assault / infectious diseases

Question 1

kochs postulates

Answer 1

1) criteria for linking a specific organism to a specific disease
2) organism is regularly found in lesions of the disease
3) organism can be isolated as single colonies
4) inoculated and infect someone

Question 2

host barriers

Answer 2

1) skin
2) urogenital tract
3) respiratory tract
4) intestinal mucosa

Question 3

skin

Answer 3

1) normal flora maintains an equilibrium
2 )keratin layer is constantly shed, eliminating most bugs
3) normal floral prevent access
4) low pH (5.5) and fatty acids inhibit growth
5) warm moist skin is susceptible to penetration (HPV)
6) microorganisms typically penetrate through lesions
- pricks, wounds, burns, needles, bites

Question 4

urogenital

Answer 4

women have 10x more UTI
- low pH
2) pyelonephritis
- bladder to kidney
3) most pathogens are bacteria for perianal area into urethra
4) during reproductive years
- glycogen converted to lactic acid by lactobacilli
- low pH suppresses STD?

Question 5

respiratory tract infection

Answer 5

1 )size of organisms important
2) damage to mucocilliary defense can be caused by smoking, cystic fibrosis, injury during intubation, aspiration of gastric juices
3) alveolar macrophages can phagocytose microbes
4) influenza inhibit ciliary motion and lower viscosity of mucus
5) tuberculosis escapes phagocytosis by killing macrophage

Question 6

intestinal stract

Answer 6

1) pathogens transmitted by food and water with feces
2) normal defenses are mucociliary cover, gastric acids,, pancreatic enzymes, bilt salts, IgA
3) interference with gastric acids, antibiotics, bowel obstructions
4 )enveloped viruses are resistant to acids and enzymes

Question 6

enteropathic bacteria

Answer 6

1) toxins that cause epithelial cells to secrete large amounts of fluid (e. coli)
2) shigella causes blood stool (dysentery)
3) cyst forms of protozoan parasites are resistant to acids

Question 7

spread through

Answer 7

1) path of least resistance
2) regional lymph nodes
3) cellulistis that gets into the chest
4) HPV and fungi free in plasma
5) herpes, HIV, carried by WBCs
6) parasites in RBCs
7) dissemination leads to systemic inflammation due to cytokines
8) massive bloodstream invasions can be fatal (sepsis)
9) organisms can cause disease at sites different to entry

Question 8

mother to child

Answer 8

1) transplacentally
2) treponema pallidum
- syphilis
- 2nd trimester
3) infection from vagina to uterus
4) child may have infections present in the vaginal fluid (HIV, HBV, chlamydia, herpes)

Question 9

release of microbes

Answer 9

1) urination, defecation, coughing, sneezing, skin shedding
2) viruses in salivary glands can be transmitted through talking or kissing

Question 10

immune evasion

Answer 10

C difficle in the intestine
- number 1 acquired in hospital
2) malaria sporozoites rapidly invade
3) cleave antibody, resist complement
4) survive phagocytosis
-carbohydrate capsule
5) shedding antigents
- makes vaccination difficult
6) causing immunosuppresion
- viruses that directly infect lymphocytes

Question 11

special techniques for diagnosis

Answer 11

1) H and E
2) special stains
- gram, acid fast bacilli stain, per-iodic acid schiff
3) labelling with specific antibody probes
4) cultures are the only way to speciate and determine drug sensitivity

Question 12

inflammatory responses

Answer 12

1) suppurative polymorphonuclear inflammation
2) mononuclear inflammation
3) chronic inflammation and scarring
4) ????

Question 13

macrophage activation adn sensitization in TB

Answer 13

1) class II MHC presents antigen to CD4 t cells
2) cytokines are released
- initiate delayed hypersensitivity reaction
3) increase phagocytosis

Question 14

bacteria

Answer 14

1) prokaryotes that lack nuclei and ER
2) large numbers are normal colonizers of skin, mouth and gut
2) most extracellular
4) some intracellular facultative
5) pyogenic
- pus forming (abscesses and suppurative exudate)
- cocci bacteria

Question 15

mechanism of bacteria induced injury

Answer 15

1) adhesins bind bacteria to host cells
2) superantigens bind to MHC II molecules on APCs
- stimulate t cells to secrete IL-2
- overproduction of cytokines
- fever, shock, multisystem organ failure
- Toxic shock syndrome

Question 16

gram -

Answer 16

1) pili adhere to epithelium

Question 17

gram +

Answer 17

1) fimbriae to adhere

Question 18

diptheria

Answer 18

1) inhibitions of cellular protein synthesis

Question 18

neutrophilic leukocytosis

Answer 18

1) shift to the left
- more immature neutrophils seen

Question 18

actinomyces

Answer 18

1) clump together
2) can be fulminant
3) seen at PA

Question 19

other infections

Answer 19

1) pneumococci
2) hemophilus influenzae
3) gonococci

Question 20

impetigo

Answer 20

1) typically childhood disease
2) staph and strep infection
3) skin of face
4) highly contagious
5) direct contact to areas of trauma
6) vesicles and crusting ulcers
7) no systemic symptoms

Question 20

tonsillitis and pharyngitis

Answer 20

1) strep throat
- streptococcal
2) beta-hemolytic streptococcal infections
- scarlet fever, strawberry tongue

Question 21

tuberculosis

Answer 21

1) collection of histicytes
2) primary TB occurs in previously unexposed people
- involves the lungs

Question 21

TB of the oral cavity

Answer 21

1) 20% people with active TB have oral lesions
2) most represent secondary infection from primary lung infection
3) gingival mucobuccal fold
4) area with trauma or periodontal disease

Question 22

primary TB

Answer 22

1) ghon focus
- primary site of infection in mid portion of one lung
2) ghon complex
- when regional lymph nodes are involved
3) miliary TB
- spread to distant organs in other parts of body 4)

Question 23

TB diagnosis and treatment

Answer 23

1) biopsy granulomatous inflammation
2) purified protein derivative skin test PPF
3) chest xray for active disease
4) combination therapy

Question 24

actinomycosis

Answer 24

1) actinomyces is the causitive organism in the majority
2) in the oral cavity
3) ulcers in mouth, periodontal disease
- entry via injury
4) high dose, long term antibiotics

Question 25

syphilis

Answer 25

1) treponema pallidum
- spirochete
2) three stages of infection
- primary: highly infection, regional lymphadenopathy, goes away
- secondary: most infections, remit, but can recur
- tertiary: non infection, palatal lesions

Question 26

congenital syphilis

Answer 26

1) transferred from infection mother to fetus
2) may cause serious and irreversible damage
3) dental abnormalities
- Hutchenson incisors
- mulberry molars

Question 27

syphilis treatment

Answer 27

1) biopsy with heavy plasma cell infiltrate
2) VDRL test
3) one shot pf penicillin

Question 28

osteomyelitis

Answer 28

1) acute: may arise from odontogenic infection
2) chronic: long standing
3) radiation, immunosuppression, medications, may complicate the problem

Question 29

bacteriophage, plasmids, transposons

Answer 29

1) infect bacteria and indirectly cause disease
2) non pathogenic bacteria to virulent ones
2 )some antibiotic resistant
- MRSA

Question 30

chlamydia, rickettsiae, mycoplasma

Answer 30

1) chlamydia
- female sterility
2) rickettsiae
- hemorrhagic vasculitis
-arthopod vectors
3) mycoplasma
- can spread through aerosol

Question 31

fungi

Answer 31

1) thick, ergosterol cell walls
2) perfect and imperfect form
- candida that are fruiting bodies
3) dermatophytes
- damage hair shaft and nails
4) deep fungal infections
- spread in immunocompromised
5) opportunistic fungi
- normal residents that cause life threatening illness in the immunocompromised
6) some are limited to certain geographic regions
- histoplasma
- coccidioides

Question 32

candida

Answer 32

1) yeast infection
2) normal oral flora in spore form
2) hyphal form is pathologic
- dry mouth
4) treated with nystatin or fluconazole
5) taste changes, angular chelitis. thrush

Question 33

candidal overgrpth

Answer 33

1) xerostomia
2) infancy
3) chemotherapy
4) a lot of stuff

Question 34

deep fungal infection

Answer 34

1) primarily involve the lung

Question 35

viruses

Answer 35

1) obligate intracellular agents
2) RNA or DNA
3) spherical or cylindrical
4 )chronic or latent infection
5) inclusion bodies
- viral particle aggregates in cells
6) many species cause same pathologic features
7) single species can cause different clinical manifestations

Question 36

virus induced injury

Answer 36

1) viral tropism
2) viral binds receptors
3) endocytosis
4) assembly and DNA replication
5) new viruses expelled
6) neoplastic cell proliferation
7) cell lysis
8)balloon degeneration with viral inclusion bodies

Question 37

squamous papilloma

Answer 37

1) removed and can go away

Question 38

verruca vulgaris

Answer 38

1) common wart of skin

Question 39

dysplastic oral warts in HIV+

Answer 39

1) dome shaped nodular lesions
2) incidence in HIV is 1-3%
3) studies suggest incidence in HAART
4) most common HPV subtypes 7,32
5) surgical excision when necessary

Question 40

HPV in head and neck squamous cell carcinoma

Answer 40

1) HPV is a causative agent for some HNSCC
- overwhelmingly HPV 16
- nasopharyngeal HPV 33
2) HPV associated HNSCC
- location is palatine and lingual tonsils
- younger and non smoking patients

Question 41

oral herpes simplex

Answer 41

1) small, viral induced vesicles that become ulcers
2) primary: follows initial HSV, fever and malaise, oral lesions at any SITE
3) secondary: reactivation of HS virus in regional ganglia, no systemic symptoms, oral lesions on keratinized mucosa

Question 42

varicella zoster

Answer 42

1) primary infection causes chicken pox
2) latent virus resides in sensory ganglia, reactivation causes shingles
3) nerve distribution for unilateral recurrence

Question 43

coxsackie virus

Answer 43

1) herpangina
- vesicles on soft palate, fever, malaise, sore throat, dysphagia,
2) hand foot and mouth disease
- 5 years or younger

Question 44

exposure to HIV

Answer 44

1) no infection
2) infection
- acute disease
3) lymphadenopathy (asymptomatic)
4) constitutional signs and symptoms
5) AIDs