correcting Epistaxis you should first use simple first aid measures. These measure include?

answer

Keep patient quite. Place the pt in the sitting position, leaning slightly forward with head tilted forward. Apply direct pressure by pinching the entire soft lower portion of the nose against the nasal septum for 10-15 mins. If it does not stop within 15-20 mins, seek medical assistance.

question

Medical Management of Epistaxis include?

answer

Apply vasoconstrictive agent, cauterization, or anterior packing. Pledgets (nasal tampon) with anesthetic solution (lidocaine) and/or vasoconstrictive agent such as cocaine or epinephrine; left in place for 10-15 mins. Silver nitrate may be used to chemically cauterize bleeding point. Thermal nitrate is reserved for more severe bleeding, which requires the use of local or general anesthesia.

question

What type of packing can be used for epistaxies if bleeding does not stop?

answer

Compressed sponges or Epistaxis balloons Both preferred over traditional Vaseline ribbon gaze because of ease of placement

question

How is packing inserted into the nares?

answer

It is advanced along the floor of the nasal cavity, the sponge expands with moisture and fill cavity and tamponade bleeding, provides pressure, Increases clot formation, protects nasal mucosa from further trauma

question

What are the complications associated with nasal packing?

answer

may impair the respiratory status, especially in older adults

question

What would you need to monitor in a patient with nasal packing?

answer

Respiratory rate, Heart rate and rhythm, Oxygen saturation using pulse oximetry (SpO2), Level of consciousness, Observe for signs of aspiration

question

What type of patient with nasal packing needs to be admitted to the hospital for close observation?

answer

any patient with posterior packing

question

Packing can be painful due to sufficient pressure and also predispose the patient to bacteria. What medication should a patient receive with nasal packing?

answer

Pts should receive mild analgesic for pain (acetaminophen with codeine) and antibiotic effective against staphylococci to protect against infection

question

How long is nasal packing left in place, and what must you do before and after removal?

answer

Nasal packing may be left in place for few days. Medicate the patient during removal to relieve discomfort. After removal, Cleanse the nares gently and Lubricate them with water-soluble jelly

question

What would you want to educate the patient on regarding home care for epitaxis?

answer

Avoid vigorous nose blowing, engaging in strenuous activity, lifting, straining for 4 to 6 weeks. Use of nasal spray and/or humidifier, to sneeze with mouth open, and to avoid the ise of aspirin containing products or NSAIDs

question

When does influenza season start and peak?

answer

Starts in September through April, and peaks November to March

question

What are the three stereotypes of Influenza?

answer

A, B, and C

question

What is the most common flu virus, most virulent, and infects a variety of animals, as well as humans?

answer

Influenza A

question

How are Influenza B and C similar?

answer

they are not divided into subtypes and only infect humans

question

What influenza causes regional epidemics and is milder than influenza A?

answer

Influenza B

question

What influenza causes a mild illness and dosen't cause an epidemic or pandemic?

answer

Influenza C

question

How often is the flu vaccine updated?

answer

annually, depending on virus strains identified by the CDC

question

When there is fewer changes in the flu, there are fewer cases resulting in the flu virus. Why does this occur?

answer

Since the flu only changed minorly the patient will have partial immunity to that flu strain, and will less likely be affected.

question

How is the influenza virus transmitted?

answer

Direct contact with infected animals, exposed to water, and surfaces or Droplet contact and inhalation or aerosolized particles

question

What is the incubation period for influenza?

answer

1 to 4 days

question

What is the peak transmission time for influenza?

answer

1 day before the onset of symptoms, continuing for 5 to 7 days

question

The onset of influenza is usually abrupt, with symptoms of?

answer

Systemic symptoms, Chills, Fever, Anorexia, Malaise, Generalized myalgia and Accompanied by Headache, Cough, Rhinorrhea, Sore throat

question

The physical finding of Influenza are usually?

answer

minimal, normal assessment on chest auscultation

question

What pulmonary complication may be associated with influenza?

answer

Dyspnea, and diffuse crackles

question

When influenza is uncomplicated, how long should the symptoms last?

answer

symptoms should subside within 7 days

question

What type of patient may experience weakness or lassitude that persist for weeks with influenza?

answer

Older adults

question

What symptoms can occur during the receovery of influenza?

answer

Hyperractive airways an chronic cough

question

What is the most common complication with influenza?

answer

Pneumonia, Primary influenza (viral) pneumonia, Experience gradual improvement of flu symptoms, then worsening cough and purulent sputum. Treatment with antibiotics usually effective if started early

question

What are important diagnostic factors associated with influenza?

answer

Health history, clinical findings, and other cases of flu in the community

question

What type of flu test involves detecting the virus in the nasal secretions, can be compeleted in physician office in less than 30 mins, results are available same day, help differentiate flu from other viral/bacterial infections, is more effective if performed within 48 hours of symptoms, and determines if an antiviral medication is an option?

answer

Rapid Flu Test

question

What are the disadvantages of the Rapid Flu Test?

answer

Miss some cases or occasionally be positive when person does not actually have flu

question

What lab test is the gold standard to diagnosis the flu, with results in 3 to 10 days, can identify viruses A, B, and other respiratory ciruses, and which strains are present, and is used as data to formulate the seasonal flu vaccine?

answer

Viral Cultures

question

What is the most effective strategy in combating the flu virus?

answer

Prevention

question

What are the two types of Flu Vaccines?

answer

Inactivated and Live Attenuated

question

What is the best time of year to receive the flu vaccine?

answer

September before exposure to the flu, because it take 2 weeks for full protection to occur

question

When is the Flu vaccine contraindicated?

answer

Guillain-Barre syndrome within 6 wks post flu vaccine, Hypersensitivity to eggs

question

What are the primary Nursing Goals associated to influenza?

answer

relief of symptoms and prevention of secondary infection

question

Unless the patient is high risk or complcations arise, what type of treatment for influenza is suggested?

answer

Supportive therapy is only necessary, including Rest, Hydration, Analgesics, Antipyretic, and Older adults and those with chronic illness may require hospitalization

question

What two types of medications can be used to prevent and treat influenza A and B, and should be given within 2 days of onset, but can be started later based on clinical judgement?

answer

Zanamivir (Relenza) an inhaler and Oseltamivir (Tamiflu) as oral capsules. Neuraminidase inhibitors that help prevent the virus from budding and spreading to other cells

question

What interventions are associated with acute viral rhinitis?

answer

Rest, Fluids, Proper diet, Antipyretics, Analgesics

question

What methods may help alleviate a sore throat?

answer

Warm salt water gargles, Ice chips, Throat lozenges, Throat sprays

question

What medications help reduce post nasal drip, cough, nasal obstruction, and nasal discharge?

answer

Antihistamines and Decongestants

question

What complications are associated with acute viral rhinitis?

answer

Pharynigitis, Sinusitis, Otitis media, Tonsillitis, Lung infections

question

When are antibiotics indicated for acute viral rhinitis?

answer

only when symptoms of complications are present, since antibitoics are not effective against viruses, and may produce antibiotic resistant bacteria If symptoms last longer than 10 to 14 days an acture bacterial sinusitis may be present, and antibiotics are prescribed

question

What is included in patient teaching associated with acute viral rhinitis?

answer

Recognize secondary infection, green, purluent drainage is a later sign and not indicative of bacterial infection, patients with chronic illness or compromised immune should avoid crowded situations and other people with cold symptoms, teach patients with chronic respiratory disease to report sputum changes, increased SOB, and chest tightness.

question

What are the symptoms of secondary bacterial infection?

answer

Temp higher than 100.4, Tender, swollen glands, Severe sinus or ear pain, and Worsening symptoms

question

In patients with pulmonary disease, signs of a infection include?

answer

change in consistency, color, or volume of sputum

question

What can help prevent the direct spread of acute viral rhinitis?

answer

Frequent hand washing and avoid face to face contact

question

What is the most important step in nursing management of allergic rhinitis?

answer

Identify and avoid triggers of allergic reactions, Instruct patient to keep diary of times when reactions occur and activities, patients are often more aware of triggers than you, patients are often more aware of intermittent allergens pets than persistent allergens dust mites, cockroaches, mold

question

What are the goals associated with the use of medications when combating allergic rhinitis?

answer

Reduce inflammation associated w/ symptoms, Reduce nasal symptoms, Minimize associated complications, Maximize quality of life

question

What medications are used for allergic rhinitis?

answer

H1 antihistamines Second generation preferred over first generation because of non-sedating effect, Advise to increase fluid intake to reduce adverse symptoms, Corticosteroids, Cromolyn, Decongestants If symptoms aren't reduce using one medication, and two drug combination using a oral and intranasal medication may be helpful

question

When the is a specific, unavoidable allergen that is detected or drugs seem to be ineffective that the patient may receive what type of therapy?

answer

Immunotherapy Allergy Shots

question

How often are allergy shots administered and what is the goal? What are alternative routes of administration?

answer

Involves controlled exposure to small amounts of the known allergen through frequent weekly injections, goal to decrease sensitivity Can also be administered sublingual or intranasal

question

What is Rhinoplasty?

answer

surgical reconstruction of the nose, performed for cosmetic reasons or improve airway function with trauma or developmental deformities result in nasal obstruction

question

What must be conducted before rhinoplasty surgery?

answer

Assess the patient's expectations of the surgery, Actual or perceived alterations of body image can affect self esteem, Computerized images can be used for patient's appearance before and after surgery, Images also used to help pt decide whether to underago surgery, and Explain expected results truthfully to avoid disappointment

question

During rhinoplasty surgery, what type of anesthesia is used and how is it performed?

answer

Performed as outpatient procedure using regional or general anesthesia, Nasal tissue added or removed, Nose may be lengthened or shortened, Plastic implants may be used to reshape nose, Incisions typically inside the nose. Sonic Rhinoplasty incorporates the use of an ultrasonic device to gently aspirate bone, enabling a refined cosmetic result

question

Nasal packing and an External plastic slpint may be applied after rhinoplasty. What do they help protect or prevent after surgery?

answer

Nasal packing may be inserted to apply pressure and prevent bleeding or septal hematoma formation. External plastic splint protects and supports the new shape of the nose during the healing

question

When is nasal packing removed after surgery, and how long is the splint left on, regarding rhinoplasty?

answer

The nasal packing is removed the day after surgery, the splint is left on for approximately 1 week

question

Before rhinoplasty the nurse should instruct and encourage the patient to do what?

answer

Instruct pt not to take aspirin containing drugs or NSAIDs for 2 weeks prior, Encourage preoperative smoking cessation to promote postoperative wound healing

question

What nursing interventions are associated with immediate care after rhinoplasty?

answer

Maintenance of the airway, Assessment of respiratory status, Pain management, Observation of surgical site for bleeding, infection, and edema

question

Patient teaching with rhinoplasty is important to help the patient detect early and late complications associated with nasal surgery. What should the nurse teach the patient?

answer

Patients typically experience temporary edema and ecchymosis, Cold compresses and elevation can help minimize swelling and discomfort. Activity restrictions to prevent bleeding and injury, No nose blowing, Swimming, Heavy lifting, Strenuous exercise. Full cosmetic result may take up to 1 year

question

An airway emergency is a medical emergency caused by?

answer

aspiration of food or foreign body, allergic reactions, edema, and inflammation caused by infections or burn, peritonsillar or retropharyngeal abcesses, malignancy, laryngeal or tracheal stenosis, and trauma

question

Symptoms of an airway obstruction include?

answer

choking, stridor, use of accessory muscles, suprasternal and intercostal reactions, flaring nostrils, wheezing, restlessness, tachycardia, cyanosis, and change in LOC

question

What are the two types of airway obstructions?

answer

Partial or complete

question

What can a complete airway obstruction result in?

answer

permanent brain damage or death if not corrected in 3 to 5 minutes

question

What interventions are associated with reestablishing a patent airway?

answer

the obstructed airway maneuver Heimlich, cricothyroidotomy, endotracheal intubation, and tracheostomy

question

Unexplained or recurrent airway obstructions would indicate the need for additional tests, what are these tests?

answer

chest x-ray, laryngoscopy, bronchoscopy

STUDY

Cell Mediated Immune Response Microbiology Public Health

Epidemiology & Infection Control – Flashcards 25 terms

Claire Scott

25 terms

Preview

Epidemiology & Infection Control – Flashcards

question

Ignaz Semmelweis was A. considered the father of infection prevention B. showed washing hands could prevent the spread of disease C. not taken very seriously by doctors D. All of the abover

answer

question

Epidemiology is the study of...

answer

the frequency and distribution of diseases in the population

question

A disease that can spread from person to person is known as... A. An epidemic B Noncommunicable C. An outbreak D. Communicable

answer

question

Measles, colds, and influenza are examples of A. communicable diseases B. secondary cases C. Common sources D. Non communicable diseases

answer

question

Secondary cases A. are when a disease is spread through an object B are when a disease is spread to another person C. only happen in communicable diseases D. A and C E. All of the above

answer

question

Food and bio-terrorism A. are common sources B. are causes of non communicable diseases C. are propagated epidemics D. A and B

answer

question

A disease that is spread through objects it called A Communicable B Non communicable C Pandemic D Propagated endemic

answer

question

The normal rate of a disease A endemic rate B disease rate C attack rate D incidence rate

answer

question

When the number of disease cases rises about the normal rate it is called... A Contagious B an epidemic C evolving D acute

answer

question

When a disease rises above the normal rate in a local area it is called A an outbreak B a common source C a pandemic D a plague

answer

question

When a disease rises about its normal rate world wide it is called... A an outbreak B a common source C a pandemic D a plague

answer

question

The rate of cases per exposed population A morbidity rate B prevalence C attack rate D endemic rate

answer

question

The number of non fatal cases A. Morbidity rate B. Attack rate c. Incidences D. Mortality rate

answer

question

The number of deaths A. Endemic rate B. Attack rate C. Morbidity D. Mortality rate

answer

question

The ratio of deaths to cases A. Attack rate B. Case fatality rate C. Incidences D. Mortality rate

answer

question

New cases per population over a given time period A. Endemic rate B. Incidences C. Prevalence D. Outbreak

answer

question

Total cases per population at one point in time. A. Endemic rate B. Incidence C. Prevalence D. Outbreak

answer

question

If a disease is highly contagious has a high a. Attack rate B. Prevalence C. Morbidity rate D. Mortality rate

answer

question

Acute diseases have A. High incidence, high prevalence B. High incidence, low prevalence C. Low incidence, low prevalence D. Low incidence, high prevalence

answer

question

Chronic diseases have A. High incidence, high prevalence B. High incidence, low prevalence C. Low incidence, low prevalence D. Low incidence, high prevalence

answer

question

What are the different types of disease transmission? a. Direct contact b. Fomites C. Vertical D. Droplets E. All of the above

answer

question

The natural habitat of the disease A. fomite B. droplet C reservoir D carrier

answer

question

Transmission from mother to child as a fetus or through breast feeding. a. Direct contact b. Fomites C. Vertical D. Droplets

answer

question

Transmission through secondary objects called fomites. a. Direct contact b. Indirect contact C. Vertical D. Droplets

answer

question

Transmission through saliva a. Direct contact b. Fomites C. Vertical D. Droplets

answer

STUDY

Cell Mediated Immune Response Host Defense Mechanisms Infectious Disease Long Term Care Facilities Tuberculin Skin Test

Exam 1 – Microbiology Definitions – Flashcards 49 terms

Mya Day

49 terms

Preview

Exam 1 – Microbiology Definitions – Flashcards

question

How is Tuberculosis transmitted?

answer

Droplet Nuclei via coughing, highly communicable

question

How is the tuberculosis primary infection acquired?

answer

the person inhales the organisms and they multiply in the alveolar macrophages unaffected by the immune system
Hypersensitivity and cell-mediated immunity develop in 2-6 weeks

question

What are the typical symptoms of tuberculosis?

answer

development of a tuberule (microscopic granuloma) in the lung

question

What is reactive tuberculosis?

answer

occurs in the lung apex via formation of pulmonary cavities

question

What is the pathogenesis of tuberculosis

answer

chronic fever, weight loss, night sweats, blood cough along with an extra-pulmonary disease (dissemination to bones and CNS)

question

How is tuberculosis diagnosed?

answer

skin test (PPD) which measured delayed-type hypersensitivity to tuberculoprotein. Tuberculosis can also be diagnosed by serodiagnosis in which the cell-mediated immune response is measured in whole blood samples inoculated with mycobacterial antigens

question

What is the treatment for tuberculosis?

answer

combined prolonged drug therapy to prevent resistance (Isoniazid, Rifampin, Ethamtubol and Pyrazinamide), treatment must be directly observed therapy (watch the patient take his drugs)

question

What is the clinical significance of NTM?

answer

bacteria can cause non-communicable chronic pulmonary diseases, disseminated diseases and cutaneous infections.

question

What are the unique characteristics of mycobacteria

answer

growth rate and recovery time and pigment production in relation to light

question

What are the 7 safety precautions to be followed while working in a mycobacteria laboratory?

answer

(1) negative pressure room (2) biological safety cabinet (3) face mask (4) safety cups for centrifugation (5) splash-proof discard containers (6) disposable loops/needles and (7) proper disposal of waste

question

What is used to digest mycobacteria for processing?

answer

NALC- N-acetyl-L-cysteine

question

What is used to decontaminate mycobacteria for processing?

answer

Sodium hydroxide or benzalkonium chloride and oxalic acid

question

What is used to concentrate mycobacteria for processing?

answer

centrifuge

question

What is used to stop the decontaminate process?

answer

phosphate buffer

question

Why do you need to digest, decontaminate and concentrate mycobacteria specimens?

answer

specimen when plated with be overgrown with normal flora.

question

What is the procedure of the auramine-rhodamine fluorochrome stain?

answer

heat fix the slides then flood with auramine-rhodamine fir 15-20 minutes, rinse with DI water, decolorized with 0.5% acid-alcohol for 2-3 minutes, rinse with DI water, flood with potassium permanganate for 2-4 minutes, rinse and allow to dry

question

What are the advantages to the auramine-rhodamine stain?

answer

Detection is enhanced against a dark background and the slide can be viewed at a lower magnification allowing for visualization of more fields at one time. Another advantage is that you can re-stain with ziehl-nelson to confirm right on the same slide, you do not need a fresh slide

question

What are the disadvantages to the auramine-rhodamine stain?

answer

rapid growers do not always appear fluorescent and you need to confirm with a ziehl- nelson stain. The stained bacteria can also float into the oil and off the slide yielding a false negative

question

What is the procedure for the Ziehl-neelsen stain?

answer

heat fix the smear to the slide, flood the slide with carbol fuchsin stain and steam the slides for 1 minute, keep stain on slides for 4-5 minutes, rinse, decolorize with 3% acid-alcohol, rinse, flood with methylene blue for 1 minute, rinse, and let dry. Red is positive for ziehl-neelsen

question

What is the procedure for the kinyoun stain?

answer

The procedure is heat fix the slide, flood with carbol fuchsin for 5 minutes, rinse, decolorize with 3% acid- alcohol, rinse, and flood with methylene blue for 1-3 minutes, rinse, let dry.

question

What is the Runyon classification?

answer

based on growth and pigment production and is used for NTM

question

What are schotochromogens?

answer

develop pigment in the dark or the light

question

Examples of schotochromogens

answer

M. scrofulaceum and M. gordonae

question

What are photochromogens?

answer

form pigment following exposure to light after being grown in the dark

question

examples of photochromogens?

answer

M. kansasii, and M. marinum

question

What are nonphotochromogens?

answer

nonpigmented whether grown in light or dark

question

examples of nonphotochromogens?

answer

M. avium-intracellulare (MAC, MAI)

question

Egg-based solid medias

answer

Lowenstein-Jensen (inhibits normal flora), Lowenstein-Jensen Gruft modification (added antibiotics) or mycobactosel (antibiotics)

question

Serum/agar based solid medias

answer

middlebrook 7H10/7H11

question

liquid media

answer

Middlebrook

question

The arylsulfatase test principle

answer

used to identify potentially pathogenic rapid growers, The enzyme arylsulfatase is present in some mycobacteria and the test is used to determine how fast the bacteria can break down phenolphthaliein disulfate into phenolphthalein which forms a pink color in the presence of sodium bicarbonate.

question

Which bacteria are arylsulfatase positive?

answer

M. fortuitum and M. chelonae and slow-growing M. marinum and M. szulgai (14 days)

question

The catalase test principle

answer

Most mycobacteria produce catalase which can split hydrogen peroxide into water and oxygen. The test can be used semi-quantitatively in that if the bacteria can produce 45 mm of bubbles in a test tube is in one group of mycobacteria and if it cannot it is another group. The ability of the catalase enzyme to remain active after heating also separates mycobacteria

question

Which bacteria are catalase negative?

answer

M. tuberculosis, M. bovis, M. gastri and M. haemophilum

question

The iron uptake test principle

answer

utilized to identify rapidly growing mycobacteria capable of converting ferric ammonium citrate to an iron oxide. An LJ slant is inoculated with the organism incubated until visible growth develops, aqueous ferric ammonium citrate added, and the slant incubated for up to 21 days at 37°C. Positive is reddish brown color in the colonies indicates production of iron oxide and Negative shows no color change.

question

The niacin accumulation test

answer

bacterium lacks the enzyme necessary to convert niacin to another metabolite in the coenzyme pathway. A positive test is yellow, a negative is clear liquid.

question

Which bacteria is niacin accumulation positive?

answer

M. tuberculosis

question

The nitrate reduction test principle

answer

The presence of nitrate is detected by production of a red colored product on the addition of several reagents. Development of a pink-red color indicates the presence of nitrite, demonstrating the ability of the organism to reduce nitrate to nitrite. If there is no color then the organism cannot reduce nitrite

question

Which bacteria is nitrate reduction positive?

answer

M. tuberculosis, M. kansasii, M. szulgai and M. fortuitum

question

Tween 80 hydrolysis test principle

answer

detect lipase that is able to hydrolyze Tween 80 into oleic acid and polyoxyethyated sorbitol

question

Which bacteria are tween 80 hydrolysis positive?

answer

Mycobacteria that are positive for Tween 80 hydrolysis are non-pathogenic, slow-growing scotochromogens and nonphotochromogens

question

Tellurite reduction test principle

answer

detect species that can reduce potassium tellurite at variable rates. If the bacteria can reduce potassium tellurite in 3-4 days, it is M. avium complex. All rapid-growers reduce tellurite in 3 days.

question

Inhibition of TCH test principle

answer

used to distinguish M. bovis from M. tuberculosis because M. bovis cannot grow in the presence of TCH.

question

The molecular methods used to identify mycobacteria

answer

DNA hybridization, amplification with reserve hybridization, amplification and restriction enzyme analysis or DNA sequencing and DNA microarrays.

question

Susceptibility testing methods for M. tuberculosis

answer

The proportion method uses standardized inoculums (100-300 colonies) to inoculate the agar-based media which contains antibiotics. It is incubated for 3 weeks and if more than 1% of the inoculums survive it indicated resistance. There is broth based susceptibility testing which take 5 days and probes for resistance genes

question

Susceptibility testing methods for NTM

answer

MIC methods with aminoglycosides and sulfonamides.

question

How do you process a sterile specimen?

answer

centrifuge and use sediment, screen by AFB smear and inoculate one liquid media and one solid media.

question

How do you process a non-sterile specimen?

answer

Liquefaction (NALC), decontamination (NaOH), neutralization (buffer or water), centrifugation, screen by AFB smear and inoculate one liquid media and one solid media.

question

What is the tuberculin skin test?

answer

used to measure delayed-type hypersensitivity to tuberculoprotein (PPD). A positive test indicates that the person was once infected at some time with M. tuberculosis or cross-reacting strain. The value of the test depends on the incidence of primary infections.

STUDY

Biology Cell Mediated Immune Response Fecal Oral Transmission Microbiology Microbiology For Health Sciences Mouth And Throat

Microbiology Final Exam Test Questions – Flashcards 148 terms

Noel Macdonald

148 terms

Preview

Microbiology Final Exam Test Questions – Flashcards

question

What is pneumococcal meningitis caused by?

answer

Streptococcus pneumoniae

question

Where is Streptococcus found normally?

answer

In the throat. Part of the normal microbiota.

question

This is a Gram+ lancet-shaped coccus. Often seen in pairs.

answer

Streptococcus Pneumoniae

question

Many strains of this bacteria are protected from phagocytosis by a polysaccharide capsule.

answer

Streptococcus Pneumoniae

question

What does Streptococcus pneumoniae commonly cause?

answer

Otitis media, sinusitus, and pneumonia...any of which can precede pneumoncoccal meningitis.

question

What is damage in Meningitis largely due to?

answer

The sever inflammatory response. Causes brain swelling and clots form in capillaries and block blood supply.

question

What is the most deathly form of meningitis?

answer

Streptococcus pneumoniae

question

What is used to treat pneumoncoccal meningitis usually?

answer

Penicillin

question

This bacteria is frequently responsible for epidemics of meningitis.

answer

Neisseria meningitidis

question

Where is Neisseria meningitidis usually found?

answer

commonly part of the normal respiratory microbiota.

question

Symptoms of this are similar to that of pneumococcal meningits, but also may include petechia. (purplish spots on the skin.)

answer

Neisseria meningitidis

question

this can lead to septic (endotoxic) shock

answer

Neisseria meningitidis

question

A gram - encapsulated diploccus. Like Niesseria gonorrhoeae, it can vary in its anitgens and acquire DNA through gene transfer easliy.

answer

Neisseria meningitidis

question

These bacteria attach by pili to mucous membranes and multiply. Proteins in their outer membranes all the bacterial cells to pass through the epithelial lining in the resp tract and into the blood to the meninges. (rare)

answer

Neisseria meningitidis

question

This bacteria releases blebs of the outer membrane and the endotoxin causes vasodilation and capillary leakage leading to drop in blood pressure and septic shock.

answer

Neisseria meningitidis

question

Avoid phagocytosis with capsule

answer

Neisseria meningitidis

question

Person to person transmission via respiratory droplets. Easy transmission in crowded, stressed populations

answer

Neisseria meningitidis

question

Meningitis is the most common result of the food-borne disease of this bacteria

answer

Listeria monocytogenes

question

Infections by this are usually mild in most healthy people. Fever and muscle aches and sometimes nausea or diarrhea.

answer

Listeria monocytogenes

question

Pregnant women who become infected usually miscarry or deliver terminally ill babies.

answer

Listeria monocytogenes

question

A motile, non-spore forming, facultative anaerobis, gram + rod that can grow at 4 degrees celcius. (Can grow on vaccum packed refrigerated foods)

answer

Listeria monocytogenes

question

Mode of entry of Listeria monocytogenes is usually what?

answer

The GI tract

question

These bacteria penetrate the intestinal mucosa through the M cells and into the Peyers patches and into the blood.

answer

Listeria monocytogenes

question

Can be killed with penicillin, but you must catch it quickly, especially in pregnant women.

answer

Listeria monocytogenes

question

This food borne disease can be killed by thouroughly cooking meat. Soft cheeses may carry as well as raw veggies.

answer

Listeria monocytogenes

question

Disfigurement, loss of limbs, and blindness can result from this bacteria.

answer

Mycobacterium leprae

question

Aerobic, rod-shaped, acid fast bacteria. Grows very slowly with a generation time of about 12 days.

answer

Mycobacterium leprae

question

Preferentially infects peripheral nerves. From there the course depends on the persons immune system.

answer

Mycobacterium leprae

question

When the cell-mediated immunity succeffully stops the proliferating bacteria Mycobacterium leprae, the disease is called what?

answer

tuberculoid leprosy

question

When cell-mediated immunity fails to develop or is suppressed.

answer

lepromatous leprosy

question

This bacteria causes a severe form of intoxication that can eventually lead to paralysis.

answer

Clostridium botulinum

question

What does the exotoxin produced by C.botulinum do? What type of toxin is it?

answer

It is an A-B toxin.
The A portion enters the nerve cell and inactivates proteins that regulate the release of neurotransmitter.
The B portion binds to specific receptors on the motor nerve endings.

question

This is a strictly anaerobic Gram +, spore-forming, rod-shaped bacterium that can cause paralysis if you ingest it. (via its' exotoxin)

answer

Clostridium botulinum.

question

There are several types of neurotoxin that Clostridium botulinum produces. What are three that are key to human cases?

answer

The A, B, and E type strains

question

How does Clostridium botulinum produce paralysis?

answer

the toxin attaches to the motor neurons blocking transmission of signals to the muscles.

question

Where does intestinal botulism usually occur?

answer

in infants. (Honey!)

question

In what way does Clostridium botulinum usually cause death?

answer

it causes respiratory paralysis.

question

Epidemic viral encephalitis is usually caused by what?

answer

Arboviruses (arthropod borne viruses)

question

THis is a group of enveloped, single stranded RNA viruses transmitted by insects, mites or ticks

answer

Arboviruses

question

What are some examples of arboviruses?

answer

Lacrosse encephalitis
West Nile encephalitis
eastern and western equinine viruses.

question

What type of bacteria is Staphylococcus aureus?

answer

It is a gram+ cocci in clusters. Coagulase positive. Facultative anaerobes. pyogenic (pus producing)

question

Where does Staphylococcus aureus normally reside?

answer

It is part of the normal microbiota. Up to 20% of healthy people carry it in their nose.

question

What can Staphylococcus aureus cause in the body?

answer

It plays a role in hair follicle infections(boils and carbuncles), Food-borne intoxication, Toxic shock syndrome, and is the leading cause of wound infections.

question

What is the medical significance of Escherichia coli? (E. coli)

answer

Normal microbiota of intestinal tract. Some strains cause
1. urinary tract infections
2. types of intestinal disease
3. some cause meningitis in newborns

question

What type of bacteria is E. coli?

answer

A gram - rod

question

What is an exotoxin?

answer

A protein that a pathogen produces that has very specific damaging effects

question

What does STEC stand for? What is the most common one? What does it cause?

answer

1. Shiga-toxin producing E.coli
2. The most common strain is 0517:H7
3. It causes colonization in the large intestine and leads to Fever, cramps, bloody diarrhea, and some hemolytic uremic syndrome.

question

What are ETEC? What do they cause?

answer

Enterotoxigenic E.coli. THey make pili that allow them to colonize the small intestine. secrete enerotoxins.

question

WHat are EIEC? What do they cause?

answer

Enteroinvasive e coli.
They invade the intestinal epithelium and cause disease similar to shigellosis.

question

What are EPEC? What do they cause?

answer

Enteropathogenic E.coli.
They produce pili that allow them to colonize the small intestine where they inject effector proteins that cause A/E lesions.

question

What are EAEC? What do they cause?

answer

Enteroaggregative E.coli. THey have pili and adhere to intestinal epith. They grow in characteristic aggregations in a thick mucous associatec biofilm. They produce enterotoxins and cytotoxins that damage cells and cause an inflammatory response.

question

DAEC? What do they cause?

answer

Diffusely adhering Ecoli. like EAEC, but they grow as a diffuse layer.

question

What does Streptococcus pyogenes cause?

answer

Strep throat, scarlet fever, wound infections(Flesh-eating disease).

question

What type of bacteria is Streptococcus pyogenes?

answer

a gram + coccus that grows in chains. Characterized by the A carb in the cell wall.

question

What are some of the mechanisms S.pyogenes uses to evade host response?

answer

a special adhesin to attach, M protein which also interferes with phagocytosis,

question

What do Psuedomonas aeruginosa infections cause?

answer

Opportunistic pathogen. Widespread in environment. health-care assoc infections, and outside hospital. Produces two pigments that color wounds green.

question

What type of bacteria is Pseudomonas aeruginosa?

answer

an aerobic, gram- rod with a single polar flagellum.

question

This type of bacteria is a non-invasive, anaerobic gram+ rod that produces am extoxin that prevents inhibitory neurons from releasing their neurotransmitter. (musles contract without control)

answer

Clostridium tetani

question

This is the exotoxin produced by C. tetani

answer

tetanospasm

question

This bacteria causes pain and swelling in wound infections, followed by discharge of a thin brown bubbly fluid and dark discoloration of overlying skin. THe toxin causes tissue necrosis.

answer

Clostridium perfringens

question

This is an alpha toxin producing anaerobe

answer

C. perfringens

question

What does C. perfringens produce?

answer

Clostridial Myonecrosis (Gas Gangrene)

question

How do you avoid/ fix gangrene?

answer

Clean wounds and remove dead tissue asap so that it doesn't have space to produce toxins

question

What are the most common ways wound infections occur?

answer

they happen easily in hospitals where the skin is broken. THey usually happen from normal microbiota of the environment.

question

What are the two bacteria that cause the most wound infections?

answer

S.aureus and S. epidermidis

question

what property of S. epidermidis help it to colonize plastic materials used in medical procedures?

answer

It binds to fibronectin the blood protein that quickly coats surgical implants in the body.

question

This is a Beta- hemolytic gram + chain forming, aerotolerant bacteria

answer

S. pyogenes

question

This protein also binds fibronectin like S.epidermidis. (An F protein)

answer

S. pyogenes

question

Strains of this produce exotoxin A, A superantigen that causes toxic shock and exotoxin B which is a protease that destroys tissue

answer

Strains of S. pyogenes

question

What is the bacteria that causes severe infection in burns that has a greenish tint?

answer

P. aeruginosa

question

This is a gram- facultatively anearobic coccobacillus. Most isolates have capsules. It usually causes infections due to animal bites.

answer

Pasteurella multocida

question

If untreated, bite wounds infected by this bacteria can cause bacteremia leading to endocarditis or meningitis.

answer

Pasteurella multocida

question

Cat scratch disease is caused by this curved, gram- rod.

answer

Bartonella henslae

question

THis is a short, curved, gram-, macroaerophilic bacterium that can cause peptic ulcers. It has multiple polar flagella covred by sheaths.

answer

Helibacter pylori

question

Infection by this bacterium can persist for year or even life. they produce urease(an enzyme that converts urea to ammonia) and burrow within mucous

answer

Helibacter pylori

question

What bacteria causes dental caries?

answer

Streptococcus mutants

question

these are gram+ cocci that live only on teeth.

answer

streptococcus mutants

question

an association of these three bacteria contribute to periodontal disease.

answer

1.porphyromonas gingivalis,2. Treponema denticola and 3.Tannerella forysthia

question

This is a ds enveloped virus that contains linear DNA. There are two types of the virus. One causes oral infections (cold sores) and the other causes genital infections(herpes)

answer

HSV-1 and HSV-2 Herpes Simplex Virus

question

WHy does HSV-1 cause reccurent cold sores?

answer

Because its non infectious DNA persists in sensory nerves and the DNA becomes the source of infectious virions that are carried to the skin or mucous membranes causing sores.

question

this type of toxin involved in intestinal infections causes water and electrolytes to flow from intestinal cells.

answer

enterotoxins

question

This type of toxin in intestinal infections causes cell death. some types can be absorbed into the blood stream resulting in systemic effects.

answer

cytotoxins

question

Characteristic damage caused when bacteria inject proteins that rearrange actin filaments resulting in the replacement of microvilli on the intestinal surface with a thick structure or "pedestal" under the bacterium.

answer

Attaching and effacing (A/E lesions)

question

What is the third way bacterium attack intestinal cells?

answer

through cell invasion. They go into and take over the cell.

question

This bacterium causes potentially fatal diarrhea. (watery diarrhea) Person can lose up to 20 liters a day! Rice water stool. Loss of fluids and electrolytes can cause death without oral rehydration therapy.

answer

Cholera caused by Vibrio Cholerae

question

This bacterium in killed by stomach acid, but if enough are ingested it can get in a produce an enterotoxin that activates ion transport channels causing chloride and other electrolytes to exit the cells.

answer

Vibrio cholerae

question

THis toxin in an A-B toxin. The b portion attaches irreversibly to receptors on the microvilli of epithelial cells ,the a (active) portion enters the cell and activates G prtoeins that usually regulate the in and outs of the cell.

answer

Vibrio cholerae

question

How are most intestinal infections spread?

answer

Via the fecal-oral route

question

These are gram- rods that classically cause dysentery.

answer

Shigella (S. dysenteriae)

question

THis species invades intestinal epithelial cells causing a strong inflammatory response.

answer

Shigella

question

Some strains of this produce a potent cytotoxin known as a shiga toxin(A-B toxin) It is responsible for HUS (hemolytic uremis syndrome)

answer

Shigella dysenteraie

question

This causes red blood cells to break up in tiny blood vessels resulting in anemia and kidney failure

answer

HUS (hemolytic uermic syndrome)

question

What two things can cause HUS?

answer

Shigella dysenterae and some E coli strains

question

This bacterium is not motile by itself but over takes the actin of the cells it invades and causes the cells to run into other cells and spread infection

answer

shigella syseteriae

question

This is a gram- rod that induces uptake by epithelial cells in the region btwn th esmall and large intestine. Bacteria multiply in the phagosome and then discharge at the base of the cell. inflammatory response increases fluid secretion.

answer

Salmonella enterica (S. enterica)

question

Ingestion of food contaminated by animal feces, especially poultry

answer

samlmonella enterica

question

What are typhoid and paratyphoid fever caused by?

answer

Typhoid fever is caused by Salmonella serotype Typhi. Paratyphoid fever by Salmonella serotype paratyphi

question

These are gram- members of the Enterobacteriaeceae family. They are serotypes of Salmonella

answer

typhi and paratyphi

question

This bacterium is a curved gram- microaerophilic rod

answer

Campylobacter jejuni (C. jejuni)

question

This bacterium has a low infected dose the bacteria multiplies within and beneath the epithelial cells causing inflammatory response.

answer

C. jejuni (Campylobacter jejuni)

question

This is a gram+, rod that is endospore forming and an obligate anaerobe. The endospores are highly resistant to common disinfectants.

answer

C. difficile (Clostridium difficile)

question

This bacteria has toxins that disrupt host cell actin, causing lethal effects to the intestinal epithelium.

answer

C. difficile

question

This disease primarily occurs in hospitalized patients on antibiotic therapy

answer

C. difficile (CDAC-Clostridium difficile associated disease.)

question

These type of virus account for nearly 500,000 deaths of children worldwide due to lack of fluid replacemtn

answer

rotavirus

question

These are naked viruses with double walled capsid and double stranded segmented RNA

answer

rotavirus

question

THese are naked, SS RNA viruses that are the most common cause of viral gastroenteris in the US.

answer

norovirus

question

This virus causes abdominal cramping vomiting and diarrhea lasting 12 to 60 hrs

answer

Norovirus

question

This is a naked, ss RNA virus of the picornavirus family. It usually has mild symptoms, but often prolonged full recovery. Vaccine is available

answer

Hep A

question

This is an enveloped DS DNA hepadnavirus that is transmitted through blood and semen. It often has acute symptoms and if chronic can lead to cirrhosis and cancer

answer

Hep B

question

This is an enveloped, SS RNA flavavirus . It has no vaccine. It usually has few symptoms, but liver damage can lead to cirrohsis and cancer

answer

Hec C

question

WHen an infection becomes ______, it means that it has been carried to all parts of the body, producing disease in one or more vital organs.

answer

Systemic

question

Illness that results from a circulating agent or its toxins

answer

sepsis (blood poisoning)

question

When a substance is circulating in the blood stream, the condition is given that specifies the nature of the substance. Ex?

answer

bacteremia, viremia, fungemia (Does not necessarily mean disease)

question

WHen sepsis causes blood pressure to fall to such low levels that blood flow to vital organs is insufficient.

answer

septic shock

question

This term is used to describe infections of the heart valves or the inner surfaces of the heart.

answer

endocarditis

question

This starts suddenly with a fever and is usually caused by virulent species such as S. aureus and S. pneumoniae. Can infect normal and abnormal heart valves.

answer

Acute bacterial endocarditis

question

This is an infection of the heart valves and inner surfaces of the heart that is slower and not usually caused by virulent species. (less likely to be fatal)

answer

subacute bacterial endocarditis (SBE)

question

Where do bacteria in SBE come from usually?

answer

from dental procedures, tooth brushing, trauma.

question

What usually causes SBE?

answer

Staphylococcus epidermidis and other normal microbiota of the skin or mouth

question

Why do the microbes live in the heart valves?

answer

They get caught in thin blood clots formed around deformes heart valves or other areas with disturbed bloodflow. They multiply and create a biofilm.

question

How does a biofilm evade host immune response?

answer

They are protected from phagocytosis and antimicrobial medications.

question

How does SBE lead to sickness?

answer

The bacteria continually wash off into the bloodstream and pieces of the infected clot can break off and block important blood vessels which can lead to death of tissue.

question

This is a component of the outer membrane of the gram- cells that can cause symptoms such as fever and shock. Lipid A is responsible for the effects of this

answer

endotoxin

question

The most fatal cases of sepsis usually involve gram ____ bacteria like E.coli P. aeruginosa and other Enterobacteriacea species .

answer

gram negative bacteria

question

What is sepsis initially caused by?

answer

It usually begins with an infection somewhere in the body other than the bloodstream. It is initially due to and overstimulation of the inflammatory response.

question

Widespread clotting often associated with Sepsis and often accompanied by hemorrhage.

answer

Disseminated intravascular coagulation. (DIC)

question

What are the steps of sepsis?

answer

1. TLRs on macrophages and neutrophils detect endotoxin or other PAMPs, and phagocytess release pro-inflammatory cytokines. WHen this occurs systemically, a cytokine storm results and further activation of the complemnet system.

question

Bacteriocidcal antibiotics often lyse bacterial cells and release more endotoxin, resulting in worsening of this blood infection.

answer

Sepsis

question

What are some of the effects of sepsis?

answer

fever, impaired oxygen exchange, increased leakage of plasma from blood vessels, tissue damage from clotting, etc...

question

This disease is widespread in the US and found in rabbits, muskrats, and bobcats.

answer

Tularemia

question

This organism causes Tularemia

answer

Francisella tularensis

question

This is a non-motile, aerobic, Gram- rod that enters through breaks in the skin or mucous membranes and is carried to the regional lymoh nodes making them large and tender.

answer

Francisella tularensis

question

THis organism is ingested by phagocytic cells and grow within them, then spread throughout the body

answer

Francisella tularensis

question

This organism is considered a category A risk for bioterrorism.

answer

Francisella tularensis

question

This

answer

question

This is a part of the family Enterobacteriaceae, is a gram- rod, and is facultatively anaerobic. It is non motile and is spread widely through fleas.

answer

Yersinia pestis (Plague)

question

If transmitted through fleas, Y. pestis results in ______ ______.
If spread through inhalation, Y.pestis results in _______ ________.

answer

1.bubonic plague
2. pneumonic plague

question

If Y.pestis spread via the bloodstream, the person may develop ____ ______. Which could lead to DIC (disseminated intravascular coagulation)

answer

septicemic plague

question

This organism forms biofilms in the diegestive tract of infected fleas so that when they try to feed, they actually regurgitate the bacteria into the bite wound

answer

Yersinia pestis (plague)

question

This is a ds DNA virus of the herpesvirus family.

answer

EBV Epstein-Barr virus

question

What disease does EBV cause?

answer

Mono

question

This virus infects the mouth and throat and then becomes latent in another cell type.
After that, it is carried to the lymph nodes where is infects B lymphocytes where it can produce a productive or latent infection.

answer

Epstein-Barr Virus

question

This is a mosquito born viral disease similar to, but milder than yellow fever. It is caused by a ss RNA virus that has 4 closely related serotypes.

answer

DENV1, DENV2, DENV3, DENV4. (dengue fever)

question

This is transmitted primarily by the Aedes family of mosquitos

answer

Dengue fever

question

THis is generally self-limiting and rarely fatal, but a severe form of the disease can occur in patients who experience a second infection of the dengue virus.

answer

1.Dengue fever
2. Dengue hemororrhagic fever

question

In this model, preexisting (dengue) antibodies from a primary dengue infection recognize the virus and bind to them forming immune complexes. However, because they are for a different serotype, they instead facilitate viral entry into cells that express Fc receptors and more freely replicate in macrophages.

answer

Antibody-dependent enhancement (ADE)

question

This is an emerging disease and the fastest spreading mosquito-born viral disease in the world currently.

answer

Dengue fever

question

This is a sickness caused by a virus that is transmitted by mosquitoes of the Aedes family, similar to dengue fever. It is an alphavirus in the family of Togaviridea.

answer

CHIK

STUDY

Cell Mediated Immune Response Immunology

Fundamentals I Test 4 Barnum – Flashcards 85 terms

William Jordan

85 terms

Preview

Fundamentals I Test 4 Barnum – Flashcards

question

What portion of the Immune System is important in adaptive immunity and is where T-cells are formed & mature?

answer

Thymus

question

What portion of the immune system houses most of the immune cells that deal with blood born infections?

answer

Spleen

question

What portion of the Immune system consists of small collections of lymphoid tissue that help clear local infection?

answer

Lymph Nodes

question

What types of cells are important for adaptive immunity?

answer

T & B cells

question

What types of cells are important in Innate Immunity?

answer

Macrophages, neutrophils, dendritic cells

question

Name the Antigen presenting immune cells.

answer

Dendritic Cells, B cells, and Macrophages

question

What types of cells are important in allergic responses?

answer

Mast Cells

question

Describe the Innate immune response.

answer

first line of defense, works with adaptive (may be able to clear infection w/o adaptive), almost immediate response, less divers

question

Describe the Adaptive immune response.

answer

takes time b/c specific T & B cells must be found & replicated, more specific, more likely to cause auto-immune problems

question

Name the organs of the body that work via Innate Immunity to protect the host.

answer

Skin, Mouth & upper alimentary canal, Stomach, Small Intestine, Large Intestine, Airway & Lungs

question

Describe the process of Phagocytosis.

answer

Bacteria attaches to membrane, ingested formong a phagosome, phagosome fuses to lysosome, enzymes digest material, digestion products released

question

Describe the process of Inflammation.

answer

Tissue damage triggers vasoactive & chemotactic factors that cause increase blood flow & capillary permeability, fluid & cells exudate from capillaires, phagocytes migrate to site via chemotaxis, phagocytes & exudates destroy bacteria

question

What structures help the innate immune system recognize infection?

answer

Pathogen Associated Molecular Patterns (PAMPs)

question

What are the receptors for microbial components such as LPS, lipoproteins, peptidoglycan & ssRNA?

answer

Pattern Recognitation Receptors (PRRs), ie. Collectins, CRP, & Toll-like

question

What type of receptors use an extracellular receptor to interact w/intracellular component to trigger cytokines? How does its recognition work?

answer

Toll-like Receptors (TLRs); it recognizes classes of bacteria not individual bacteria

question

What is described as encountering pathogen getting sick then being immune or getting vaccine to get immunity?

answer

Active Immunity

question

What is being immune w/o encountering pathogen ie. given Abs?

answer

Passive Immunity

question

What has B cells that have been triggered to become Plasma cells?

answer

Humoral Immunity

question

What's the most important cell in Cell-mediated Immunity?

answer

T-cells

question

What type of immune cells prodcue cytokines that direct the immune response?

answer

T helper Cells

question

What type of immune cells are turned on by Th1 cells and directly kill body cells that have been invaded by virus or bacteria inducing apoptosis?

answer

T cytotoxic Cells

question

What is described as T regulatory cells ; cytokines helping turn T cell response back off after infection?

answer

Self-Limiting Response

question

What helps combat self-reactive T cells?

answer

Tolerance

question

What are the two most important functions of cytokines?

answer

regulate immune system and therapeutic reagents

question

What is the term for cytokines made by monocytes? What about those made by activated T cells?

answer

Monokines; Lymphokines

question

What cytokines are made by leukocytes ; act on leukocytes?

answer

Interleukins; now know lots of cells can make these

question

What cytokines are important in controlling viral infections ; augmenting immune responses?

answer

Interferons

question

What cytokines are important in the maturation of leukocytes?

answer

Colony-Stimulating Factors

question

What cytokines are important in directed migration of leukocytes during immune responses?

answer

Chemokines

question

What cytokines are involved in stem cell differentiation ; other functions?

answer

Growth Factors

question

What are the four main functions of Cytokines?

answer

1. Pleiotropic (mediate different fxns)
2. Redundant (can do the same thing)
3. Synergistic (when acting together their fxn is more than additive)
4. Antagonistic (help turn immune system off)

question

Name 5 properties of cytokines.

answer

1. low MW proteins or glycoproteins
2. Synthesized in active ; inactive forms
3. Secretion brief ; self-limiting
4. Active at very low concentrations
5. Signal cells by binding specific receptors on target cells

question

What are the 4 main properties of cytokine receptors?

answer

1. each cytokine has a receptor
2. grouped into 5 families
3. often mutli-chain complexes
4. signaling through receptors requires multiple events

question

What are the 5 cytokine receptor families?

answer

Immunoglobulin: IL-1
Class I: IL-2 (hematopoietin)
Chemokine: IL-8 ; Chemokines
Class II: IFN-;,;,; (interferon)
TNF: TNF-;,;

question

What portion of the cytokine receptor actually binds to the cytokine?; Which portion send signals to direct cell activity?

answer

Cognate receptor subunit; Signaling receptor subunit
;

question

How can cytokine receptors send signals to effect transcription?

answer

JAK's phosphorylate STATs which dimerize & can cross the nuclear membrane in order to effect transcription

question

What effect occurs when a cytokine acts on the cell that produced it? Give an example.

answer

Autocrine; IL-2 → Tcells

question

What effect is described as a cytokine acting on adjacent/nearby cells? Give an example.

answer

Paracrine; Interferons

question

What effect is described as a cytokine acting on distant parts of the body like a hormone? Give an example.

answer

Endocrine; TNF & IL-1

question

What cytokine is an important signal for B cells to continue maturation?

answer

IL-7

question

What cytokine are T cells dependent on for activation after Ag binding?

answer

IL-2

question

What is aided by cytokines produced by Th1 cells? Give examples of these cytokines.

answer

Cell-mediated Immunity; IFN-γ and IL-2

question

What is aided by cytokines produced by Th2 cells? Give examples of these cytokines.

answer

Antibody production; IL-4,5,6

question

What cytokine is a major growth factor for B cells? What cytokines are involved in isotype switching?

answer

Growth factor=IL-6; Isotype switching= TGF-β for IgA and IL-4 for IgE

question

What recognized viral genetic material as foreign? What does their binding lead to?

answer

TLRs; production of Interferons

question

What are the two types of interferons and where are they produced? What are their innate & adaptive functions?

answer

Type I: produced by all cells (IFN-α/β)
Type II: prodcued by active Tcells (IFN-γ)
Innate: viral clearance
Adaptive: lymphocyte activation/maturation, induces MHC expression

question

What portion of the bacteria do TLRs bind? Give examples.

answer

PAMPS; TLR-4=LPS and TLR-5=flagellin

question

What three events occur in Acute Phase Response? Which cytokines direct this response?

answer

1. Eliminate invading pathogen
2. Prevent on-going tissue damage
3. Activte repair processes
"Pro-inflammatory" cytokines: TNF-α, IL-1, IL-6, IL-8, and IFN-γ

question

What are 6 characteristics of Tumor Necrosis Factor-Alpha?

answer

induced by LPS and made by fibroblasts & MO; activates myeloid cells; induce production of cytokines, initiates acute phase response (fever); induces adhesion molecule expression; toxic at high levels (septicemia)

question

What are the three groups of Acute Phase Proteins? Give examples.

answer

1. Host Defense Proteins: CRP, complement, fibrinogen
2. Proteinase Inhibitors: C1 inhibitor, α1-proteinase inhibitor
3. Anti-oxidants: Haptoglobin, ceruloplasmin

question

What are chemokines classified by, what are they involved in, and where are they expressed?

answer

by Cysteine Motifs; inflammation, cell recruitment, lymphocyte trafficking, lymphoid organ development, & wound healing; in primary & secondary lymphoid organs

question

What are the current cytokine therapies?

answer

IFN-α: chronic myeloid leukemia, Bechet's disease, aggressive oral giant cell tumors
TNF-;: root resorption, refractory posterior uveitis, rheumatoid arthritis, (anti) orofacial granulomatosis
IFN-;: multiple sclerosis

question

What is defined as a groupd of sequentially reacting protein, which upon activation, mediate a number of biological reactions important to host defense?

answer

Complement

question

Tell whether the proteins of Activation, Regulation, and Receptors are Serum Soluble or Membrane Bound.

answer

Activation=Serum Soluble;; Regulation=Both;; Receptors=Membrane Bound

question

What Domain do the following Complement Proteins belong to: Enzymes, Collectins, Cytolytic, Regulatory and Receptor, and True?

answer

Enzymes: Serine Protease Domain
Collectins: Collagen Stalk, Globular Domain, MACPF/CDC superfamily
Regulatory and Receptor: SCR Domain
"True" Complement Proteins: C3,4,5

question

T/F; The same fragments are generated through both the classical ; alternative pathways.

answer

True

question

What are the functions of both cleavage products of C3 and C5?

answer

C3a: Chemotaxis and Inflammation
C3b: Opsonization, Neutralization, and Bcell activation
C5a: Chemotaxis and Inflammation
C5b: Lytic complex formation

question

Describe the opsonization of C3b.

answer

covalently binds to surface of invading pathogen via amide (NH2) or ester

question

What activates complement in each of the three pathways?

answer

Classical: Ag-Ab complexes (uses one IgM or two IgG molecules)
Mannan-Binding Protein: Mannose, N-acetylglucosamine
Alternative: LPS, zymosan

question

Describe the action of C1q.

answer

C1q auto-activates C1s ; C1r which activates the classical pathway

question

Describe the make-up and function of C3 convertase.

answer

C2a + C4b (C2a=enzymatic portion); cleaves C3, when C3b is added to complex it becomes C5 convertase

question

Describe the way in which the complement system causes a cell to lyse.

answer

C5b bind C6,7,8 which triggers C9 to form a pore to lyse the cell

question

What initiates the alternative pathway?; Describe it's action.

answer

C3 tickover; C3 interacts with water which binds Factor B, Factor D cleaved Factor B leaving Factor Bb+C3H₂0 = Alternative Pathway Initiator Convertase (cleaves C3 & joins classical pathway)

question

Describe the functions of C3a & C5a.

answer

Anaphylatoxic & Chemotactic molecules; Degranulation; Increased vascular permeability; Induce cytokine release, adhesion molecules, and acute phase protein expression; Induces respiratory burst

question

What are the functions of C5b?

answer

Initiation of the Membrane Attack Complex leading to formation of membranolytic pore-forming complex and signals transduction for cellular events

question

What are the functions of C3b?

answer

Opsonization of Ag-Ab complexes for clearance, Solubilization of immune complexes, and neutralization of invading pathogens

question

What five things regulate complement?

answer

1. Regulation proportional to amount of activator
2. Limited half-life of convertases
3. Inhibitory protein control early activation
4. Carboxypeptidases inactivate anaphylatoxins
5. Inhibitory proteins modulate MAC formation

question

What is the effect of DAF on Complement?

answer

DAF binds C3b & prevents Factor B from binding to form C3 Convertase (Alt Path); if convertase is already formed, DAF can increase its decay

question

What is the effect of CD59 on complement?

answer

binds C5b,6,7,8 complex & blocks C9 addition = can't form pore complex; if one C9 has already attached CD59 can prevent more from attaching ; the pore from growing

question

Which complement deficiencies cause recurrent bacterial infections?

answer

Activation Component Deficiencies ; Terminal Component Deficiencies (common in Japan ; predisposed to Meningitis)

question

What are the Complement Deficiencies that have to do with Regulatory Components?; What about those with Receptor deficiences?

answer

Reg=HANE(spontaneous inflammation, low C1 inhibitor levels), PNH (spontaneous RBC lysis), ; aHUS;; Receptor=SLE (also Activation - Lupus)

question

At what level of the vasculature does leukocyte rolling take place?

answer

Post-Capillary Venules (b/c the vessels are smaller ; blood flow is slower)

question

What are the four families of adhesion molecules?

answer

1. Selectins: C-type lectins
2. Integrins: Heterodimeric Receptors, ;2-Integrins
3. Cell Adhesion Molecules (CAMs): made of Ig Domains
4. Signaling Molecules: chemoattractant ; chemokine receptors

question

What are the physical factors influencing lymphocyte/leukocyte migration?

answer

Blood Flow, Physical Barriers, and Ability to Detect Infection

question

What mediates rolling and where are these components found?

answer

Selectins ; Carbohydrate Ligans; P ; E-Selectins on endothelial cells, L-Selectins on leukocytes, ligands on both

question

T/F; If you are missing even part of the sLe molecule the leukocytes will not stick.

answer

True

question

What are the two ways to see leukocyte rolling?

answer

Intravital Microscopy and Parallel Plate Flow Chamber

question

Which Immunoserveillance disorder results in no binding to selectins?

answer

Incomplete Glycosylation of sLew^x
(LAD II is a Leukocyte Adhesion Deficiency)

question

What does infection interacting with chemotactic receptors and ligands result in?

answer

Activates endothelial cells and lukocytes, causes "inside-out signaling", gradient-dependent migration of leukocytes

question

What is the most common conformation of the ;₂-integrins; what causes them to change conformation?

answer

closed/unactivated; expression of ICAM increases which results in inside-out signaling causing integrins to be in the open conformation and stick more tightly to the cell

question

What type of integrin is expressed on neutorphils (PMNs) and Macrophages and is also called CR3 or CD18/CD11b?

answer

Mac-1

question

What is the result of missing functional CD18?

answer

CD18 is part of Mac-1; without it None of the CD's make it to the cell surface to be expressed, neither does CR4 (b/c CR4=CD18/CD11c)

question

What molecules assist the leukocyte in diapedesis?

answer

Proteases: open space b/w the endothelial cells
PECAM: helps trafficking of cell into tissue, expressed on neutrophil & endothelial cell
Mac-1 & ICAM: interact to help pull cell through
JAM: Junction Adhesion Molecules, expressed on endothelial cells, interact with integrin molecules (act as train tracks)

question

What molecule mediates rolling only in lymph nodes & why?

answer

PNAd; b/c you don't want lymphocytes sticking to the rest of your endothelium

question

Where does Naive Lymphocyte Homing occur?

answer

High Endothelial Venules (found only in lymph nodes)

STUDY

Cell Mediated Immune Response Hematology Hematopoietic Stem Cell Total Iron Binding Capacity

GI- Microbiology – Flashcards 73 terms

Amari Finch

73 terms

Preview

GI- Microbiology – Flashcards

question

How can infection cause anemia?

answer

bacterial infections suppress erythropoietin production and the proliferation of erythroid progenitors; and also chronic infections impair iron utilization

question

Lab results for Iron in anemia of chronic disease

answer

low sFe, reduced TIBC, and abundant stored Iron in tissue macrophages

question

Cause of pure red cell aplasia

answer

B19 virus

question

Infections that lead to aplastic anemia
(4 viruses)

answer

hepatitis virus, CMV, EMV, and HSV

question

Infections that lead to hemolytic anemia
(2 parasites)

answer

Bebesia leads to cell lysis
Leishmania causes production of oxidative metabolic products that lyse RBCs

question

Bacterial toxins that might cause toxin production

answer

- alpha toxin in Clostridium perfringens
- Capsular polysaccharide (PRP) of hameophilus influenza type B binds red cell surface and anti-PRP antibodies lyse the cell

question

Parasitic infection which causes microcytic anemia

answer

iron deficiency anemia, associated with Hook Worm

question

Infections that lead to megaloblastic anemia

answer

B12 deficiency accompanying D. Latum infection

question

B19 presentation in various hosts
(child, adult, chronic hemolytic anemia, immunocompromised patient, fetus)

answer

fifth's disease
polyarthropathy
transient aplastic crisis (TAC)
PRCA Pure red cell aplasia
congenital anemia, hydrops fetalis

question

B19 virus and anemia
(target; cell, presentation)

answer

erythroid progenitor cells;and erythroblasts, blood group antigen P
erythema infectiosum, arthalgia, arthritis

question

What is transient aplastic crisis, what is the presentation;and what infection is it associated with?

answer

TAC is the abrupt cessation of erythropoiesis
reticulocytopenia, absent erthyroid precursors in the bone marrow and precipitous worsening of anemia
B19 associated TAC is found in patients with underlying hemolytic disorders or in patients with high RBC turnover

question

If a pregnant woman in her second trimester is exposed to parvovirus B19, what thest should be done first?

answer

obtain IgG and IgM serology ASAP

question

What would each of the possible serology results of pregnant woman in her second trimester indicate/
- positive IgG result and negative IgM
- positive IgG and IgM
- negative IgG and positive IgM
- negative IgG and negative IgM

answer

- indicates past infection (no risk to fetus)
- indicates infection with in the last 1-120 days (possible risk to fetus)
- indicates acute infection (higher risk to fetus)
- indicates the mother is not immune and that no evidence of acute infection is noted.; Repeat the test in three weeks.

question

Treatments for the following anemias:
- pure red cell aplasia
- aplastic crisis
- HIV

answer

- intravenous immunoglobulin (IVIG)
- packed RBCs
- HAART

question

Two target cells of Malaria parasites leading to anemia

answer

P.vivax binds Duffy blood group antigen
P. falciparum binds to sialic acid residues on glycophorin A

question

Babesia microti
(transmission, population, acute and chronic presentation)

answer

tick-transmitted protozoan
immunocompromised
inclusions- tends to form ring froms in tetrads
acute- malaise, headache, chills, sweating, periodic fatigue
chronic- hemolytic anemia, renal failure

question

Symptoms of Hook Worm infrection

answer

often asymptomatic
iron (microcytic) deficiency anemia
respiratory symptoms, itch, edema

question

D. Latum
(associated anemia, other symptoms, diagnosis)

answer

B12 deficiency leading to megaloblastic anemia
salt craving, intermittent abdominal discomfort
detection of large operculated eggs in stool or recovery of proglottids

question

Bartonella bacilliformis
(Gram stain, different disease presentations)

answer

gram-negative rods that penetrate RBCs
carrion disease- acute febrile illness
oroya fever- severe anemia
verruga peruana- blood-filled nodules

question

5 common features of H. pylori and C. jejuni

answer

- spiral or curved shape
- gram negative rods
- low G-C bqase ratio
- inability to ferment or to oxidize carbohydrates
- microaerophilic

question

H. pylori
(urease, H2S production, nitrate reduction, growth at 42 C, shape, size)

answer

positive
negative
negative
negative
spiral with 3 unipolar flagella
1 x 4 um

question

C. jejuni
(urease, H2S production, nitrate reduction, growth at 42 C, shape, size)

answer

negative
positive
positive
positive
bipolar flagella
not very wide

question

Describe the symptoms associated with a C. jejuni infection

answer

up to 10 stools/day
bloody diarrhea
RUQ pain- often only symptom

question

Describe the symptoms of a C. fetus infection

answer

endocarditis, septic thrombophlebitis
arthritis spetic abortion, meningoencephalitis, spontaneous peritonitis

question

hyatid cysts in the liver

answer

Echinococcus granulosus

question

biliary obstruction

answer

Ascaris lumbricoides

question

Treatment of Campylobacter Infections

answer

fluid and electrolyte replacemnet
empirical antibiotics for patients with high fever or bloody or frequent diarrhea
erthromycin clears in 72 hours

question

Virulent factor of H. pylori

answer

O-side chain resembles the blood group antigens so serve to protect the bacteria from immune clearance

question

selequae of h. pylori

answer

gastric ulcers, MALT (mucus associated tissue lymphoma)

question

treatment for H. pylori

answer

PPI
clarithromycin
beta-lactams

question

bacteria found in scondary periotinitis caused by appendicitis perforation

answer

Prevotella melaninogenica

question

Most important cause of endemic severe diarrheal illness

answer

Rotavirus group A

question

Rotavirus
(S/Sx, D, T)

answer

over a week duration
ELISA/Latex agglutination in stool samples
severe if ass. w/ dehydration and electrolyte imbalance
vaccines are available

question

Explain the role of the NSP4 protein in rotavirus in causing diarrhea

answer

intracellular release of Ca leading to diarrhea
disrupts tight junction allowing for paracellular flow of H2O and electrolytes
sitmulates the ENS

question

Name three virulence factors of adenovirus

answer

inhibition of MHC I expression
E proteins- block apoptosis by binding Rb and p53
VA-RNAS block interferon anti-viral response

question

General characteristics of Enterobacteriaceae

answer

Gram-negative rods
motile and facultative anaerobes
LPS is the major cell wall antigen

question

Distinguish between typhoid and non-typhoid serovars of Salmonella

answer

typhoid serovars: human-to-human, fecal-oral
non-typhoid: animal or contaminated food handling

question

Summarize virulence factors employed by Salmonella to establish infection

answer

attachment to epithelial cells by fimbriae; invade through M cells and enterocytes
replication occurs in the endocytic vacuole; disseminated infection can occur
enterotoxin produced

question

Define; MacConkey Media

answer

bile salts and crystal violet inhibit gram-positive
fermentation of lactose produces pink

question

Describe EMB Media

answer

Eosin blue and methylene blue inhibit the growth of gram positives
blue or green with lactose fermentation

question

Discuss the mechanism by which Shigella invades intestinal epithelial cells

answer

invades M cells of the colon by type III secretion
invades neighbor cells by comet-like actin tail
IL-1 release and PMN migration causes further loss in cell integrity
;

question

Define the mechanism of action of Shiga toxin

answer

AB subunit is cleaved by the protease furin
the A subunit inhibits protein translation by cleaving 28S rRNA
this causes cellular damage to intestinal epithelium

question

ETEC
(site of action, disease, pathogenesis ; virulence factors)

answer

small intestine
Traveler's diarrhea
enterotoxins stimulate hypersecretions of fluids and electrolytes, colonization factor antigens

question

EHEC
(site of action, disease, pathogenesis & virulence factors)

answer

large intestine
hemolytic-uremic syndrome
shiga toxin disrupts protein synthesis. A/E lesions on microvilli results in decreased absorption. Bfp, intimin adhesion

question

EIEC
(site of action, disease, pathogenesis & virulence factors)

answer

diarrhea which progresses to dysentery with bloody stools
invasion mediated by invasive plasmid antigen

question

Explain how SMAC media aids in the diagnosis of E.Coli.

answer

E. coli O157:H7 (EHEC) is the only E.coli strain that does not ferment sorbitol

question

What is the cause of Hemolytic Uremic Syndrome?

answer

Shiga toxin form EHEC damages kidneys which release erythropoietin

question

Yersininae enterocolitica
(general characterisitics, source, CF, Labs)

answer

gram - rod, intracellular, cold tolerant
contaminated meat
gastroenteritis involving distal ileum, colon, and mesenteric lymph nodes, possible sequelae of autoimmune disorder
lactose negative, urease negative, motility at cold temperatures

question

After three days of vacationing in the city of Lima, Peru, a newly married couple fall ill with what appears to be the same condition. Both experience vomiting, watery diarrhea, nausea, and abdominal cramps. An analysis of their stool results in the isolation of gram-negative rods which produce colonies on MacConkey that are pink Which of the following is the most likely causative microorganism?

answer

E. coli (is a lactose fermenter)

question

A 28-year-old woman complains of painful swelling of the right knee and and tender skin eruptions on both shins. For the past two weeks she has also had watery diarrhea that developed after she consumed some raw pork. She also complains of low-grade fever and mild abdominal pain. Both red and white blood cells were observed in her stool sample. A stool sample revealed a gram-negative rod that was only motile at temperatures below 30°C. Clear colonies on MacConkey agar

answer

Yersiniae enterocolitica ( motility below 30 C)

question

A 16-year-old boy is brought to the emergency room by his parents, as he has been experiencing bloody diarrhea for 1 week. He also complains of not urinating often and blood in his urine when he does. His laboratory studies demonstrate an increased BUN and creatinine and the presence of gram-negative rods which produce beige colonies on SMAC and colonies on EMB as shown below (green). The condition is associated with infection by which of the following E. coli types?

answer

EHEC (beige on SMAC)

question

A 36-year-old man comes to the emergency room because of the development of sudden nausea, vomiting, and diarrhea with blood and mucus, as well as crampy abdominal pain. He had just returned yesterday from a business trip to South America and has been experiencing these symptoms for two days. Leukocytes were found in his stools as well as a gram-negative non-motile rod. Growth on MacConkey media after 48 hours shows clear colonies. Which of the following is the most likely causative microorganism?

answer

Shigella dysenteriae (non-motile, non-lactose fermenter)

question

A 3-year-old man presents with sudden-onset, crampy abdominal pain and diarrhea. The diarrhea is watery and contains mucus. The patient also complains of low-grade fever with chills, malaise, nausea, and vomiting. Careful history reveals that he had ingested partially cooked eggs at a poultry farm 24 hours before his symptoms began. Based on this limited information, which of the following microorganism would you most likely suspect?

answer

Salmonella enterica (sudden, mucus, poultry)

question

A 3-month-old female infant was brought to the emergency department of a general hospital with a 5-day history of decreased activity, decreased oral intake, upper airway congestion, and general irritability. There was no history of fever or vomiting. During the previous 2 weeks, she had been constipated, and twice her mother had given a tablespoon of honey for treatment. The physical examination revealed dry oral mucosa, a sluggish pupillary response, and significant hypotonia. A gram stain of the fecal sample revealed a gram positive spore forming rod. Which of the following is the most likely diagnosis?

answer

C. Botulism (flaccid paralysis)

question

A 67-year-old man presented with fever, abdominal cramping, and frequent diarrhea for four days. Three weeks before the current episode, he had undergone a hip replacement and was rehabilitating in an orthopedic unit. During the hospitalization, he developed a nosocomial pneumonia and was treated empirically with clindamycin. He gradually improved and was discharged a week before his current presentation, with maintenance oral antibiotics. Which of the following is the most likely diagnosis?

answer

Shigella sonnei (nosocomial infection)

question

C. difficile
(CF, and A and B toxins)

answer

pseudomembranous colitis
A- enterotoxin--> recruits PMNs
B- causes cytoskeletal damage

question

C. perfringens
(LF and A and B toxins)

answer

lechtinase enzyme destoys cells
causes precipitate growth on egg yolk agar
A enterotoxin disrupts ion transport
B enterotoxin forms pores--> bloody diarrhea

question

C. botulism
(CF, source)

answer

1-3 days of weakness, blurred vision, and constipation
flaccid paralysis
canned foods

question

Specifics about two forms of Bacillus Cereus

answer

emetic and diarrheal form
diarrheal form lasts longer, from meat and is heat labile

question

Giardia lambia
(transmission, symptoms, E, D)

answer

fecal-oral
diarrhea, increased fat and mucus in stool
worldwide, primarily human-to-human transmission
cysts (stain with Trichrome stain)and smiley-face trophozoite (stain with Kohn and Giemsa stain) forms are detected in feces

question

What stain is diagnostic for Cryptosporium?

answer

acid-fast stain, it won't stain with trichrome

question

What is the treatment for cryptosporidium infection?

answer

hydration, no drugs; are effective against crypto

question

Cryptosporidium
(Et, Sx, E, D);

answer

fecal-oral
frothy BMs, anorexia, self-limiting, immunocompromised pateints cannot self cure
oocysts, acid fast stain

question

Balantidium coli
(E, Sx, E, D)

answer

fecal-oral
intermittent diarrhea with blood and pus, ulceration
worldwide, swine #1 animal reservoir
microscopic exam, bean-shaped macronucleus

question

How does the O/P of E. histolytica read?

answer

trichrome stain shows ingested red blood cells

question

E. histolytica
(Et, Sx, E, D)

answer

fecal-oral
dysentery, RUQ
worldwide, human-to-human
microscpic exam, motile trophozites
PCR differentiate histolytica from dispar

question

O/P of Ascaris lumbricoides

answer

large, mamillated coat and tapered end in fertilized egg

question

O/P of stengyloides stercoralis

answer

muscular neck, distinguished from hookworm by mouth at one end and notched tail on the other

question

O/P of schistosoma mansoni

answer

large spine projecting out of one side

question

Life cycle of ascaris lubricoides

answer

ingested eggs travel to the lunges
larvae break free
in 3 weeks larvae pass and can be swallowed back into the small intestine

question

O/P of trichus trichiura

answer

white worm , barrel shaped eggs with mucoid plugs at both ends

question

Trichuris trichiura
(Et, Sx, E, D)

answer

fecal-oral
diarrhea, rectal prolapse in children
Worldwide
concentrated microscopic specimen

question

Schistosoma mansoni
(Et, Sx, E, D)

answer

skin penetration by cercariae from snails
dermatitis, enlarged liver and lymph nodes, eosinophilia and dysentery
South America and Africa
schistosome eggs in stool and urine

STUDY

Cell Mediated Immune Response Immunology Normal Immune Response

immunity – Microbiology – Flashcards 74 terms

Lesly Nixon

74 terms

Preview

immunity – Microbiology – Flashcards

question

Innate immunity

answer

There is immediate maximal response, not antigen specific, and exposure results in no immunological memory

question

Adaptive immunity

answer

Response is antigen dependent, there is a lag time between exposure and maximum response, antigen specific, exposure results in immunological memory, and recognition by antibody and T cell receptors

question

Species resisitant

answer

Only affects certain animals or plants and not humans because our physiology is different

question

Innate immunity

answer

Present at birth

question

Adaptive immunity

answer

Acquired over time from exposure

question

Skin (dermis/epidermis)

answer

Has chemicals that defend against pathogens. Perspiration secreted by sweat glands; sebum secreted by oil glands

question

Mucous membranes

answer

Lines all body cavities open to environment, produces chemical that defends against pathogens

question

Lacrimal apparatus

answer

Lysozymes that destroy bacteria

question

Normal microbiota

answer

Microbial anatonism, makes it hard for pathogens to compete

question

Plasma

answer

Liquid part of blood that carries blood cells, and plasma proteins which help with inflammation and blood clotting. Iron binding proteins bind to iron in blood which makes iron unavailable to pathogens

question

Erythrocytes (RBC'S)

answer

Most numerous in body. Biconcave shape and transports gases

question

Leukocytes (WBC'S)

answer

Used in immunity, broken into two catergories: granulocytes that contain granules and can exit the blood and agranulocytes which don't contain granules

question

Granulocytes

answer

Broken down into Basophils, Eosinophils, and Neutrophils

question

Agranulocytes

answer

Broken down into lymphocytes and monocytes

question

Basophils

answer

Stain blue; not phagocytic, release chemical to cause inflammation

question

Eosinophils

answer

Stain orange/red; phagocytic, high number in blood indicates allergic reaction or infection with helmin worms

question

Neutrophils

answer

Stain light purple; phagocytic

question

Lymphocytes

answer

Smallest WBC'S; nuclei covers almost entire cell, plays a part in adaptive immunity

question

Monocytes

answer

Leaves blood stream and become macrophage and eat foreign pathogens

question

Platelets

answer

Broken pieces of cells used for clotting; helps with inflammation

question

Nonphagocytic killings

answer

Broken into 3 types: killing by Eosinophils, killing by natural killer lymphocytes, and killing by neutrophils

question

Killing by Eosinophils

answer

Secrete antimicrobial chemicals, protect from helmins

question

Killing by natural killer lymphocytes

answer

Secrete toxins that attack virally affected cells

question

Killing by neutrophils

answer

Produce enzymes that create bleach with kills the bacteria

question

Toll like receptors (TLRs)

answer

10 in body, proteins that are part of WBC'S and act as an early warning system. They detect pathogen associates molecular patterns (microbes). Very important because if they fail your immune system is compromised

question

NOD proteins

answer

Proteins found on leukocytes that bind to certain things and cause cell death and other responses

question

Interferons

answer

Protects us from viral infections. Broken into 2 types: type 1 (alpha and beta) 2hich is released within hours of infection to let neighboring cells know a virus is present and type 2 (gamma) which is activated by T cells and starts phagocytosis

question

Complement

answer

Activation results in lysis of the foreign cell. Indirectly trigger inflammation and fever. Can be activated in three ways: classical pathway is activated by antibodies, alternative pathway is activated by exotoxins, and Lectin pathway is activated by molecules on bacteria

question

Inflammation

answer

-itis / swelling

question

Fever

answer

Body temperature over 37*C which enhances interferons and inhibits growth of some microbes and phagocytosis

question

5 attributes of adaptive immunity

answer

Specificity, inducibility, clonality, unresponsive to self, and memory

question

Specificity

answer

Responds to a certain shape

question

Inducibility

answer

Activates only when pathogens are present

question

Clonality

answer

Once induced, can clone cells to attack virus

question

Unresponsive to self

answer

Your body does not attack itself

question

Memory

answer

Will remember pathogen

question

Lymph

answer

Watery liquid that carries toxins and pathogens out of the body

question

Primary lymph organs

answer

Are WBC'S that mature in red bone marrow and thymus

question

Secondary lymph organs

answer

Are the lymph nodes, spleen, and lymphocytes

question

Antigens

answer

Shapes found on pathogens. 3 types: exogenous, endogenous, and autogenous

question

Exogenous

answer

Responds to things on the outside

question

Endogenous

answer

Pathogens that reproduce inside the cell

question

Autogenous

answer

Produced from a normal cell process

question

Epitopes

answer

3D shape on nucleus membrane that body recongnizes

question

Function of B cells

answer

Secretion of antibodies

question

Five antibody functions

answer

Neutralization, opsonization, oxidation, agglutonation, and ADCC

question

Neutralization

answer

Neutralizes toxins and prevents it from attachment

question

Opsonization

answer

Changes shape of antigen and activates phagocytosis

question

Oxidation

answer

Produces oxidants that destroy cell

question

Agglutonation

answer

Sticking them all together to get rid of them all at once

question

ADCC

answer

Natural killer B cells that lyse cells

question

Function of T cells

answer

To work against intracellular pathogens and cancer cells

question

3 types of T cells

answer

Cytotoxin, helper, and regulatory

question

Cytotoxin

answer

Directly kills other cells

question

Helper

answer

Assist with activating B cells

question

Regulatory

answer

Turns off the response tying to regulate immune system

question

Major histocompatibility complex

answer

Holds pathogen in place for T cells at the antigen binding site

question

Cell mediated immune responses

answer

Responds to intracellular pathogens and abnormal body cells. Antigen is present. MHC2 and epitote hols in place till T cell arrives and binds. T cell will differentiate and turns into a cell that can destroy pathogen. T cell makes clones of pathogen destroying cells and attaches to pathogens which causes them to lyse

question

Antibody immune responses

answer

Helper t cells bind MHC and epitotes to pathogen. Makes clones. They activate and attach to B cells. B cells will then be activated and differentiate to make plasma cells to bind and destroy pathogen.

question

T independent

answer

B cells that do not require helper T cells and are found in the interstitial fluid.

question

T dependent

answer

B cells that require helper T cells and are found in the lymph nodes

question

Immunological memory formed

answer

They are produced by B cell proliferation but does not secrete antibodies. These are long living ells that stay in the lymphoid tissue and initiates production if antigen is encountered again. This is important because your body will know how to fight that specific antigen much quicker subsequent times so they won't make you sick

question

Naturally aquired
(Active immunity)

answer

Is something you acquire from coming in contact with a certain pathogen

question

Artificially acquired
(Passive immunity)

answer

Is something you acquire an immunity from due to a vaccine

question

5 different types of vaccines

answer

Attenuated, inactive, toxoid, combination, and gene technology

question

Attenuated

answer

Live pathogens, can cause mild infection

question

Inactive

answer

Whole or pieces of dead pathogens

question

Toxoid

answer

Gives you modified toxins that won't cause the disease but will build up immunity

question

Combination

answer

Combines pathogens

question

Gene technology

answer

Takes genes and recombines them to make them safe

question

Concerns and problems associated with vaccine safety

answer

Mild toxicity, risk of anaphylactic shock, residual virulence from attenuated viruses

question

Mild toxicity

answer

Allergic reactions, injection site soreness

question

Residual virulence from attenuated viruses

answer

A little sicker than normal.

question

Debunked

answer

Allegations that certain vaccines can cause autism, diabetes, and asthma but research has debunked these allegations

STUDY

Cell Mediated Immune Response Immune System Microbiology Toxic Shock Syndrome Type Iii Secretion System

Microbiology 303 Final Exam – Flashcards 365 terms

Ken Ericksen

365 terms

Preview

Microbiology 303 Final Exam – Flashcards

question

Faculative Intracellular Pathogens

answer

can live in host or freely

question

Intracellular Pathogens

answer

seek refuge by invading host

question

Pollutants that cause eutrophication

answer

nitrogen, phosphates

question

Cold Seeps

answer

microbial communities at unheated benthic where methane and petroleum seep out

question

Amensalism

answer

one species harms another (nonspecific)

question

Synergism

answer

mutualism, but both species can thrive separately

question

Syntropy

answer

feeding together of two species on something that wouldn't otherwise be digestable

question

Metagenomics

answer

sequencing of genomes in an environmental community

question

Pan-genome

answer

core genome and accessory genes present in isolates

question

Core genome

answer

genes present in all sequenced genomes of species

question

Hopanoids

answer

steroid-like molecules of bacteria membranes

question

Serotyping

answer

identifying variations within subspecies of pathogen

question

How technology spreads disease

answer

colonization of woods and rainforests
transplants and transfusions
modern meat-processing
transportation

question

Pandemic

answer

epidemic over large area

question

Propagated Epidemic

answer

epidemic where infected spread disease to healthy

question

Epidemic

answer

outbreak, high frequency over short period
from one source; little transmission by infected

question

Endemic

answer

low frequency of disease; normally present

question

Epidemiology

answer

study of factors affecting illness and health of populations

question

Survival strategies for pathogens of of cell, but still in host

answer

secretion of capsule
manufacturing of proteins that bind to antibodies
cause apoptosis of phagocytes
alter cell surface
(all to avoid detection and attachment of antibodies)

question

Survival strategies for pathogens in cell

answer

use hemolysin to break out of phagosome
secrete proteins to prevent fusion of phagosome with lysosome
mature in acidic lysosome

question

Vectors

answer

intermediates for pathogen transmission

question

Fomites

answer

inanimate objects that relay pathogens

question

Opportunistic pathogens

answer

cause disease in compromised host

question

Primary pathogens

answer

cause disease in otherwise healthy host by breaching defenses

question

Signature-tagged mutagenesis

answer

mutate pathogen and tag it
inoculate host
recover pathogen and determine which mutations prevented growth in host

question

in vivo expression technology

answer

identify promotors that transcribe only when infecting a host

question

Lipopolysaccharides

answer

endotoxin that activates inflammatory response that can also cause toxic shock

question

AB toxin

answer

5 B subunits surround A and delivers A to host
A subunit is toxic

question

5 types of toxin function

answer

1. causes host cell membrane leakage
2. block protein synthesis
3. block 2nd messenger pathways
4. superantigens overactivate immune system
5. proteases cleave host proteins

question

Pilus assembly

answer

protein secreted into periplasm
secreted to site of assembly
subunits strung together
tips of pili bind to host

question

Pili/Fimbriae

answer

hollow fibrils made of pilin with tips that bind to host
prevents expulsion from host

question

Pathogenicity island characteristics

answer

multiple genes associated with pathogenicity transferred as block from other organisms
flanked by phage or plasmid genes
different base ratio than other parts of genome

question

Examples of virulence factors

answer

toxins, attachment proteins, capsules

question

Lethal Dose (LD50)

answer

number of organisms to kill 50% of hosts

question

Virulence

answer

frequency of lethal infections

question

Infectious Dose (ID50)

answer

number of organisms to colonize 50% of host
measure pathogenicity

question

Exotoxin

answer

nonprotein; hyperactivates immune system

question

Endotoxin

answer

toxic proteins; kills host to unlock nutrients

question

Pathogenicity

answer

ability to cause disease

question

Steps of Infection

answer

1. encounter
2. entry
3. establish infection
4. cause damage

question

Benefits of biofilms to microbes

answer

protection from:
predators
phages
biocides
antibiotics
immunophagocytes
antibodies

question

Biofilms

answer

community of bacteria enclosed in ECM

question

Quorum sensing compounds

answer

oligopeptides (gram +)
n-acyl homoserine lactones (AHLs) (gram -)
Al-2 INTER species communication (gram +/-)

question

Uses of quorum sensing

answer

adapt to availability of nutrients
defense
avoidance of toxins
coordination of virulence to escape
immune response and establish infection

question

Quorum sensing

answer

ability of bacteria to communicate and coordinate behavior via small molecules (inter and intra species)

question

Microbial predators

answer

protists, viruses, bacterial predators

question

Tube worms and microbes

answer

worm takes up CO2 and H2S
microbes must oxidize to make organic matter

question

Metabolism of deep sea ocean vents

answer

producers oxides H2S for energy
methanogens and methanotrophs prevent CO2 buildup
hydrogen oxidizers convert H2 and S --> H2S

question

Hawaiian bobtailed squid

answer

host for bioluminescent bacteria
bacteria emit light to match moonlight to eliminate shadow on ocean floor
undetectable by predators

question

Microbes and coral

answer

bacteria and algae help coral fix N2, photosynthesis, protection against pathogens

question

Rumen and microbes

answer

break down cellulose in anaerobic environment

question

Arbuscular mycorrhizal fungi

answer

improve acquisition of phosphate, nitrogen, water
reduce incidence of root disease

question

Rhizosphere

answer

region of soil surrounding rocks

question

Rhizoplane

answer

root surface

question

Mycorrhizae

answer

fungal infection in plants that increase ability to absorb nutrients

question

Rhizobium infection cycle

answer

legumes secrete flavanoids
rhizobia express nod genes and enter cortical cells
remains in symbiosome
Rhizobia fix nitrogen; plant provides nutrients

question

Chloroplast homolog

answer

cyanobacteria

question

Mitochondria homolog

answer

rickettsiae

question

Syntrophy

answer

both organisms combine metabolic capabilities to catabolize substances they couldn't alone

question

Cycle leading to acid rain

answer

phytoplankton produce DMSP to protect against UV
other bacteria convert DMSP-->DMS (volatile, acts as nuclei for cloud formation)
DMS is hydrated to sulfuric acid, which falls as acid rain

question

Characteristics of phosphorus cycle

answer

same oxidation state
no gas intermediate
soluble in oceans

question

Dissimilatory nitrate

answer

used as and e- acceptor in e- transport chain

question

Assimilatory nitrate

answer

used as nutrient

question

Annamox

answer

anaerobic formation of N2 from ammonia and nitrite

question

Denitrification

answer

cascade of anaerobic respirations converting nitrate-->N2
nitrate-->nitrite-->nitric oxide-->nitrous oxide-->nitrogen gas

question

Nitrification

answer

ammonia-->nitrite-->nitrate
oxidation
makes nitrogen available to plants

question

Nitrogen fixation

answer

nitrogen gas-->ammonia
nitrogenase reduces nitrogen
complex cofactors make it oxygen sensitive

question

Methylotrophs (rxn too.)

answer

oxidize methane to CO2
CH4 + SO4 --> CO2 + H2S + OH-
CH4 + H2O --> CO2 + 4H2
removal of H2 drives rxn to right

question

Methanogenic Archaea

answer

break down trapped carbon compounds in anaerobic environments to CH4

question

Why viruses aren't "living"

answer

no cellular integrity
only a protein and nucleic acid
depend on host for survival and replication

question

Dinoflagellates

answer

alveolate
2 long flagella
red algal chloroplast
secrete neurotoxins via extrusome

question

Yeast classification

answer

unicellular fungi

question

Growth of fungi

answer

growth material is secreted at hyphal tips

question

Fungi food absorption

answer

must absorb as individual molecules

question

Material of fungi walls

answer

chitin

question

Alveolates

answer

ciliated protists

question

Protist classifications

answer

amoebas, alveolates, heterokonts, euglenozoa, excavates

question

Archaeal genomes

answer

circular, similar to bacteria

question

Protein chemistry for increased stability

answer

ion pairs, acidic/basic residues, disulfide bridges, hydrogen bonds, hydrophobic interactions

question

Archaeal lipids

answer

ether-linked, making it more resistant to acid and heat

question

Gram-negative proteobacteria

answer

light-supplemented heterotrophs
adaptable metabolisms

question

Akinetes

answer

specialized pore cells
survive desiccation and then germinate at better conditions

question

Hormogonia

answer

short chains of motile cells

question

Gas vesicles

answer

used for buoyancy to maintain position

question

Carboxysomes

answer

carbon dioxide fixation location

question

Thylakoids

answer

photosynthetic apparatus separate from plasma membrane

question

Heterocysts

answer

cell part specialized in nitrogen fixing

question

Cyanobacteria

answer

oxygenic phototrophs
photolyze water to make oxygen
photolyze hydrogen
reduce sulfur compounds
only bacteria producers

question

Chloroflexi

answer

phototrphic, filamentous
moderate thermophiles
lots of membrane-bound chlorophylls

question

Xerophile

answer

have little water activity

question

Psychrophile

answer

live at low temperature environments

question

Oligotroph

answer

live in low carbon environment

question

Hyperthermophile

answer

live in high temperature environments

question

Halophile

answer

lives in high salt environments

question

Endolith

answer

live within rock crystals

question

Prebiotic soup

answer

basic components from abiotic factors infused with electricity formed biomolecules

question

Panspernia

answer

idea that life came from other planets

question

Metabolism of early microbes

answer

sulfur-based
anaerobic metabolism
reduction of nitrate and sulfate

question

Early Earth atmosphere

answer

CH4, CO2, N2, NH4+, H2S, FeS, CO, H2

question

Viroids

answer

infectious single strand RNA

question

Koch's postulates

answer

microbe found in all cases, but not healthy
microbe isolated and grown
induce disease by introducing microbe
can obtain microbe from diseased

question

RNA World Theory

answer

RNA can:
store info
duplicate
catalyze (ribosomes)
later, DNA and proteins took over these roles

question

Definition of Life

answer

structure and form
catalytic activity
self-replication
membrane compartmentalization
metabolism of energy

question

Barophile

answer

live in high pressure environment

question

Alkaliphile

answer

live in basic environments

question

Acidophiles

answer

live in acidic environments

question

Metabolist theory

answer

components of metabolism arose from self-sustaining abiotic rxns
proteins and metabolism formed first

question

Extremophiles

answer

species that grow in extreme environments

question

Psychrophiles

answer

thrive at cold temperatures

question

Paralogous proteins

answer

gene duplication and independent mutation of two protein lines

question

Orthologous proteins

answer

proteins that diverge from one another in different species

question

Proteobacteria resemble...

answer

mitochondria

question

Endosymbiosis example: sea slug & chloroplasts

answer

sea slugs engulf chloroplasts
chloroplasts perform photosynthesis

question

Endosymbiosis example: aphids

answer

have symbionts that make essential amino acids for them

question

Endosymbiosis example: amoeba and cyanobacteria

answer

cyanobacteria provides food
amoeba provides protection

question

Virulence factors

answer

help establish organism that can alter host functions to cause disease

question

Immunopathogenesis

answer

when immune response to pathogen is contributing cause to pathology

question

Genomic islands

answer

group of genes transferred together horizontally frequently
linked to tRNA
abnormal base-pair ratio
flanked by genes similar to phage/plasmid

question

Horizontal gene transfer

answer

DNA transfer via plasmids, transposons, bacteriophages
with genes coding for metabolism, stress response, pathogenicity

question

Vertical gene transfer

answer

parent-->child

question

Reductive evolution

answer

loss or mutation of DNA encoding for unselected traits

question

Shared ancestor (progenote) characteristics

answer

genetic code
fueling pathways
protein synthesis
very inefficient

question

When microbes originated

answer

3 billion years ago

question

Requirements for phylogenetic marker study

answer

gene must be present in organisms studied
gene can't be horizontally transferred
gene must have conservation
must be large enough

question

Chemiosmotic theory

answer

redox reactions of e- transport chain store energy in proton gradients in mitochondria

question

Lithotrophs

answer

feed on only inorganic minerals

question

Archaea

answer

can survive extreme pH and temperatures

question

Lichens

answer

algae live in fungus
algae provides food
fungus provides protection

question

Stomalites

answer

layers of earliest microorganisms

question

Types of microbes

answer

bacteria
archaea
eukaryotic microbes: yeasts, protists, algae

question

Thermophile

answer

live in hot water
branched off early

question

Uses for Sugar

answer

carbon & energy sources, storage material, adhesives, parts of other structures, virulence factors, signaling

question

Stabilizing forces of proteins

answer

hydrophobic interactions, hydrogen bonds, ionic interactions, disulfide bonds

question

Lipid structure

answer

glycerol backbone with hydrophilic phosphate group and two fatty acid side chains

question

Hopanoid

answer

planar, rigid structure within phospholipid bilayer; improves membrane stability

question

Linkage in bacterial and eukaryotic membranes

answer

ester-linked

question

Linkage in archaeal membranes

answer

ether-linked; more stable

question

Membrane structure is stabilized by

answer

hydrophobic interactions, hydrogen bonds, negative charges on proteins and cations

question

Diffusion

answer

passive transport through membrane from high to low concentration

question

Facilitated diffusion

answer

passive transport flowing down concentration gradient via protein

question

Symport

answer

transport of two molecules through same protein in same direction

question

Antiport

answer

transport of two molecules through same protein in opposite direction

question

ATP-binding cassette transporter

answer

active transporter
hydrophobic channel and two proteins that bind ATP for uptake of particular molecule

question

Group translocation

answer

active transport; intake of one molecule affects the uptake of others nearby via different proteins

question

ATP synthase

answer

generates ATP through flowing of H+ ions

question

periplasm location in gram+

answer

between cytoplasm and peptidoglycan

question

periplasm location in gram-

answer

between cytoplasm and outer membrane

question

Functions of the periplasm

answer

has protein-folders, hydrolytic enzymes, used to adjust osmotic stress, transport, chemoreception, detoxification

question

FtsZ function

answer

forms contractile ring for cytokinesis

question

MreB function

answer

encircles cell; involved in cell division

question

Cytoplasm functions

answer

involved in shaping, strength, transport, movement, chromosome separation, cell division, organization

question

Carboxysomes

answer

CO2 concentrator that contains RubisCO that fixes CO2

question

Mitochondria

answer

catabolizes nutrients via TCA cycle to make ATP

question

Chloroplast

answer

contains thylakoids (folds) where photosynthesis takes place; converts light to ATP & reducing power

question

magnetosome

answer

bacteria that move along magnetic fields in order to maintain proper spacing in water column to live in environment with right amount of oxygen

question

Gas vesicles

answer

filled by cell to manage level in water column

question

Endospore

answer

cell structure that is resistant to heat, radiation, chemicals, dessication

question

Capsule

answer

adds protection especially against phagocytes of immune system

question

Outer membrane functions

answer

contains porins to allow passage of small molecules

question

Peptidoglycan structure

answer

cross-linked glycopeptides; amide bonds between strings of amino acids and glucose derivatives

question

location of peptidoglycan

answer

in bacteria; one molecule that surrounds entire cell

question

Techoic acid

answer

stabilizes cell wall in gram+ bacteria

question

S-layer

answer

lots of disulfide bonds, but function unknown

question

Gram+ envelope structure

answer

polysaccharides and S-layer (protein)
thick cell wall with peptidoglycan cross-links; thin periplasm; contains membrane

question

Gram- envelope structure

answer

some have capsule of polysaccharide; outer membrane of lipopolysaccharide in outer leaflet; thin cell wall with fewer crosslinks; thick periplasm, plasma membrane

question

Gram- outer membrane

answer

made of lipopolysaccharides
contains O-polysaccharide antigen that determines virulence and can be altered
endotoxin

question

Cell wall structure

answer

made of peptidoglycan and sugar chains linked by amino acid polymer cross-links

question

Archaeal cell wall

answer

made of peudomurien (like peptidoglycan); may have S-layer, ether linked

question

Polar arrangement of flagella

answer

one flagellum on cell

question

Lophotrichous arrangement of flagella

answer

many flagella on one end of cell

question

Peritrichous arrangement of flagella

answer

multiple flagella at different places

question

Difference between prokaryotic and eukaryotic flagella

answer

prokaryotic flagella rotate to move cell
eukaryotic flagella whip to move cell

question

Swarming Motility System

answer

movement across solid surface by hyperflagellated cells

question

Swimming Motility System

answer

movement through liquid medium with flagella

question

Type IV pili mechanism

answer

"cast & reel" mechanism

question

Mechanisms of cell movement

answer

swarming, swimming, type IV pili, excretion of surface slime to slide across, rotary motors

question

Mycoplasma

answer

cell wall-less bacteria; must live in host; tough membrane w/sterols

question

Thermoplasma

answer

cell wall-less; low pH and high temperature environment; rigid membrane with tetra-ether lipids

question

Gram Stain technique

answer

distinguishes gram+ and gram- bacteria
add crystal violet to bacteria
precipitate dye with I-
extract precipitated dye
this removes all dye from gram-
gram positive still contains crystal violet due to the peptidoglycans that are present

question

Macronutrients for microbes

answer

carbon, oxygen, nitrogen, hydrogen, phosphorus

question

Sources of carbon

answer

CO2, sugar, organic acids, fatty acids, amino acids

question

Nitrogen is needed for

answer

amino acids, nucleic acids, peptidoglycan layer

question

Nitrogen sources

answer

amino acids, nucleic acids, nitrate, ammonia, nitrogen gas

question

Phosphorus is needed for

answer

phospholipids, nucleic acids, ATP synthesis

question

Phosphorus sources

answer

phosphate, degraded organics

question

Micronutrients for microbes

answer

sulfur, potassium, magnesium, calcium, iron

question

Sulfur needed for

answer

amino acids, vitamins

question

Sources of sulfur

answer

sulfate, elemental sulfur, dihydrogen sulfide

question

Potassium use

answer

acts as cell cation

question

Magnesium use

answer

stabilizes ribosomes, cell membranes, nucleic acids
required for ATP-dependent enzymes (forms complex w/ATP)

question

Calcium use

answer

stabilizes walls and spores

question

sodium use

answer

maintenance of osmotic balance

question

iron use

answer

used by cell enzymes

question

Trace elements needed by microbes

answer

transition elements

question

Growth factors

answer

used by cell to make coenzymes

question

Conenzyme of folic acid

answer

tetrahydrofolate

question

Function of tetrahydrofolate

answer

synthesis of nitrogenous bases

question

Coenzyme of biotin

answer

biotin

question

Function of biotin

answer

CO2 fixation

question

Coenzyme of lipoic acid

answer

lipamide

question

Function of lipamide

answer

Decarboxylation of keto acids

question

Coenzyme of Pantothenate

answer

coenzyme A

question

Function of coenzyme A

answer

utilized in metabolism

question

Coenzyme form of nicotinic acid

answer

NAD and NADP

question

Function of nicotinic acid

answer

electron carrier

question

Coenzyme form of pyridoxine

answer

pyridoxal phosphate

question

Function of pyridoxine

answer

amino acid metabolism

question

Coenzyme of Riboflavin

answer

FAD

question

Function of FAD

answer

electron carrier

question

Thiamine coenzyme

answer

TPP

question

Function of TPP

answer

C2 unit carrier

question

Cobalamin coenzyme

answer

adenosylcobalamin

question

Function of adenosylcobalamin

answer

transfers methyl groups

question

Photolithoautotrophs

answer

energy source: light
carbon source: CO2
reducing power source: inorganics

question

Photoheterotrophs

answer

energy source: light
carbon source: organics
reducing power source: organics

question

Chemolithoautotrophs

answer

energy source: chemicals
carbon source: CO2
reducing power source: inorganics

question

Chemoheterotrophs

answer

energy source: organics
carbon source: organics
reducing power source: organics

question

Chemo-

answer

gets energy from chemicals and organic compounds

question

Process of division in spherical bacteria

answer

septation

question

Division in Gram- rod-shaped bacteria

answer

Z ring forms when both nucleoids are present
pulls membranes inward
synthesizes new peptidoglycan

question

Division in Gram+ rod-shaped bacteria

answer

Z-ring forms at middle
peptidoglycan forms down middle

question

Min protein function

answer

determines location of Z ring
MinE depolymerizes MinCD, causing both proteins to oscilate back and forth
when MinE runs out, MinCD complex reforms and causes Z-ring to form

question

Influences on growth rate

answer

rate of catalysis, metabolism speed, nutrient availability, temperature, pH, gases available

question

Growth rate constant

answer

rate of exponential growth

question

Growth rate equation

answer

final # cells= initial # cells * 2^(# generations)

question

Psychorphile

answer

lives in -5-10 degrees Celsius

question

Mesophile

answer

lives in 10-45 degrees Celsius

question

What temperature classification of bacteria infect humans?

answer

mesophiles

question

Thermophile

answer

lives in 40-80 degrees Celsius

question

Hyperthermophile

answer

lives in 80+ degrees Celsius

question

How do cells adjust to cold temperatures?

answer

incorporate unsaturated fatty acids to increase membrane fluidity; express enzymes that are effective at low temperatures

question

How do cells adjust to hot temperatures?

answer

incorporate saturated fatty acids, more sterols and hopanoids to decrease membrane fluidity; express enzymes resistant to denaturation; use chaperones to stabilize proteins

question

Strict aerobes

answer

require oxygen

question

Strict anaerobes

answer

don't use oxygen and are killed by it

question

Facultative anaerobes

answer

can use oxygen, but can grow without it

question

Aerotolerant anaerobes

answer

can survive in oxygen, but don't use it

question

Microaerophiles

answer

require oxygen, but can't survive in atmospheric conditions

question

How do cells adjust to acidic conditions?

answer

seal off membrane to prevent H+ ions from entering

question

How do cells adjust to basic conditions?

answer

utilize other monovalent ions for cell processes; use antiport to expel ion and take up H+ ions

question

Membrane-permeant organic acids

answer

weak acids that can enter cell membrane in uncharged form and then dissociate to cause decrease in pH

question

Neutralophiles

answer

grow best in pH 5-8

question

What pH classification of microbes are pathogens?

answer

neutralophiles

question

Acidophiles

answer

grow best in pH 0-5
tetraether lipids in membrane decrease H+ permeability

question

Alkaliphiles

answer

grow best 9-11
diether lipids that prevent proton linkage
expel Na+ ions to take up H+

question

How do cells prevent water loss?

answer

synthesize compatible solutes

question

How do cells prevent water gain?

answer

release solutes

question

Sterilization

answer

process where living cells, spores, viruses, are destroyed on an object

question

Disinfection

answer

killing or removal of disease-producing organisms from inanimate surfaces

question

Antisepsis

answer

removal of pathogens from surface of living tissues

question

Sanitation

answer

reducing microbial population to safe levels

question

Bactericidal

answer

antibacterial agents

question

Germicidal

answer

chemical substances that kill microbes and pathogens

question

Pasteurization

answer

heating food to temperature long enough to kill most heat resistant nonspore pathogens

question

Decimal reduction time

answer

length of time it takes agent to kill 90% of population

question

Decimal reduction time is affected by

answer

population size, population composition, agent concentration, duration of exposure

question

targets of antiobiotics

answer

cross-link assembly in membrane, protein synthesis, nutrient synthesis, gene expression, DNA replication

question

How microbes resist drugs

answer

add group to antibiotic to inactivate it, pump out antibiotic, lack molecular target of antibiotic, modify receptors so it is unrecognizable

question

Bioremediation

answer

treatment of radioactive waste using genetically engineered bacteria

question

Fe/Mn oxidation

answer

oxidize iron, making it insoluble (Fe2+-->Fe3+)
gets carbon from CO2

question

Methanogenic archaea

answer

reduce CO2-->CH4

question

How to drive a reaction by altering concentrations

answer

increase reactants; decrease products

question

Oxidant

answer

accepts electrons

question

Reductant

answer

donates electrons

question

Sign of redox potential that means oxidized form is more stable

answer

negative

question

Sign of redox potential that means reduced form is more stable

answer

positive

question

NAD+

answer

accepts 2e- at once and 2H+

question

FAD

answer

accepts 1e- or 2e-, can also accept H+

question

one-electron carriers

answer

transition metal complexes that cannot accept protons

question

Characteristics of energy carriers

answer

phosphorylated compounds or compounds with high energy bonds

question

Types of high energy bonds

answer

anhydride bond, thioester bond, ester bond

question

Holoenzyme

answer

complete enzyme

question

What does catabolism achieve?

answer

chemical energy, reducing power, building blocks for biosynthesis

question

oxidative phosphorylation

answer

synthesis of ATP by ion-driven ATPase; respiration
substrate is passed from carrier to carrier to be reduced and eventually combines O2 and H+ to make water; generates proton motive force

question

substrate level phosphorylation

answer

synthesis of ATP from ADP coupled with breakdown of bonds; fermentation

question

NAD+/NADH

answer

energy carrier that donates and accepts 2-3 times more energy than ATP

question

structure of NADH

answer

ADP attached to stable ring; ring has N base and sugar phosphate

question

How NADH holds electrons

answer

aromatic ring is disrupted by addition of 2 electrons and H+; must transfer electrons to another carrier or substrate to reduce it

question

FAD

answer

accepts 2e- and 2H+ to form FADH2

question

cytochrome

answer

extracts energy from electron by pushing protons out of cell; must tolerate/avoid oxygen

question

ETS in steps

answer

1. protons & electrons brought to flavoprotein
2. electrons passed to Fe/S
3. Proton extruded to make PMF
4. electrons from Fe/S enter quinine pool
5. protons picked up from cytosol
6. electrons are brought to heme and Fe/S clusters of cytochromes
7. electrons from Fe/S centers are brought to heme
8. cytochrome oxidase transfers electrons to final acceptor and consumes protons from cytoplasm

question

F0 mechanism of ATP synthase

answer

a-subunit port of entry for protons
interacts with c unit to deprotonate amino acid residue
neutralized c subunit can rotate and bring neutral c to exit where proton is lost, and then reprotonated

question

F1 mechanism of ATP synthase

answer

active site on beta unit where ADP and phosphate loosely bind
rotation of F0 drives this rotation
rotation switches binding to tight state forming ATP
Another rotation brings to open state to release ATP

question

Proton motive force-driven ATP synthesis

answer

splits hydrogen to create protons and provide energy to make NADH and ATP

question

Sulfur oxidizers

answer

oxidize sulfur to pump out H+ and drive production of ATP and NADH

question

Iron oxidizers

answer

oxidize iron to pump out H+ and drive production of ATP

question

Anaerobic respiration

answer

less efficient than aerobic respiration; still involves ETS, but O2 is not terminal acceptor

question

Nitrate reducers

answer

nitrate-->nitrite, nirate-->nitrogen gas
ineffective, toxic
only used when oxygen is scarce

question

hydrogenotrophic methanogenesis

answer

CO2-->CH4
CO2 is activated and then reduced by methanofuran
Methanopterin reduces it twice more
then forms CH4

question

Homoacetogenesis

answer

CO2-->acetate

question

light-drive energy generation

answer

use light to make ATP & reducing power

question

Light-driven proton motive force

answer

light hits compound to bring electron up an energy level
electron flows down transport system to make NADPH or NADH
enters a second photosystem to repeat and recycle electrons

question

Capture of light in archaea

answer

involves retinal

question

sensory rhodopsins

answer

drive archaeal cell away from damaging light and towards optimal absorbing light

question

CO2 fixation

answer

gets reducing power from sulfur containing compounds (anaerobic) or water (aerobic)

question

organotrophy

answer

organic compounds donate electrons

question

organic respiration

answer

catabolism with inorganic or small organic electron acceptor using glycolysis, TCA cycle, ETS

question

Lithotrophy

answer

inorganic compounds donate electrons

question

methanogenesis

answer

anaerobic with inorganic donor and CO2 acceptor

question

Photoautotrophy

answer

photolysis of water (aerobic) or others (anaerobic) using photosystems

question

photoheterotrophy

answer

catabolism with light absorption supplements

question

What do obligate fermenters lack?

answer

ETS

question

Fermentation steps

answer

1. activate substrate
2. rearrange C skeleton
3. oxidize activated substrate
4. couple reaction to synthesize ATP
5. balance oxidation with reduction
6. excretion of products

question

What glucose breakdown yields

answer

two 3-carbon sugars + 4H+ on NADH

question

Glycolysis

answer

glucose 6-phosphate-->fructose 6-phosphate-(phosphorylation)->2 pyruvates, 2 net ATP, 2 net NADH

question

Entner-Duodoroff (ED) pathway

answer

glucose 6-phosphate-(oxidation)->6-phosphogluconate-->1 pyruvate + 1 G3P-->G3P enters glycolysis , 1 net ATP, 1 net NADH, 1 net NADPH

question

Pentose-phosphate shunt (PPS)

answer

glucose 6-phosphate-(oxidation)->6-phosphogluconate-(decarboxylation)->ribulose 5-phosphate (used for biosynthesis, or converted to pyruvate)
makes 1 ATP and 2NADPH

question

Amphibolic pathway

answer

can participate in both catabolism and anabolism, simply by reversing process

question

Steps that regulate glycolysis

answer

involves steps that are not reversible

question

How fermentation completes catabolism

answer

recycles e- carriers by transferring H's back to pyruvate products

question

Mixed acid fermentation

answer

forms various products depending on pH

question

Acetyl-CoA

answer

esterified coenzyme A to acetyl group

question

Catabolism of fats

answer

uses lipases to generate acetyl-CoA that feeds into TCA cycle by dehydrating, then adding water and oxidizing to ketone

question

Catabolism of aliphatic hydrocarbons

answer

addition of oxygen, then two oxidations

question

Catabolism of aromatics

answer

attach CoA, removal of aromaticity, break ring, then oxidize

question

Catabolism of proteins

answer

broken down to peptides then amino acids to feed into TCA cycle

question

Cycles involved in CO2 fixation

answer

Calvin cycle, reductive TCA cycle, reductive acetyl-CoA pathway, methylotrophic strategy

question

Calvin cycle steps

answer

1. 3CO2-->G3P
2. 1CO2-->rubisco-diphosphate -->6-carbon product-->2 G3Ps
each cycle yields 1 G3P and spends 9ATP

question

Reductive TCA cycle

answer

TCA cycle in reverse, but some enzymes are replaced because they can't run in reverse

question

Methylotrophic strategy

answer

pick up CO2 to detoxify formaldehyde

question

Biosynthesis of fatty acids

answer

CO2+acetyl-CoA-->malonyl CoA that then progresses to form fatty acid and kick off CO2

question

Rubisco

answer

fixes CO2, housed in carboxysome

question

Where does nitrogen fixation occur?

answer

in cells that have differentiated into heterocysts so that O2 isn't there because nitrogen fixation is toxic in presence of oxygen

question

Rhizobia

answer

fix nitrogen in symbiosis with legumes
make leghemoglobin that binds to oxygen and prevent it from reacting with nitrogen fixation; also don't let ammonia freely float around

question

Why do ensymes require metal cofactors?

answer

bind to active sites of enzymes; play structural roles

question

Siderophores

answer

take up iron for bacterial cells; used by pathogens to survive and cause disease

question

What's the difference between cofactors and coenzymes?

answer

coenzymes: organic, required by some enzymes for catalysis
cofactors: inorganic, required for or increase rate of catalysis

question

Nucleoside

answer

base + sugar

question

Nucleotide

answer

base, sugar, phosphate

question

Purines

answer

adenine and guanine; double-ring

question

pyrimidines

answer

thymine, cytosine, uracil; single-ring

question

Difference between RNA and DNA sugar

answer

ribose has 2' -OH group, so it's more easily cleaved

question

What does double-stranding of DNA accomplish?

answer

protection from chemical attack; information redundancy; repair mechanisms

question

Ribozymes

answer

RNA that catalyzes reactions

question

Riboswitch

answer

mRNA with a UTR that binds to metabolite in order to hide a ribosome binding site, creating a terminator

question

Helicase

answer

unwinds DNA

question

Primase

answer

adds RNA priming strand

question

DNA Polymerase III

answer

adds nucleotides during replication

question

Sigma subunit of RNA polymerase recognizes what?

answer

-35 and -10 regions and binds to promoter

question

Rho-independent termination

answer

G-C rich stem-loop forms, followed by a series of A's, causing the polymerase to fall off

question

Rho-dependent termination

answer

polymerase stalls and Rho protein cleaves it off

question

Wobble rule

answer

3rd nucleotide of a codon can bind to something else; G can bind to U or C; U can bind to A or G

question

Polar mutations

answer

block translation, causing a stoppage in downstream transcription, since both occur at the same time

question

Transition mutation

answer

conversion of a purine to another purine or pyrimidine to another pyrimidine

question

Transversion mutation

answer

conversion of purine to pyrimidine or vice versa

question

Effect of UV rays

answer

cause pyrimidine dimers to form

question

Effects of X-rays and Gamma rays

answer

double-stranded breaks in DNA

question

Effects of oxidation on DNA

answer

deamination, depurination, methylation

question

Mismatch repair mechansim

answer

repairs base substitutions
substitution is recognized by MutS; Excision is performed by MutL and MutH; repair is performed by Pol I

question

Base excision repair

answer

removal of damaged bases, and then a separation of that gap

question

Addiction System

answer

plasmid has a long-lived poison and a short-lived antidote; daughter cells that inherit the plasmid will survive because they have the antidote code, but ones that don't will die because the poison lingers from the parental cells

question

Uncoating of Eukaryotic viruses

answer

can be uncoated upon attaching to membrane; can be uncoated once inside cell into an endosome (derived from cell membrane); can be uncoated upon attaching to nuclear membrane

question

RNA-RNA polymerase

answer

involved in replication of RNA of viruses; doesn't proofread

question

+RNA virus

answer

has ribosome that makes RNA-RNA polymerase

question

-RNA virus

answer

needs to bring an RNA-RNA polymerase with it because it doesn't have a ribosome to transcribe RNA-RNA polymerase

question

Viroids

answer

naked nucleic acid molecules that act as plant pathogens

question

Prions

answer

single protein molecules that infect

question

Histidine protein kinase

answer

senses stimulus; phosphorylates itself and transfers phosphate to response regulator

question

phosphatase

answer

removes phosphate from response regulator

question

What does membrane curvature control?

answer

where lipids are positioned and localization of some proteins

question

What shapes membrane curvature?

answer

peptidoglycans

question

Cardiolipin (CL) structure

answer

2 phosphate groups with side chains on each

question

Where is cardiolipin found?

answer

found in bacteria and membranes related to mitochondria and chloroplasts at poles of septum

question

What does cardiolipin do?

answer

destabilizes planar lipid bilayers

question

How to bend bacteria

answer

use lysozyme to turn it into a sphere then confine them to microchambers; sphere membranes will then conform to curvature of the chambers

question

MinD

answer

protein that inhibits division plane formation

STUDY

Acid Fast Stain Cell Mediated Immune Response Gram Positive Cocci Microbiology Microeconomics

OCTC-Micro-Chapter 19 – Flashcards 197 terms

Viola Marenco

197 terms

Preview

OCTC-Micro-Chapter 19 – Flashcards

question

Pathogenic Gram-Positive Cocci and Bacilli

answer

Stain purple when gram-stained

question

Staphylococcus is a _____ member of every human’s microbiota.

answer

Normal

question

Staphylococcus is located:

answer

In nasopharynx
On skin
Colonizes the infant w/in hours

question

Staphylococcus found in hospitals in

answer

Nurseries and surgical wards.

question

Staphylococci live and reproduce on

answer

almost every square inch of human skin

question

Staphpylococcus can be ______ pathogens causing anywhere from minor to life threatening diseases

answer

opportunistic

question

Staphylococcus genus name comes from Greek term staphle meaning ______

answer

“bunches of grapes”

question

Coccus (pl.cocci) =

answer

spherical–shaped bacterial cell

question

staph =

answer

staff or group (Cluster like grapes)

question

Staphylococcus colonies appear

answer

cream colored, white to light gold, and “buttery-looking”

question

Staphylococcus is Gram _____

answer

positive cocci, nonmotile, facultative anaerobes

question

Staphylococcus grows best when _____ present, but can continue to grow under ____ conditions.

answer

O2, anaerobic

question

Staphylococcus is _____-tolerant

answer

salt

question

Staphylococcus tolerates the ____ present on human skin

answer

salt

question

Staphylococcus is tolerant of desiccation (capsule). What does this mean?

answer

allows survival on environmental surfaces such as fomites
Object inadvertently used to transfer pathogen to new host: needle or coin

question

Staphylococci are catalase positive or negative?

answer

positive

question

Catalase Converts H202, (hydrogen peroxide) Into_____ and ____?

answer

H20 and 02

question

Staphylococci can disarm neutrophil’s and macrophage’s H2O2 with ______?

answer

catalase

question

_______ is secreted by neutrophils and macrophages to kill bacteria

answer

Hydrogen peroxide

question

To test for catalase:

answer

Inoculating loop is rubbed across a colony of Staphylococcus and mixed with H202 on a slide.
If bubbles appear, the enzyme catalase must be present.
So Staphylococcus is catalyst positive

question

Staphylococcal infections range from the

answer

trivial to the rapidly fatal

question

Are Staphylococcal infections easy to treat?

answer

No, They can be difficult to treat

question

Why are Staphylococcal infections difficult to treat?

answer

Because staphylococci can acquire antibiotic resistance

question

“Staph” infections result when staphylococci

answer

breach the body’s physical barriers.

question

Entry of only a few hundred bacteria (ID) can result in

answer

disease

question

Staphylococci are ______ in nature with about a _____ species part of our human flora

answer

ubiquitous, dozen

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How many species are commonly associated with staphylococcal diseases in humans?

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What are the 2 species commonly associated with staphylococcal diseases in humans?

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1.Staphylococcus aureus is one of the most common causes of infections
2.Less virulent,opportunist Staphylococcus epidermis may cause prosthetic implant infections

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Staphylococcus aureus is one of the most common causes of

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infections

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Less virulent, opportunist Staphylococcus epidermis may cause

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prosthetic implant infections

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Staphylococcus epidermidis is the______ of human skin

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Normal microbiota

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Staphylococcus epidermidis is the normal microbiota of human skin that can cause ?

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opportunistic infections to immunocompromised patients or when introduced into parts of body

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Staphylococcus aureus is located on

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skin, nares, mucous membranes (pharynx and vagina)

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What pigment is Staphylococcus aureus on sheep blood agar?

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Gold pigment

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Pathogenicity of Staphylococus (3 things)

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1.Cell wall structures that prevent phagocytosis
2. Enzymes
3. Production of toxins

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Cell wall structures that prevent phagocytosis (3 things)

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a. Protein A
b. Bound coagulase
c. Capsule/slime layer

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2. Enzymes (5 things)

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a. Coagulase
b. Staphylokinase
c. Hyaluronidase
d. Lipase
e. B-lactamses

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3. Toxins (4 things)

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a. Cytolytic toxins
b. Exfoliative toxins
c. Toxic-shock-syndrome (TSS) toxin
d. Enterotoxins

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Staphylococcus aureus has Protein A which causes_____to bind upside-down _____ antigen. This _____ opponization and ________.

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antibody stems,S. aureus
Inhibits, phagocytosis

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Staphylococcus aureus has ________ that converts fibrinogen into ______ that form clots around pathogen.

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enzyme coagulase, fibrin

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Fibrin clots ______ Staphylococcus aureus from phagocytic cells

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hide

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Staphylococcus aureus forms slime layer/capsule that prevents:

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Phagocytosis and Dessiccation

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Slime layer facilitates attachment of
Staphylococcus to artificial surfaces such as (5 things)

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catheters, shunts, artificial heart valves and joints

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Coagulase triggers fibrin clotting, which hides the _______

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Staphylococcus aureus

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Staphylokinase

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Dissolves fibrin threads in clots, allowing S.aureus to free itself from clots and spread to new location

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Hyaluronidase

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Breaks down hyaluronic acid, enabling S. aureus spread deeper between cells

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Lipases =

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digest lipids allowing Staphylococcus aureus to grow on surface of skin and sebaceous glands

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B-lactamase =

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penicillinase now in 90% of S. aureus strains and thus resistant to penicillin and cephalosporins

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Cytolytic toxins Disrupts the ______ ______ ______of a variety of cells such as

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mammalian cytoplasmic membrane
Heart, skeletal muscle, renal cells, platelets

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Hemolysins damage

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RBCs

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Leukocidin lyses

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Leukocytes, Macrophages, and neutrophils

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Leukocidin provides S. aureus ______ from _____.

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protection from phagocytosis

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Exfoliative toxins = ET causes

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Exofoliation

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Exfoliative toxin dissolves

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desmosomes
The patient’s epidermal layer of skin to slough off

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Toxic-shock-syndrome toxin symptoms

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High fever, rash, peeling of skin, vasodilation, drop in BP

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Staphylococcus aureus produces enterotoxin proteins which in turn stimulate which 4 things?

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Intestinal muscle contractions
Nausea
Intense vomiting
Associated with staphylococcal food poisoning

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Staphylococcus aureus Enterotoxins are ____ stable

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heat

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Heat does not denature_____ protein

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enterotoxin

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cover dish dinner; take home leftovers; reheat = zap in microwave. This process Does not _______the Enterotoxin

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denature

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Staphylococcal Diseases categorized as which 3 things?

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1. Noninvasive Disease
2. Cutaneous Disease
3. Systemic Disease

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1. Noninvasive Disease

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Food poisoning
Ingestion of Staphylococcus aureus contaminated food

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Ingestion of Staphylococcus aureus contaminated food Bacteria grow on food and secretes

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Enterotoxin that is heat stable

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Common cause of food poisoning?

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Staphylococcus aureus

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Food poisoning is caused by ______ rather than by ______ of the bacteria

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enterotoxin, invasion

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Food must remain at ________for several hours for bacteria to grow, reproduce, and produce toxin

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room temperature

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Enterotoxin causes ____, ____, ____ for how long?

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nausea, vomiting, diarrhea for 24 hours

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Reheating may kill ______ bacteria but does not inactivate _______.

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S. aureus, enterotoxin

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2. Cutaneous Disease
Various skin conditions: name 6

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Scalded skin syndrome
Impetigo
Folliculitis
Sty
Furuncles
Carbuncle

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Staphylococcus aureus causes localized _______(pus filled lesions)lesions

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pyogenic

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Pyogenic =

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pus filled lesions

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Scalded skin syndrome =
Exfoliative toxin causes: name 4 things

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Reddening of skin
Large blisters
Epidermis peels off in two days
Subject to secondary bacterial infection

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Scalded skin syndrome = Exfoliative toxin Usually affects ______ of severed umbilicus & Older children with ______.

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neonates, skin infections

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Staphylococcus aureus causes 80% of

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impetigo

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impetigo is what and occurs on who?

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Small, flattened, red patches on face, limbs of children whose immune system is not fully developed

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impetigo mostly occurs on _____ as pus filled vesicles that crust over and become honey colored, wet, flaky. The pus is filled with ____ and ____

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face, S. aureus and WBC

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Folliculitis =

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Infection of hair follicle

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Folliculitis Becomes red, swollen, and pus filled. When it occurs at base of eye in eyelash follicle it is called a

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Sty

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Furuncle = boil
Penetrates into the ______?

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Large, painful, raised nodular extension of folliculitis to surrounding tissue.
Penetrates into the subcutaneous layer

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Carbuncle =

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several furuncles coalesce

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Carbuncle

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Larger, deeper, more painful
May have to be surgically drained
Can be the size of baseball

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Carbuncle May cause____ and _____ as S. aureus spreads into underlying tissues
may need ______.

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fever, chills, antibiotics

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S. aureus can cause a variety of potentially fatal _____ _____ When introduced to deeper tissues of the body such as ___, ____, ____, and ____.

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systemic infections
Blood, heart, lungs, and bones

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3. Systemic Disease 6 things

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TSS
Pneumonia
Bacteremia
Endocarditis
Osteomyelitis
Empyema

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Staphylococcus aureus produce _____ toxin

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TSS

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Staphylococcus aureus can grow in a _____ or _____ vagina and produce the toxin and cause______.

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wound,abraded
Toxic shock syndrome

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can TSS occur in both males and females?

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Yes

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Toxic Shock Syndrome Toxin causes:

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Fever
Vomiting and Diarrhea
Red rash
Loss of sheets of skin
Low BP, shock
Multi-organ failure due to shock

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TSS fatal in ____% cases. Why?

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5%, When BP drops so low O2 cannot be carried to vital organs and causes shock, death

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Staphylococcus aureus in blood is ______ and Accounts for half of all ______ infections

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Bacteremia , noscomial

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Staphylococcus aureus Bacteremia Causes:

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Furuncles
Vaginal infections
Infected surgical wounds

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Hospitalized patients with chronic disease that contract S. aureus bacteremia have a

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high mortality rate

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Staphylococcus aureus = Endocarditis

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Attacks lining of heart and valves

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Endocarditis is one of the consequences of _______.

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staphylococcal bacteremia

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Staphylococcus aureus = Endocarditis
Symptoms are _____ and ______.

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nonspecific, flulike

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Staphylococcus aureus = Endocarditis
Blood pumped from heart ______ which in turn makes the ____ drop.
50% patients do not

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drops, BP, survive

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Staphylococcus aureus in blood invades _____ causing______.

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lungs, pneumonia

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Mortality rate for staphylococcal pneumonia is _____%.

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50%.

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Staphylococcal pneumonia known to occur as secondary infection to

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influenza

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Staphylococcal pneumonia Particularly occurs in _____ and_______ patients

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infants,cystic fibrosis

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In 10% of patients with Staphylococcal pneumonia… The fluid filling the alveoli is _____, this condition is called ______.

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pus, empyema

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When Staphpylococcus aureusInvades a bone, it causes

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Staphylococcal osteomyelitis

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Staphylococcal osteomyelitis Signs and symptoms are: Inflammation of

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Bone marrow, diaphysis and periosteum
Fever, Chills, Swelling and pain
(Brake hip and get stahpylococcus aureus infection in bone)

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Diagnosis of Staphylococcus Infections

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Detection of Gram-positive bacteria
Isolated from pus, blood, or other fluids

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Treatment: ______ is the drug of choice to treat staphylococcal infections.

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Methicillin

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Treatment:Since (1962) 1987 have:
MRSA =

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methicillin-resistant Staphylococcus aureus

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Treatment: Since 2002 have:
VRSA =

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vancomycin resistant S. aureus

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Prevention = some humans are carriers

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Hand antisepsis
Proper cleansing of wounds and surgical openings
Aseptic use of catheters or indwelling needles
Appropriate use of antiseptics

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The Genus Streptococcus Is a diverse group of

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Gram positive cocci

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Streptococcus can be arranged in ____ or ______

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Pairs or chains

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Streptococcus are arranged in pairs called

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diplococci

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Streptococcus are Arranged in chains like a strip of button
candy called

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streptococci

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Streptococcus is Catalase _____

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negative

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Most Streptococcus are _______ ________.

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facultative anaerobes

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Serological classification of Streptococcus is useful in _______.

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identification

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The Lancefield classification Developed by Rebecca Lancefield in 1938 was
Based on ______ ______.

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serological classification

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The Lancefield classification puts various strains of Streptococcus into _____ different groups.

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19.

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Lancefield groups go from _____ to ____.

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A – S

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Lancefield groups A and B are ______ and ______.

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GAS and GBS

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GAS and GBS Include the significant streptococcal pathogens of _____.

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humans

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There are _____ species of Streptococci
only a few (5) are ______ _______.

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Thirty, human pathogens

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Group A Streptococcus =

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Streptococcus pyogenes

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What do Group A (GAS) Streptococcus pyogenes look like?

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Looks like chain of purple pearls on slide

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Group A Streptococcus: GAS
On blood agar plate, Streptococcus pyogenes forms ______ colonies surrounded by _____ of beta-hemolysis on blood agar plates.

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white, zone

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Streptococcus pyogenes lyse _____ leaving a ____ zone around ____ colony.

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RBC, clear, white

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What is the main representative of group A Streptococcus (GAS)?

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Streptococcus pyogenes

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What is the most serious streptococcal pathogen?

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Streptococcus pyogenes

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Streptococcus pyogenes has a number of
Structures, Enzymes and Toxins that enable it to survive as a ______.

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pathogen

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Pathogenic strains of Streptococcus pyogenes form _____

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capsules

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What are the structural components and enzymes of Streptococcus pyogenes? 5 things?

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1.Protein M (protein A in S. aureus)
2.Hyaluronic acid capsule
3.Streptokinase Enzymes
4.Hyaluronidase = spreading factor

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Protein M ________ complement. Thereby interfering with opsonization, phagocytosis, and lysis of bacteria.

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destabilizes,

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Hyaluronic acid capsule acts to ______ the bacteria

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camouflage(WBC cannot recognize)

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Streptokinase Enzymes ______ blood clots and _______ spread of Streptococcus pyogenes into ______ and _____tissue

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dissolves, facilitates, damaged and infected

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Hyaluronidase called the ______ ______, dissolves hyaluronic acid and facilitates spread of Streptococcus pyogenes into deeper tissue

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spreading factor

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What are Streptococcus pyogenes major Extracellular Toxins? 3 things

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Exotoxins
Pyrogenic toxins/ Erythrogenic toxins
Streptolysins toxins

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Streptococcus pyogenes :Pyrogenic toxins Stimulate______ and ______ cells to release cytokines/pyrogenes

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macrophages and helper T cells

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Streptococcus pyogenes :Pyrogenic toxins Stimulate ______ , causes ____ , and _____ toxic shock

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fever,rash and streptococcal

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Because Pyrogenic toxins cause blood capillaries near surface of skin to dilate producing a red rash known as ____ _____, Some scientist call the toxins _________ toxins

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(scarlet fever), Erythrogenic

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Streptolysins toxins Cause _____ of sheep blood agar. Clear zone around colony

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hemolysis

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Streptolysins toxins Lyses _____, _____ and _______Which interfere with O2 carrying capacity, Immunity, Blood clotting.

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RBCs, WBCs and Platelets.

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Streptolysins toxins also lyse other tissue cells such as

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Liver cells
Cardiac muscle cells
Kidney cells

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Humans are only significant reservoir of ___ to ____ % of population are carriers of virulent strains of Streptococcus pyogenes

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5-15%

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Streptococcus pyogenes
Typically causes disease when:

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Competing normal flora is depleted
Immunity is impaired
When large inoculum enables it to get a foot hold (infectious dose) before antibodies form against it

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Streptococcus pyogenes
Causes following diseases: KNOW these 7

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Strep throat
Erysipelas
Streptococcal toxic shock syndrome
Necrotizing fasciitis
Scarlet fever
Rheumatic fever
Post streptococcal glomerulonephritis

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What is the Streptococcus pyogenes strain for Sore throat, strep throat, or tonsillitis ?

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Streptococcal pharyngitis

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Bacteriological or serological testare needed for a sure diagnosis of ______ _____

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Streptococcal pharyngitis

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What is Streptococcal pharyngitis treated with?

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penicillin

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What is a Sequela?

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a condition following and resulting from a disease

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_____ is a morbid complication that follows a disease

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Sequela

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Some diseases leave sequela In the form of long-term or permanent

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Damage to tissues or organs

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Examples of Sequelas:
Meningitis can result in _____

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deafness

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Examples of Sequelas:
Strep throat can result in _____ _____

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scarlet fever

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Examples of Sequelas:
Strep throat can result in _____ ______ disease

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rheumatic heart

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What is Pyoderma?

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streptococcal impetigo

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streptococcal impetigo is a localized _____ ______.

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ski