chapter 20, 14, and diseases Flashcards
1
Q
Define Drug
A
any chemical that can affect human physiology in any way
2
Q
Define Chemotherapy/chemotherapeutic agent
A
drug used to treat disease
3
Q
Define Anti-microbial drug/agent or anti-microbial chemotherapy
A
chemotherapeutic agent used to treat infectious disease
4
Q
What is an antibiotic?
A
an anti-microbial agent used to treat bacterial infections, that is produced by another organism
5
Q
Give the 4 different classes of anti-microbials
A
- Anti-bacterial drugs
- Anti-viral drugs
- Anti-fungal drugs
- Anti-protozoal and Anti-helminthic
6
Q
What is a semi-synthetic antibiotic?
A
An antibiotic that’s been altered. Part from nature, part made in lab
( a modified antibiotic )
7
Q
What is a synthetic antibiotic?
A
An anti-bacterial drug that is synthesized entirely in a lab
an antimicrobial that has synthetic structure
8
Q
Anti-microbial drugs are chemicals that are intended to have selective toxicity against microbes. Antibiotics are one of these.
What is selective toxicity?
A
they kill microbial cells but not the host cell
9
Q
What are broad spectrum antibiotics?
A
active against most bacteria. Used when they aren’t quite sure what’s wrong
10
Q
Define Narrow Spectrum Antibiotics
A
they are much more specific than broad spectrum. active against some bacteria, usually gram + or -
11
Q
High toxicity in microorganisms and low toxicity in humans= good ___________ _____
A
therapeutic index
12
Q
Define Therapeutic index and tell whether a high or large number is good or bad
A
the ratio of the toxic dose to the therapeutic dose.
high therapeutic index = less toxic to the patient
13
Q
Antimicrobials that have a high therapeutic index are less toxic to the patient.
true or false?
A
true
14
Q
What 2 things are the sources for most of our common Antibiotics and semi-synthetics?
A
- Fungi
* * Bacteria
15
Q
Which bacteria do 50% of our antibiotics come from?
A
Streptomyces spp.
16
Q
Describe process of making antibiotics
3 steps
A
- grow organism in proper conditions
- siphon off liquid extract antibiotic and purify
- make changes in lab if necessary
17
Q
Define drug pipeline
A
a set of drug candidates that a pharm. company has under discovery or development and is testing at any given point.
18
Q
What are they testing for in clinical trials?
A
I. Safe?
II. Effective?
III. Relative Effectiveness
19
Q
List the different ways that Anti-bacterial drugs have selective toxicity. Explain what they target in bacteria to weaken/inhibit or kill it
A
- Inhibit cell wall synthesis
- Inhibit protein synthesis
- Inhibit Nucleic Acid replication & transcription
- Injury to plasma membrane
- Inhibit essential metabolite synthesis (effecting enzyme)
20
Q
Give 3 examples of Anti-bacterial drugs
A
- Penicillin
- Vancomycin
- Streptomycin
21
Q
Give examples of Cell wall inhibitors
A
- Penicillin
- Vancomycin ( polypeptides )
- antimycobacterium inhibit as well
22
Q
tell us a little about penicillin. What is the natural form called?
A
- Penicillin G : natural
- people are allergic to it
- it comes from fungi
- natural penicillin is gram +
23
Q
What enzyme do some people have that makes it so that penicillin is not an effective drug for them?
A
Penicillinase
24
Q
Name a few protein synthesis inhibitors (anti-bacterial drugs)
A
Tetracyclins
Aminoglycosides
25
What do we call the nutrients taken to feed normal flora?
| generally fibers that humans cannot digest
Pre-biotics
26
What are probiotics?
bacteria taken to replenish normal flora lost during antibiotic treatment
27
Are there many anti-fungals out there?
no, not many
28
Are anti-fungals natural and synthetics?
yes
29
Are anti-fungals normally narrow spec or broad spec?
broad spec
30
What types of selective toxicity do antivirals have?
* Fushion inhibitors
* Nucleic Acid inhibitors
* Assembly Inhibitors
* Exit inhibitors
31
Give two facts about antiviral drugs
* Extremely narrow spectrum (1 type of virus)
| * Synthetic
32
Give two facts about antiprotozoan/ antihelminthic drugs
* very few
| * Natural and synthetic
33
What does antibiotic resistance, initiation and spread have to do with?
mutations
34
Which category of mechanism or mutation does Penicillinase do, and explain how?
Drug Inactivation
| Penicillinase is an enzyme that changes a portion of the penicillin (molecule) and renders it inactive
35
List all 5 mechanisms or mutations which make microorganisms resistant to a drug
* Drug Inactivation
* Decreased Permeability
* Activation of Drug Pumps
* Change in drug binding site
* Alternate metabolic pathway
36
What happens with Decreased Permeability?
The receptor that transports the drug is altered so that the drug cannot enter the cell
37
What occurs with the Activation of drug pumps as a mechanism?
Specialized membrane proteins are activated and continually pump the drug out of the cell
38
What happens when there's a change in drug binding site?
The binding site on the target (ribosome), is altered, so the drug has no effect
39
What happens with the use of an alternate metabolic pathway?
When the drug has blocked the usual metabolic pathway, so the microbe circumvents (gets around) it by using an alternate, unblocked pathway (route) that achieves the required outcome.
40
Define transformation
the genetic alteration of a cell as a result of the cell picking up (through cell membrane) and using DNA that's freely floating around
41
Define Transduction
a process of genetic recombination in bacteria in which genes from a host cell (bacterium), are incorporated into the genome of a bacterial virus (bacteriophage) and then carried to another host cell when the bacteriophage initiates another cycle of infection
42
define process of conjugation
One bacteria is the donor and one is the recipient. The donor bacteria carries a DNA sequence called fertility factor (F-Factor). the F-Factor allows the donor to create a pilus that connects the two bacteria. Donor bacteria transfers genetic material to recipient bacteria, usually in the form of a plasmid. The genetic material transferred during conjugation typically provides the recipient Bacteria with a genetic advantage. In many cases conjugation serves to transfer plasmids that carry antibiotic resistance genes
43
What 4 ways do mutations spread?
Transformation
Transduction
Conjugation
then Binary Fission!
44
How can we slow the spread of antibiotic resistance within the bacterial population?
* limit use of same antibiotic over and over again
(rotate drugs)
* Agricultural
(ex: stop using antibiotics to fatten livestock)
* Appropriate dosing
* Drug Combinations
* new variations of drugs
45
Has the overuse of Antibiotics in animal agriculture, led to antibiotic resistant strains of bacteria?
Yes.
| The risk of resistance rises each time bacteria are exposed to antimicrobials
46
It is estimated that over one half of the antibiotics in the US are used in food animal production.
true or false?
true
47
Name the 5 general ways normal flora acquired?
* Birth
* breathing
* Touch
* Liquids
* Solid food
48
What part of the human body is " topographically outside of the body, so to speak" ?
the Gastrointestinal Tract (GI Tract)
49
Name all the places that you can harbor a normal flora
| 8 different areas
* skin/ mucous membranes
* Upper Respiratory tract
* GI tract (various places)
* Outer opening of urethra
* External Genitalia
* Vagina
* External ear and Canal
* External eye (lids/lash follicles
50
What Anatomical Sites and Fluids should be sterile (Microbe-Free)
(give broad answers)
All Internal Tissues and Organs
| Fluids within an Organ or Tissue
51
List some of the Internal Tissues and Organs that should be Microbe-Free (sterile)
* Heart/ CV system
* Liver
* Lungs
* Brain/Spinal cord
* Kidneys/bladder
* Bones/ Muscles
52
List some of the fluids found within an Organ or tissue that should be Microbe-free (sterile)
* Blood
* Urine in kidneys, ureters, bladder
* CSF
* Semen prior to entering urethra
* Saliva prior to entering oral cavity
* Amniotic fluid surrounding the embryo and fetus
53
Name three broad groups of bacteria that are found in humans
* Normal flora : Microorganisms that have a mutual relationship with the human host
* Pathogens: microorganisms that cause disease in a healthy person
* Opportunistic Pathogens : Normal flora that can cause disease under specific circumstances
54
Define Infection
Any microorganism replicating in tissues of the body
55
When does something considered a Disease?
* Disruption of normal body processes
| * Collection of signs and symptoms
56
What do we call a disease that is caused by microorganisms?
Infectious disease
57
HIV is the infection that leads to AIDS which is the _______
disease
58
What is a Primary Infection?
Original Pathogen
59
What is a Secondary Infection?
A second pathogen that gains entry because of the first Pathogen
60
If chicken pox is the primary Infection and the child scratches so hard it breaks the skin and S. aureus gets in and causes an infection, what is S. aureus considered?
Secondary Infection
61
Define Infectious Dose
the quantity of a pathogen (measured in number of organsims) required to cause an infection in the host.
(different for different pathogens)
62
What is the Infectious dose of Measles Virus?
1
| that's why its so scary
63
Which can be seen or measured by an outside observer, signs or symptoms?
signs
64
What are symptoms?
things felt by the patient that cannot be measured by an outsider.
subjective
65
Out of malaise, increase in WBC count, and a fever, which are signs and which are symptoms?
Malaise: Symptom
WBC Count: Sign
Fever: Sign
66
What would be examples of non-living reservoirs?
Soil and water
67
What is the word for when a disease is transmitted from animal to human?
Zoonoses
68
Name the 3 types of Reservoirs
* Human Reservoirs
* Animal Reservoirs
* Non-living Reservoirs
69
Define Reservoir
Habitat of the pathogen in the natural world
70
Define endemic
Infectious disease predictable, stable transmission (each year)
around the same amount of people getting sick or dying
71
Define Sporadic
Infectious disease number is low, so sporadic it can't be predicted how/when it'll occur
72
Anytime a new pathogen jumps into the human species, the number was clearly non-existent before and now there is a number of cases, so what would this be considered?
Epidemic
73
What is an Epidemic?
More than the expected amount of cases
74
When is something a Pandemic?
When there is more than the expected amount on more than one continent
75
How do you calculate Morbidity Rate?
```
# of new cases during a specific time
--------------------------------------------------------
# of individuals in population
```
76
How do you calculate Mortality Rate?
of deaths due to given disease
-----------------------------------------------------------
size of total population with the disease
77
What does it mean if Morbidity rate is 10%?
1/10 of people will get it
| of total population
78
What does it mean if Mortality rate is 10%?
1/10 of the people who get the disease will die from it
79
What does it mean if you are a "carrier" ?
You have the infection and/or disease but you are asymptomatic.
(don't have any symptoms from it but can still spread it)
80
define Zoonosis
disease caused by a pathogen with an animal reservoir
81
what is a Communicable disease?
Transmissable to others
82
What is a Contagious Disease?
EASILY transmissable from one person to another
83
What is a Noncommunicable disease?
Not transmissable from one person to another
84
What is the surface called involved in indirect contact transmission?
fomite
85
What is direct contact transmission?
you must touch, person to person
86
What is droplet transmission?
| Is it considered Airborne?
* transmission via droplets, less than 1 meter
| * not considered airborne
87
Waterborne, foodborne, and airborne are what type of transmission. define?
Vehicle Transmission
| transmission by an inanimate reservoir
88
Define Vector transmission
animals/insects/spiders that transmit organisms
89
define biological vector
when the insect/animal has the disease and then drinks your blood or bites you and transmits it
90
define mechanical vector
when the insect steps in organism and then lands on you or your food, you eat your food and get sick, he's a mechanical vector
91
What portion of an antigen do antibodies see?
Fc portion
| not the Y
92
Can Staph aureus do transformation (pick up naked DNA)?
Yes
93
What is Protein A?
a surface protein found in cell wall of staph. aureus
that can bind the Fc region of an antibody
Protein A covers itself with antibodies
94
Which two enzymes can most staph aureus make?
Coagulase
Staphylokinase
it can build a blood clot up around itself to protect it and then dissolve it once it feels safe
95
What are virulence factors?
Toxins
96
s. aureus is notorious for gaining antibiotic resistance and is known as a tissue _________
destroyer
97
What is Panton-Valentine Leukocidin?
enzyme that kills neutrophils
98
What toxin is known to chop up desmosomes?
Exfoliative toxin
99
How many different enterotoxins are there?
what do enterotoxins induce?
(hint: entero tube down you)
5 (A,B,C,D,E)
| Diarrhea and vomitting
100
What is the resistant form of staph aureus found in hospitals?
MRSA
| 50% of Nosocomial infections are MRSA
101
what % of US population are carriers of staph aureus ?
33%
102
Most common way staph aureus is spread?
contact transmission (direct/indirect)
103
Best antibiotics against Staph Aureus?
"cillins" but not original Penicillin
BEST Methicillin and Oxacillin (only 2% resist)
90% of staph produce penicillinase
104
What do you treat MRSA with?
Vancomycin
| Linezolid
105
Which pH is staph aureus sensitive to?
| what temp does it like (thermo, meso, psychro?)
sensitive to acid
| mesophile
106
What makes us sick when we cook our food at high temps to kill staph aureus and other things?
toxins
| they are heat stable
107
Half the strains of staph make enterotoxins. What 2 things are enterotoxins stable in that help them easily make us sick through food?
acid stable and heat stable
108
What's the difference between Pyrogenic and Pyogenic and which one is staph. aureus?
pyrogenic: fever
pyogenic: pus staph. aureus is pyogenic
109
List the skin issues associated with staph. aureus
* impetigo : blisters/patches/pus/scab
* folliculitis : like a zit but surrounding area inflamed, staph aureus stuck inside
* Boil-furuncle : folliculitis that gets worse. hair follice gets plugged and infection spreads
* Carbuncle: a boil that continues to get worse, huge, or multiples coming together. when your boil starts making you feel sick and you can feel cytokines
110
define systemic infection
bacteria widespread through body
111
define bacteremia
infection, bacteria in bloodstream
112
define pneumonia
bacterial infection causing immune response in your lungs. fluid build up in lung sacs
113
bacteria growing====>immune activation===>cytokine production=====> ______
sepsis
114
What causes sepsis?
cytokines from many infections
you vasodilation all over to get WBC out
blood pressure very low
heart rate high
115
How does sepsis turn into septic shock?
your organs start shutting down from low BP
| BP becomes refractory to treatment meaning it is too low and wont respond to drugs anymore
116
mortality rate for septic shock?
50/50
117
define toxic shock syndrome
all signs of sepsis but progressed very quickly to septic shock
118
what make toxic shock syndrome progress so quickly
staph aureus turn on gene TSST-1 giving it superantigens which cause every TH to think its a match and then a cytokine storm occurs. no stopping it
