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Respiratory > Bacterial/Respiratory > Flashcards

Bacterial/Respiratory Flashcards

1
Q

Entry/spread of bacteria into lower (sterile) RT
5 methods

A
  • Direct inhalation: determined by particle size
  • Aspiration of upper airway contents
  • Spread along mucous membrane surface
  • Hematogenous spread
  • Direct penetration (i.e. intratracheal tube)
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2
Q

4 Important defense barriers to bacterial infections

A
  • Ability to filter particles based on size
  • Mucociliary escalator
  • Respiratory tract secretions
  • Localized immune cells and responses
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3
Q

Bordetella pertussis
Corynebacterium diphtheriae
Neisseria meningitidis
Streptococcus pyogenes
Staphylococcus aureus
Streptococcus pneumoniae

Upper or Lower tract infection?

A

Upper tract infections

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4
Q

Mycobacterium tuberculosis

Legionella pneumophila

Pseudomonas aeruginosa

Mycoplasma pneumoniae

Haemophilus influenzae

Streptococcus pneumoniae

Upper or lower tract infections

A

Lower tract infections

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5
Q

Streptococcus pyrogenes

Morphology:

Disease:

3 key virulence factors:

vaccine:

A

Gram + cocci in chains

strep throat, scarlet fever

B-hemolytic, hyaluronic capsule, M protein

NO vaccine

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6
Q

Gram + cocci in chains

strep throat, scarlet fever

B-hemolytic, hyaluronic capsule, M protein

NO vaccine

A

Streptococcus pyrogenes

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7
Q

Streptococcus pneumonia

morphology:

Diseases

Virulence factors

Vaccine

A

Gram + cocci in chais

otitis media/sinusitis/pneumonia

alpha-hemolytic, polysaccharide capsule, pneumolysin

Yes vaccine

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8
Q

Staphylococcus aureus

Morphology:

Disease:

virulence factors:

vaccine:

A

G + cocci clusters

URI, pneumonia

polysaccarade capsule, protein A, lots of toxins

NO vaccine

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9
Q

Neisseria meningtidis

morphology

diseases

virulence factors

vaccine

A

Gram - Diplococci

Pharyngitis, pneumonia

Polysaccharide capsule, pilin, makes endotoxin

YES

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10
Q

Haemophilus Influenza

morphology

diseases

virulence factors

vaccine

A

Gm - Pleomorphic, short rods

Otitis media, sinusitis, pneumonia
Nonencapsulated and encapsulated, several adhesins
Yes

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11
Q

Mycobacterium tuberculosis

morphology

diseases

virulence factors

vaccine

A

Acid-Fast Rods

Tuberculosis

Acute/latent infections, lipid-rich cell envelope
Yes

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12
Q

Legionella pneumophila

morphology

diseases

virulence

vaccine

A

Gm - Rods

Legionairre’s disease and Pontiac Fever
Opportunistic, numerous enzymes
No

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13
Q

Pseudomonas aeruginosa

morphology

diseases

virulence factors

vaccine

A

Gm - Rods

Otitis media, pneumonia

Opportunistic, numerous enzymes,forms biofilms
No

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14
Q

Mycoplasma pneumoniae

morphology

disease

virulence fators

vaccine

A

Does not stain Pleomorphic shape

Tracheobronchitis, pneumonia

Lacks cell wall, P1 adhesin
No

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15
Q

Corynebacterium diphtheria

morphology

disease

virulence

vaccines

A

Gram + rods in club or V shape

Diphtheria, pseudomembrane in RT

Diphtheria toxin, loca and systemic infection

Yes vaccine

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16
Q

Bordetella pertussis

morphology

diseases

virulence factors

vaccine

A

Gm - Pleomorphic, coccobacillus
Pertussis

Pertussis toxin, pertactin, FHA, fimbriae
Yes

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17
Q

pili, fimbriae, adhesins are used by pathogens for:

lysins, proteases, elastases are used by pathogens for:

proteases, capsule are used by pathogens for:

A

Adherence and/or invasion to/of RT tissues

  • Secretion of tissue damaging enzymes
  • Factors that inhibit or neutralize host defense mechanisms
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18
Q

ribosylate G-proteins and EF-2, phospholipases: used by bacteria for:

superantigens cause what in the host:

• Form microcommunities \_\_\_\_\_\_\_to resist elimination
overproduce polysaccharides (alginate)
A

Toxins that alter/inactivate host cell functions

overstimulate the immune response

(biofilms)

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19
Q

Bordetella pertussis is Gram _____ coccobacillus, strict _____

Adheres to cilia of epithelium and makes _______

A

Gram -

strict aerobe

makes PTx

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20
Q

Pertussis expresses several adhesins including :

Its is______ infectious and transmittable; primarily disease of the_____, and______ are often asymptomatic carriers

A

FHA (filamentous hemagglutinin), pertactin, and pili

highly

disease of young

aduts are carriers

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21
Q

Whooping cough (pertussis). Three distinct phases:

A

catarrhal, paroxysmal, and convalescence

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22
Q

What’s the deal with the pertussus vaccine?

A 
Vaccine available (acellular against PTx, FHA, 
pertactin), but possibly is waning in efficacy.
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23
Q

B.pertussis mechanism of disease elicitation:

A
  1. Bacteria binds to ciliated epithelium
  2. PTx alters adenylate cyclase activity
    - ADP-ribosylates Gialph, elevates cAMP production, increases secreations and mucus produciton
  3. Other secreated factors damages the mucocilliary escalator

–> end result is Whooping Cough

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24
Q

Corynebacterium diptheriae

Gram_____; often arranged in_____; main virulence factor is diphtheria toxin (DTx) and __________ (inhibits protein synthesis);

A

-positive

pallisades

ADP-ribosylates EF-2

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25
Q

Corynebacterium diphteriae

produces_____ required for bacterial colonization of upper RT; global
distribution but uncommon in US and other developed areas due to vaccine

Non toxin-producing strains produce a localized infection resulting in __________. Toxin-producing strains also cause________ disease

A

pili

pseudomembrane

systemic

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26
Q

Mechanism of C.diphtheriae

  • ______ mediate adherence to respiratory epithelium
  • Extensive bacterial replication at _________
  • Two stages: _______
A

Pili

surface of epithelium

invasion and toxigenesis

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27
Q

Vaccination against diphtheria toxin has greatly reduced morbidity in the U.S.

Vaccine- __________ diphtheria toxin (diphtheria toxoid)
DT- also carrier for _________ CRM 197 a point mutation within DT that inactivates the toxin.

A

vaccine: Formalin inactivated

conjugate vaccines (Hib)-

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28
Q

Gm negative diplococci; oxidase +; catalase +; polysaccharide capsule; produce pili;

common inhabitant of the nasopharynx of healthy individuals (most often children).

A

Neisseria meningitidis

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29
Q

Diseaese associated with RT from neisseria meningitidis

A

Pharyngitis, Pneumonia – usually preceded by respiratory tract infection.
Often seen in individuals with underlying disease or in kids. Greatest
concern is progression to meningitis

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30
Q

Mechanis of N. Meningitidis

A

capsule, type IV pili, endotoxin, LOS

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31
Q

Capsule biologic effect

A

prevents phagocytosis and complement fixation

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32
Q

Type IV pili biologic effect

A

allows colonization of nasophyarnx

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33
Q

Endotoxin biologic effect

A

responsible for most clincal manifestations

34
Q

Effect of LOS

A

lipooligosaccharide with endotoxin activity

35
Q

N. meningitidis vaccine-________
• Polyvalent vaccine developed against serogroups:
• Administered to individuals ______
• MCV4-conjugate vaccine =
• MPSV4-capsule vaccine =

A

polysaccharide capsule

A, C, Y, and W135

>2 y.o.a.

55 y.o.a and younger

55 y.o.a and older

36
Q

Streptococcus Pyogenes (group A strep)

Key features:

A

Gram + cocci arrangements in chains

beta-hemolytic and posseses M protein and has hyaluronic acid capsule, lots of virulence factors and is catalase negative

37
Q

Diseases associated with Strep. pyogenes

A

Pharyngitis (Strep throat): redness and edema of the mucous
membranes, fever, purulent exudate, tonsilitus
Scarlet fever: streptococcal pharyngitis and an erythematous punctiform
ras

38
Q

What does steptolysin O and S do?

A

lyses leukocyteds, plats, erythrocytes

39
Q

What does M protein do?

M-like protein?

A

M-protein = adhesin; antiphagocytic and degrades complement compenent C3b

M like: binds immunoglobulins

40
Q

What does F protein do?

A

mediates adherance to epithelial cells

41
Q

biological effect of streptokinase

A

lyses blood clots and facilitates spread of bacteria in tissue

42
Q

Mechanism of disease elicitation of S. Pyogenes

A

• Surface proteins (M protein, F protein, LTA)
promote adherence in pharynx
• Localized tissue destruction due to secreted enzymes
• Scarlet fever is secondary complication. Due to pyrogenic exotoxins –superantigens, not bacterial dissemination

43
Q

Gm+ cocci often in clusters; catalase +; produces a polysaccharide capsule; surface coated with protein A; produces many different toxins and cytopathic enzymes

A

Staphylococcus aureus

44
Q

Who do we see Staphylococcus aureus caused pneumonia in and why?

A

mostly in very young or elderly with underlying pulmonary disease.

Aquired from aspiration of oral secreations OR hematogenous spread from distant infection site.

45
Q
A
46
Q

what are the virululence factors in streptococcus pyogenes?

A

Capsule and LTA

M protein, M-like protein, F protein

Pyrogenic exotoxins

Steptolysin S and O

Streptokinase

DNAse and C5a peptidase

47
Q

What does coagulase do as viruluence factor?

Hyaluronidase?

A

coagulase = convertis fibrinogen to fibrin

hyaluronidase promotes spread of bacterium

48
Q

Disease mechanism of S. aureus

A

• Normal component of nasopharyngeal flora
• Pulmonary tissue destruction due to secreted
enyzmes
• Can spread to other infection sites to manifest different disease symptomology

49
Q

Virulence factors of S. aureus

A

Capsule, LTA, Protein A, Cytotoxins

Coagulase, Hyaluronidase, Lipases, Nucleases

50
Q

Streptococcus penumoniae:

Gram_____,

______ Lancefield designation

_____ hemolytic

A

Gram + cocci (often in diplococci)

No lancefield classificaiton

alpha-lytic

51
Q

In Streptococcus pneumonia, virulent stains make _______ with over 90 forms

A

polysaccharide capsule

52
Q

Diseases associated with S. pneumoniae

A

lobar pneumonia, sinusitis, otitis media

53
Q

Biological effect of :

secratory IgA protease

Teichonioc acid:

Hydrogen peroxide:

A

secreatory IgA protease: disrupts sIgA medated clearance

Teichoic acid: activates alternative complement path

Hydrogen peroxide: allows ROI to cause tissue damage

54
Q

biologic effects of

pneumolysin:

Phosphorycholine:

Peptidoglycan fragments:

A

Pneumolysin: destroy cilated epithelial cells

Phosphorycholine: enhances bacterial uptake by host cells

Peptidoglycan fragments: activates alternative complement pathway

55
Q

Virulence factors in S. pneumoniae

A

surface protein adhesions, secratory IgA protease,

pneumolysin, teichoic acid,

peptidoglycan fragments, hydrogen peroxide,

phosphorycholine, capsule

56
Q

What is the basis of the S.pneumoniae vaccine?

Adults and children > 2 years get what kind?

Children under 2 get what kind?

A

vaccine based on polysaccharide capsule

>2 you get vaccine with over 23 dif capsular polysacs

Under 2 you get 13-valent conjugated vaccine

57
Q

Haemophilus Influenzae

Small Gm____ rods; require____ and ____ for growth;

invasive species possess
_________

A

gram negative

need heme and NAD

posseses polysaccharide capsule

58
Q

What uses uses pili and OMPs to bind respiratory epithelial
cells

A

H. influenza

59
Q

What RT diseaes are assoicated with H.influenza

A

Pneumonia, sinusitis, otitis, epiglottitis.

Non-encapsulated strains colonize upper RT. Lower RT infections more common in kids or individuals with underlying condition.

60
Q

Mechanism of disease in H. influenza

A

• Attaches to respiratory epithelium through pili and
OMPs
• Gain access to underlying submucosa by invading
between epithelium
• Cause induction of l_ocalized pro-inflammatory_
response

61
Q

What are the virulence factors associated with H. Influenza

A

Capsule, pili, OMPs and LOS (has endotoxin activity)

62
Q

H. influenzae vaccine-________
• Vaccine to Hib (H. influenzae type B)
• Three _______vaccines and combination Hib-
conjugate vaccines available.
• Hib disease in children decreased by _____since vaccine introduced

A

polysaccharide capsule

monovalent conjugate

99%

63
Q

Has no cell wall (no gram stain)

is coccoid or pleomorphic,

bound by triple layerd membrane with sterols

OBLIGATE AEROBE

A

Mycoplasma pneumoniae

64
Q

Mycoplasma pneumonie produces what diseases?

What does it produce so it can associate with upper airway epithelial cells?

A

Tracheobronchitis and atypical pneumonia

makes P1 adhesion

65
Q

Mechanism of disease in Mycoplasma pneumoniae

A
  1. Associates w/ upper airway via P1 adhesion
  2. close associaiton == accumulate toxic metabolites + oxidation of lipids
  3. Binding destroys cilia + inhibits clearance == get shedding of bacterium in respiratory secreations
  4. Induces inflammatory response–> enhances cell damage via oversecrating cytokines
66
Q

Gram negative rod

Single polar flagella

oxidase +

A

Pseudomonas aeruginosa

67
Q

Psueodomonas aeruginosa forms ____ and is what type of pathogen?

A

forms biofils

opportunistic pathogen (has lots of virulence factors)

68
Q
A
69
Q

Infects lots of anatomical sites and in RT is most commonly associated with cystic fibrosis patients

A

Pseudomonas aeruginosa

70
Q
A
71
Q

Mechanism of diseaes in Pseudomonas aeruginosa

A
  1. Opportunist.. must breach host defense!
  2. Biofilm fomration to resist clearance
  3. Makes pilins + adhesins to promote assocation with respiratory epithelial cells
  4. Makes lots of proteins: proteaseas, exotosins, endotoxins, DNAses to damage/inactivate host cells
72
Q

Legionella pneumophila

Gram_____ rod; opportunistic pathogen; single polar flagella;
maintained in _________;

produces

A

negative

water supplies and/or amoeba in environment

cytotoxins, hemolysins, endotoxins, and lipases.

73
Q

Diseases associated with Legionella pneumophila:

_______: severe pneumonia-like symptoms
________: self-limiting flu-like disease

A

Legionnaire’s disease

Pontiac fever

74
Q
A
75
Q

Must grow on special medium with specific nutrients and typically is detected by flourescent antibody stain

A

Legionella pneumophila

76
Q

Looks fried egg like on agar medium and has pleomorphic structure

A

Mycoplasma penumonaie

77
Q

Mechanism of diseaes in Legionella pneumophila

A

• Survives inside alveolar macrophages within lungs
• Production of various enzymes (phosphatase, lipase,
and nuclease) kills infected host cell
• Little is known about what responsible for difference in disease presentation

78
Q

Mycobacterium tuberculosis

_____rods (although bacterium is considered to be a Gram-positive); thick waxy cell wall containing _____ and lipoarabinomannan; survives within_____; causes acute or latent infection

A

Acid-fast

mycolic acids

granulomas

79
Q

Diseaes mechanism of M. tuberculosis

A
  1. survives and persists w/in host-generated granulomas (latency)
  2. Reactivates to cauase acute diseaes
  3. Symptomology primarily over-exaggerated host response to infection–> get tissue necrosis
80
Q

Virulence factors in M.Tuberculosis

A

Long chain fatty acics: mycolic acid and liparabinomannan are impervious cell envelopes, helps prevent damage by host

Cord factor inhibts PMNs

Respiratory (15 decks)

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