Exam: Final - Lectures 25-32 Flashcards

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1
Q

Adaptive Immunity is acquired two different ways: ______ acquired and _____ acquired.

A

Naturally acquired and artificially acquired.

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2
Q

Both naturally and artificially acquired adaptive immunities have active and passive states. Describe the active and passive states for both.

A

In naturally acquired, ACTIVE state is when antigens enter the body naturally and the body induces antibodies and specialized lymphocytes. PASSIVE state is when the antibodies are passed from the mother to the fetus via placenta or through the mother’s milk.

In artificially acquired adaptive immunities, ACTIVE state is when antigens are introduced in vaccines and the body then produces antibodies and specialized lymphocytes in response. The PASSIVE state here is when preformed antibodies in immune serum are introduced by injection.

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3
Q

Passive immunization offers what kind of protection? (Short term or long term)?

A

Short term. Used for immunosuppressed patients.

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4
Q

Passive immunization can be used to immunize against ____ and immunize offspring against _______.

A

Rabies and hepatitis B.

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5
Q

Active immunization is when you inject an animal with a/an _________, _____, ______ or _____. As a result, T and B cells respond. If successful, you challenge the animal with a pathogen and note the efficacy if protected.

A

An antigen/live/killed or attenuated virus.

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6
Q

Variolation is a form of ______ that started in 16th century China. Uses a small dose of virulent virus.

A

vaccination

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7
Q

In 1796, Jenner used cowpox to protect against ________. The mechanism was an antigenically related live virus

A

Smallpox.

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8
Q

Administration of the Smallpox vaccine uses a ___________ needle.

A

Bifurcated

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9
Q

Describe the method of vaccine administration when using a bifurcated needle for vaccines such as Smallpox.

A

A droplet of vaccine solution is dripped off the tip of the bifurcated needle onto the deltoid and then the skin is rapidly pricked by the needle at least 15 times in the area of the droplet.

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10
Q

What are the current types of vaccines?

(There are 5 with an additional 2 for bacteria)

A

Live attenuated virus (Serial Passage of Virulent Virus or deliberate alteration of genes, marker genes)
Inactivated whole virus (Dead)
Subunit (often the viral attachment protein HBV)
Recombinant/vector-based vaccines (Can be attenuated or subunits inside of another virus)
Nucleic Acid Based (DNA/RNA)

For bacteria:
Toxoids
Extracts

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11
Q

Advantages of Live Attenuated Viral Vaccines:

A

Effective in small doses due to biological amplification.
Duration is longer, often a lifetime
Better cellular responses, more antigens
Can be given orally to stimulate IgA
Adjuvants not needed

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12
Q

Disadvantages of a Live Attenuated Viral Vaccine

A

Reversion to virulence (Polio)
The Vaccine itself may cause outbreaks, or may harm immune compromised individuals
Vaccine does not always take (Too attenuated)

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13
Q

Inactivated (Dead) Vaccines Advantages

A

Polyvalent - Multiple strains, many viruses in one vaccine (such as with Influenza A and B)
Stable in field
No natural spread

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14
Q

Inactivated (Dead) Vaccine Disadvantages

A

Complete inactivation required which can reduce potency
Adjuvants needed (Side effects as a result)
Larger doses required, more frequent immunization by injection as a result, no IgA
Duration of immunity not as long
Cellular response not complete

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15
Q

DNA vaccines work by isolating a gene for immunogen, inserting the gene into an expression plasmid that will grow in a bacteria, transform the bacteria, grow it, and then purify the plasmid DNA. The final step is to __________.

A

Immunize a host with the plasmid containing gene after purification.

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16
Q

Adjuvant:

A

A substance used to enhance the bodies response to an antigen.

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17
Q

Bacteria vaccines exist despite popular notions otherwise. What are some examples?

A

Extract vaccines for pertussis.
Carbohydrate vaccines for meningococcus.
Toxoid vaccines for tetanus and diphtheria.
Attenuated vaccines for BCG strain of TB.
Conjugated bacterial vaccine, carbohydrate+protein for Haemophilus influenzae type B

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18
Q

Viral Vaccine Examples:
Inactivated: _________
Attenuated: __________
Subunit vaccine: ___________

A

Inactivated: Influenza
Attenuated: Polio, MMR
Subunit: Hepatitis B

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19
Q

DTaP is what kind of vaccine (Viral or Bacterial) and is used to inoculate against what?

A

It is a bacterial vaccine and is used to promote an immunity to Diptheria (D), Tetanus (T) and acellular Pertussis (aP).

Immunity for the first two are through purified toxoids. The last is provided by fragments or subunits.

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20
Q

Vaccine Type: Smallpox

A

Live vaccinia virus

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21
Q

Vaccine Type: Poliomyelitis

A

Inactivated and attenuated virus

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22
Q

Vaccine Type: Rabies

A

Inactivated Virus

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23
Q

Vaccine Type: Hepatitis A:

A

Inactivated Virus

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24
Q

Vaccine Type: Influenza

A

Inactivated (Flu shot) or attenuated (Flu mist)

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25
Q

Vaccine Type: Measles

A

Attenuated Virus

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26
Q

Vaccine Type: Mumps

A

Attenuated Virus

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27
Q

Vaccine Type: Rubella

A

Attenuated Virus

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28
Q

Vaccine Type: Chickenpox (Varicella Zoster)

A

Attenuated Virus

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29
Q

Vaccine Type: Hepatitis B:

A

Antigenic fragments (recombinant vaccine)

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30
Q

Wakefield Study of 1989 that proposed vaccines were unsafe was retracted and the Doctor’s medical license pulled.

A

Dumbass, idiot, moron, loser.

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31
Q

Diagnostic Immunology involves these five systems:

A
  1. Precipitation reactions
  2. Agglutination reactions
  3. ELISA tests
  4. Western blot tests
  5. Fluorescent-antibody techniques.
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32
Q

Agglutination Reactions:

A

Involve particulate antigens and antibodies where an antibody such as IgM adheres multiple of a type of cell or pathogen together. Easier for the immune system to dispatch of infected cells or pathogens en-masse.

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33
Q

Antibody titer is the concentration of antibodies against a particular antigen.

A

Yep.

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34
Q

Viral Hemagglutination

A

Like agglutination, but caused by a virulence factor or virus. As the name suggests, it is the agglutination of red blood cells by a virus.

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35
Q

ELISA

A

Enzyme-Linked Immunosorbent Assay.
An antibody is absorbed into a well.
A patient sample is added; complementary antigen binds to antibody.
Enzyme-linked antibody specific for test antigen is added and binds to antigen, forming a sandwich.
Enzyme’s substrate is added and reaction produces a product that causes a visible color change.

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36
Q

Monoclonal Antibody

A
  1. Antigen is given to a mouse.
  2. Mouse produces antibodies.
  3. Spleen of mouse is removed. Cells from spleen are placed in a suspension of myeloma cells which grow continuously but do not produce antibodies.
  4. Spleen cells producing antibodies and myeloma cells hybridize, forming a hybrid cell type which both grows continuously AND produces the target antibody.
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37
Q

Monoclonal antibodies can sometimes be distinguished by the ending of their name “mab” or “nab”. This is because….

A

Monoclonal antibodies is referred to as MABs or Mabs.

Example: Trastuzumab (Breast cancer antibodies)
Muromonab-CD3: For Kidney transplants
Infliximab: For Crohn’s Disease.

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38
Q

Which of the followings could be used as a
vaccine strategy?

A. Live attenuated whole agent.
B. Inactivated (dead) whole agent.
C. Subunit - often the viral surface protein.
D. Toxoid.
E. All of these.

A

E: All of these.

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39
Q

Which vaccines more closely mimic an
actual infection?
a. attenuated whole - agent
b. inactivated whole - agent
c. subunit
d. conjugated

A

A. Attenuated whole - agent

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40
Q

Which of the following is a
nonimmunological test?

a. ELISA
b. PCR
c. Western blot
d. FACS

A

B. PCR

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41
Q

An organism that causes disease:

A

Pathogen

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42
Q

The ability to cause disease

A

Pathogenicity

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43
Q

Virulence is the

A

degree of pathogenicity

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44
Q

Virulence factors are

A

Factors which give the pathogen an edge in compromising cells and becoming pathogenic such as capsules, certain toxins, fimbriae, etc.

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45
Q

Growing and multiplying of pathogens in the host is an

A

infection

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46
Q

An abnormal state in which the body is not functioning normally is a

A

disease (diseased)

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47
Q

True or False: Infection doesn’t always cause disease.

A

True.

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48
Q

Primary pathogens have the ability to

A

Penetrate host defenses.

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49
Q

Opportunistic pathogens cause disease in

A

compromised hosts. Loss of microflora, immune system interference or breaks in tissue allow opportunistic pathogens to proliferate.

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50
Q

ID50

A

Infectious dose for 50% of the test population. A smaller number is equated to a much more infectious force.

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51
Q

LD50

A

Lethal dose (of a toxin) for 50% of a test population. Lower numbers mean a more potent toxin.

LD50 is a measure of virulence.

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52
Q

Which of the following strains of
Legionella pneumophila most easily
causes an infection?
A) Strain A ID50=200 cfu
B) Strain B ID50=5000 cfu
C) Strain C ID50=50 cfu
D) Strain D ID50=500 cfu
E) Can’t tell
5

A

Strain C.

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53
Q

Reservoirs of Infection are continual sources of infection for

A

Humans: AIDS, gonorrhea and other STD’s
Animals: Rabies and Lyme Disease
Nonliving: Botulism, tetanus, anthrax, and, soil.

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54
Q

Portals of Entry include

A

Skin, mucous membranes (respiratory, digestive tracts, genitourinary tracts)
Parenteral route (injection either artificially or naturally)

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55
Q

Fomite:

A

An object or material likely to carry a pathogen or infected material

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56
Q

Severity or Duration of Disease: Acute

A

Symptoms develop rapidly

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57
Q

Severity or Duration of Disease: Chronic

A

Disease develops slowly

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58
Q

Severity or Duration of Disease: Subacute

A

Symptoms between acute and chronic

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59
Q

Severity or Duration of Disease: Latent

A

Disease with a period of no symptoms when the pathogen is inactive (eg., herpes)

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60
Q

To cause disease, all pathogens must:

A

Enter a host
Find their unique niche
Avoid, circumvent, or, subvert normal host defenses
Multiply and eventually be transmitted to a new susceptive host

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61
Q

Molecular Koch’s Postulates:

A
  1. The phenotype under review or study should be associated with the pathogenic strains of a species
  2. Specific inactivation of the suspected virulence gene(s) should lead to a measurable loss in virulence or pathogenicity.
    The gene(s) should be isolated by molecular methods. (loss of
    function expt to prove requirement)
  3. Reversion or replacement of the mutated gene should restore pathogenicity.

Logic: Both are required to prove a virulence factor is
required and sufficient for causing pathogenesis

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62
Q

Virulence factors may be found on or in

A

pathogenicity islands or in plasmids

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63
Q

Pathogenicity islands are a section of genome that contain multiple virulence genes which are often flanked by phage or plasmid genes and have a different GC content from the rest of the genome.

A
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64
Q

The first step towards infection is ______ or ________.

A

Attachment or adhesion.

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65
Q

Attachment or adhesion of bacterial cells involves use of their

A

Pili (fimbriae): Hollow fibrils with tips to bind to host cells
AND
Adhesins: Surface proteins that bind host cells

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66
Q

Adhesion of viruses is made possible by their _______

A

Capsid or envelope proteins

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67
Q

Bacteria attach to surfaces in bulk, forming a

A

biofilm

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68
Q

Examples of Virulence Factors Toxin:

A

Toxin: Substance that contributes to pathogenicity
Toxoid: Inactivated toxin used in a vaccine
Antitoxin: Antibodies against a specific toxin

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69
Q

Toxins subvert Host functions. There are two major kinds: _______ and ______

A

Exotoxins and Endotoxins

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70
Q

Exotoxins:

A

Proteins produced by various types of bacteria. Kill host cells and unlock their nutrients.

71
Q

Endotoxins:

A

A part of the LPS of Gram-Negative bacteria.
Can hyperactivate host immune systems to harmful levels.

72
Q

Mechanism of Actions of Exotoxins involve:

A
  1. Plasma Membrane Disruption
  2. Cytoskeleton Alterations
  3. Protein Synthesis Disruption
  4. Cell cycle disruption
  5. Signal Transduction Disruptiuon
  6. Cell-cell adherence
  7. Vesicular Traffic
  8. Inhibit Exocytosis
  9. Superantigens
73
Q

Hemolysins are:

A

Toxins which lyse red blood cells

74
Q

Leukocidins are:

A

Toxins which lyse white blood cells.

75
Q

Toxins that disrupt the membrane include two types:

_______ forming and _________

A

Pore-forming toxins and phospholipase toxins

76
Q

Pore-forming exotoxins:

A

Alpha toxin of Staph. aureus and Listeriolysin O of Listeria monocytogenes

S. aureus alpha exotoxin is hemolytic and forms a transmembrane, seven-member pore in target cell membranes.

77
Q

Phospholipase exotoxins:

A

Phospholipase C of Clostridium perfringens

78
Q

Two-Subunit AB exotins:

A

Made of multiple subunits, this exotoxin has a B subunit which binds to host cell and delivers the A subunit into the cytoplasm which has the toxic activity (such as ADP-ribosyltransferase) as seen in Diptheria toxin and Cholera toxin

79
Q

Diptheria Toxin:

A

Exotoxin, ribosylates elongation factor 2, blocks ribosome function; cell dies

Forms a pseudomembrane over trachea

80
Q

Cholera toxin:

A

Made by Vibrio Cholerae, this exotoxin ribosylates to over-activate the adenylate cyclase release. The overabundance of cAMP activates ion transport channels which leads to water and Chloride to rush out of the cell. This causes uncontrollable diarrhea.

81
Q

Anthrax Toxin is a toxin produced by Bacillus anthracis. It is a plasmid-encoded tripartite toxin (three-part toxin) that involves these three systems:

A

Protective antigen (PA) which binds membrane receptor and forms a pore.
Edema factor (EF) which raises cAMP levels, causing fluid secretion and tissue swelling.
Lethal factor (LF) cleaves protein kinases, blocking the immune system from attacking.

82
Q

Type III Secretion

A

Use of a molecular syringe to inject proteins from the bacteria cytoplasm directly into the host cell. Genes for this are usually located on pathogenicity islands.

83
Q

What three bacteria typically use a form of type III secretion?

A

Salmonella, Yersinia, and, Shigella.

84
Q

Endotoxins are made only by

A

Gram-Negative bacteria

85
Q

LPS stands for

A

Lipopolysaccharide

86
Q

The Endotoxin LPS is _______ which is released when _________.

A

Lipid A, which is released when bacteria die.

Lipid A serves as a microbe-associated molecular pattern (MAMP) which binds to certain TLR’s on macrophages or B cells. This causes massive cytokine release from host cells, triggering fever, shock, and, death.

87
Q

How do some pathogens survive within the host?

A

Cells ingest pathogens in a phagosome to digest them, however some pathogens use hemolysin to break out (such as Shigella or Listeria)

Some phagosome fuses with acidic lysosome and some pathogens respond by secreting proteins to prevent fusion (Salmonella, Chlamydia, Mycobacterium, Legionella)

Some pathogens mature in acidic environments (Coxiella burnettii or Q-fever)

88
Q

Staph. aureus cell wall does what to avoid immune responses:

A

Binds Fc fragments of antibodies so that the antibodies attach “upside down”. This prevents opsonization.

Some pathogens also alter surface antigens periodically.

To clarify, it binds the “tail” of the antibody instead of one of the variable regions.

89
Q

How do bacteria recognize the host enevironment?

A

Through two-component signal transduction, the detection of magnesium concentration and pH AND through Quorum sensing which detects exotoxins made by other cells and delays toxin synthesis until many bacteria are present.

90
Q

Quorum Sensing:

A

Detect exotoxins made by other cells
Delays toxin synthesis until many bacteria present
Possible pathway for preventing pathogen growth?

91
Q

Endotoxins include which of the
following?
A. diphtheria toxin
B. lipopolysaccharide
C. tetanus toxin
D. botulinum toxin

A

B. Lipopolysaccharide

92
Q

Bacterial exotoxins can _____________ .
A) cause host cell membrane leakage
B) interfere with host 2nd messenger pathways
C) block host protein synthesis
D) do all of these
E) do none of these

A

D. Do all of these

93
Q

The final outcome of most host-parasite
relationships depends on
A. the number of organisms present in or
on the host.
B. the virulence of the organism.
C. the host’s defenses.
D. all of the choices

A

D. All of the choices

94
Q

The Study of where and When diseases occur

A

Epidemiology

95
Q

John Snow

A

Father of Epidemics
(Knows something. Does not say But’Cheese’MaQueen)

96
Q

Low frequency or normally present

A

Endemic (Think of endemic life in an area)

97
Q

High frequency over a short-period of time, or an outbreak

A

Epidemic

98
Q

Pandemic

A

Spread all over the world (Pan)

99
Q

Principles of Epidemiology include

A

Identifying “Patient Zero”
Identify any reservoir’s for the disease

100
Q

Nosocomial infections are

A

Hospital acquired infections and are typically antibiotic resistant.

101
Q

EID’s

A

Emerging Infectious Diseases

102
Q

Reasons for Increase of EID:

A
  1. World Population Growth
  2. Increased International Travel
  3. Habitat Disruption
  4. Microbial Evolution and development of resistance
  5. Inadequate public infrastructures.
103
Q

Categories of Bioterrorism Agents (CDC)

A

Category A, B, and, C

104
Q

Category A of Bioterrorism Agents:

A

“The Killer”

These are relatively easy to disseminate or transmit person-to-person.
Cause high mortality with potential for major public health threat and cause public panic and social disruption.

Viruses: Variola major, viral hemorrhagic fever and (filo-, arena-, bunya- and flaviviruses)

Bacteria: Bacillus anthracis, Yersenia pestis, Francisella tularnesis, Clostridium Botulinum

105
Q

Category B of Bioterrorism Agents:

A

“The Disablers”

Moderately easy to disseminate, moderate morbidity, low mortality, require enhanced diagnostic capabilities and disease surveillance.

Examples: C. Burnetti, Brucella spp, Ricin toxin

Subset includes food and waterborne agents

Salmonella, Shigella, Cryptosporidium

106
Q

Category C of Bioterrorism Agents:

A

“Future Threats”

Emerging pathogens with potential for mass dissemination because of availability, ease of production, potential for high morbidity/mortality

E.g. Hantavirus, yellow fever, MDR, TB

107
Q

4 Biological Safety Levels:

A

BSL 1-4

108
Q

Biological Safety Level (BSL) 1

A

Normal sterile techniques

109
Q

Biological Safety Level (BSL) 2

A

Limited lab access, biosafety cabinets

Agents with little risk of aerosol transmission

110
Q

Biological Safety Level (BSL) 3

A

Labs with negative air pressure. Found with agents that can cause disease via inhalation.

111
Q

Biological Safety Level (BSL) 4

A

Complete isolation due to extremely high risk of transmission and aerosol transmission

112
Q

John Snow is considered the father of
epidemiology for his work on
a) malaria.
b)gonorrhea.
c)cholera.
d)influenza.
e)chlamydia.

A

C. Cholera

113
Q

Which of the following viruses has been
linked to microcephaly in newborns?
a)Ebola virus
b)Marburg virus
c) Yellow fever virus
d)Zika virus
e)Dengue virus

A

D. Zika virus

114
Q

Normal flora of the Skin:

A

Gram positive bacteria such as Staph, strept, Diptheroids.

Some yeasts as well.

Can withstand dying, fatty acids, low pH and high salt.

115
Q

Staphylococcus

A

Gram Positive, low GC, cocci in clusters.
Coagulase enzyme clots fibrin in blood.

Pathogenic S. aureus produce extracellular enzymes and toxins.

Causes: Folliculitis, furuncles (boils) and carbuncles and sty(e).

In blood stream causes Toxemia, Scalded-skin syndrome and Toxic Shock Syndrome

116
Q

Streptococcus

A

Gram positive, cocci in chains.

Hemolysis, classified into groups according to hemolytic enzymes and surface antigens.

Group A (most important)
Groups B, C, and, O

Several virulence factors (M protein, extracellular enzymes, and toxins)

Causes Impetigo (isolated pustules), Ersipelas

117
Q

Group A Streptococcal infections can cause_________ AND _________ , or “flesh-eating” disease.

A

Cellulitis AND necrotizing fasciitis

118
Q

Pseudomonas are

A

Gram negative rods, five groups with an unusual metabolism (they grow on traces of organic substance in soap or in liner adhesive)

Environmental (soils and water)

Opportunists

Cause dermatitis, wound and skin infections, otitis externa (swimmers ear) and burn patient infections.

*BLUE-GREEN PUS.

Can also cause Hot-Tub Rash

119
Q

Viral infections of the Skin

A

Warts - Papiloma virus
Fever Blisters - Herpes Simplex
Chickenpox-shingles - Varicella zoster (latency in dorsal-root ganglion)
Smallpox - Variola virus
Paramyxovirus - rubeola (Measles)
Togavirus - rubella (German measles)

120
Q

Herpesvirus or Herpes Simplex Virus 1 and 2 or HSV-1 and HSV2 cause…

A

Cold stores, herpes encephalitis.

HSV-1 latent in trigeminal nerve ganglia

HSV-2 latent in sacral nerve ganglia

Acyclovir may lessen symptoms

121
Q

Varicella-zoster virus (VZV) or HHV-3 is transmitted by

A

The respiratory route. It is very contagious. Causes pus-filled vesicles. Virus may remain latent in dorsal root ganglion.

122
Q

Shingles

A

Reactivation of latent VZV releases viruses that move along peripheral nerves to skin.

123
Q

Measles is caused by ________ and has another name _______.

A

Caused by paramyxoviruses and is also known as rubeola.

124
Q

Measles is transmitted by the

A

respiratory route. Prevented by the MMR vaccine.

125
Q

German measles are also known as _________ and are caused by _______.

A

Also known as rubella and caused by togavirus. Causes a macular rash and fever.

A macule is a flat, reddened area of skin present in a rash.

126
Q

Eye infections:
Bacterial Conjunctivitis caused by…

A

Bacterial Conjunctivitis caused by Neisseria gonorrhoeae and Chlamydia trachomatis.

Leading cause of blindness worldwide.

127
Q

Bacteria can grow in the cerebrospinal fluid (CF) in the ____________ space in the CNS.

A

Subarachnoid space

128
Q

Blood-brain barrier (capillaries) prevent passage of _________ into the ________.

A

drugs or other materials into the CNS.

129
Q

Meningitis is

A

Inflammation of the meninges (the membranes surrounding the brain and spinal cord)

130
Q

Encephalitis is

A

Inflammation of the brain

131
Q

Fever, headache, and stiff neck
Followed by nausea and vomiting
May progress to convulsions and coma
Diagnosis by Gram stain or latex
agglutination of CSF
Treated with cephalosporins (first choice)

A

Bacterial Meningitis

132
Q

Occurs mostly in children (6 months to 4
years).
Gram-negative aerobic bacteria, normal
throat microbiota
Capsule antigen type B
Prevented by Hib vaccine

A

Haemophilus influenzae
Meningitis

133
Q

N. meningitidis Gram-negative aerobic cocci, capsule
10% of people are healthy nasopharyngeal carriers
Begins as a throat infection, rash
Serotype B is the most common in US In US, sporadic meningococcal outbreaks among
college students live in dorms. Vaccination is recommended for college students.

A

Neisseria Meningitis,
Meningococcal Meningitis

134
Q

Gram-positive cocci
70% of people are healthy nasopharyngeal
carriers
Most common in children (1 month to 4 years)
Mortality: 30% in children, 80% in elderly
Prevented by vaccination

A

Streptococcus pneumoniae Meningitis,
Pneumococcal Meningitis

135
Q

Viral meningitis is easier or more difficult to treat than bacterial meninigitis?

A

Easier.

136
Q

Clostridium tetani causes…

A

Tetanus. It is an anaerobic, Gram positive rod that is endospore forming. The toxin it releases blocks the release of an inhibitory neurotransmitter, causing motor neurons to constantly fire.

Prevented with DTP

137
Q

Clostridium botulinum causes….

A

Botulism. This bacteria is an anaerobic gram positive rod that is endospore forming. Found in canned food unless autoclaved properly. The toxin it releases blocks the release of acetylcholine. This consequently blocks muscle movement.

138
Q

Viral diseases-Poliomyelitis

A
  1. Symptoms
    1) Initial sore throat and
    nausea
    2) Infection and disease (1-
    10 %)
    3) Viral syndrome to
    progressive paralysis
  2. An enterovirus -> viremia ->
    neurons-destruction of motor
    neuron
  3. A stable virus - acid stable
  4. Three serotypes - vaccines to
    each
    1) Salk vaccine (IPV,1954),
    Inactivated virus
    2) Sabin vaccine
    (OPV,1963), attenuated
    virus

Viral diseases-Poliomyelitis

139
Q

Viral diseases: Rabies

A

Causes hydrophobia. Transmitted via rhabdovirus via an animal bite. Multiples in skeletal muscles and then brain cells, causing encephalitis. Incubation period may be VERY long time. Fatal encephalitis.

Treatment and prevention: Vaccine, immune globulin.

140
Q

Which of the following microorganisms
can cause toxic shock syndrome (TSS)?
A) Escherichia coli
B) Mycobacteria tuberculosis
C) Staphylococcus aureus
D) Neisseria menigitidis

A

C. Staphylococcus aureus

141
Q

Skin warts are caused by_____.
A) papillomavirus.
B) poxvirus.
C) herpesvirus.
D) parvovirus.
E) Staphylococcus aureus.
S

A

A. Papilomavirus

142
Q

Which of the following pairs is mismatched?

A) Chickenpox - Poxvirus
B) Conjunctivitis - Chlamydia trachomatis
C) Keratitis - Acanthamoeba
D) Otitis externa - Pseudomonas
E) Buruli ulcer - Mycobacterium

A

A. Chickenpox - Poxvirus

143
Q

The tetanus vaccine is a(n)

a. conjugated vaccine.
b. toxoid.
c. attenuated whole-agent vaccine.
d. inactivated whole-agent vaccine.

A

B. Toxoid

144
Q

Vaccine can be used as post-exposure
treatment for ________ ?
a. Polio.
b. Smallpox.
c. Rabies.
d. Creutzfeldt-Jakob disease.

A

C. Rabies

145
Q

Microbial Diseases of the Upper Respiratory System:

A

Laryngitis: S. pneumoniae, S. pyogenes, viruses
Tonsillitis: S. pneumoniae, S. pyogenes, viruses
Sinusitis: Bacteria
Epiglottitis: H. influenzae

146
Q

Otitis media is…

A

An infection of the middle ear via the auditory canal.
Can be caused by S. pneuomniae, H. influenzae
Treated with broad spectrum antibiotics

146
Q

Microbial Diseases of the Lower Respiratory System

A

Bacteria, viruses, and fungi cause
Bronchitis
Bronchiolitis
Pneumonia

147
Q

Pertussis (Whooping Cough) is caused by…

A

Bordetella pertussis. It is a gram negative coccobacillus that releases a pertussis toxin. Possesses a tracheal cytotoxin, a cell wall peptidoglycan fragment that damages ciliated cells so that mucus accumulates.

Prevented with DTaP (aP = acellular Pertussis)

148
Q

Tuberculosis is caused by…

A

Mycobacterium tuberculosis. It is an acid-fast rod. Accounts for most cases.

Less than 1% caused by M. bovis and is not transmissible by humans.

M. avium-intracellular infects people with late stage HIV infection.

149
Q

Tuberculosis is treated with…

A

Long term treatment with multiple antibiotics.

Can be avoided with vaccines such as BCG (Bacilus Calmette-Guerin) vaccine.

Live, attenuated arivulent M. bovis not widely used in the U.S

150
Q

Tuberculosis is diagnosed by…

A

Tuberculin skin test screening.

A positive reaction means a current or previous TB infection.

Follow this up with an X-ray or CT, an acid-fast staining of sputum, and culturing bacteria.

151
Q

Streptococcus pneumonia causes ________ and is a Gram _________ bacteria that is treated by ____________. It is the primary causative agent for typical pneuomonias.

A

Typical Pneuomonia or Pneumomoccal Pneumonia. It is a Gram Positive bacteria and a diplococci (Looks like two cocci half merged). It is treated by penicillin.

152
Q

Haemophilus Influenzae Pneumonia caused by

A

Gram-negative coccobacillus. Found in individuals with alcoholism, poor nutrition, cancer, diabetes or other predisposing factors.

Treated with second-generation cephalosporins.

153
Q

Atypical Pneumonias have an insidious onset and a nonproductive cough. It has _______ complications than Typical Pneumonias.

A

Fewer.

154
Q

Mycoplasma pneumoniae causes atypical pneuomonias.

A

Mycoplasma lack cell walls.

Grow extracellularly, forming “fried-egg” colonies.

Diagnosed by PCR or IgM antibodies.

Response is tetracycline.

155
Q

Legionella spp causes Atypical pneumonias. The pneumonias is also called Legionnaire’s disease or legionellosis. It is a Gram __________ rod. Found in __________ and is transmitted by __________.

A

Gram negative rod, found in water, transmitted by water aerosols.

High mortality rate, causes pontiac fever.

Treatment is Erythromycin

156
Q

Atypical pneumonias - Chlamydia psittaci

A

1) Gram-negative, obligate intracellular bacterium
2) Parrot fever, ornithosis, psittacosis
3) Carried by nearly all birds, transmitted to humans
by elementary bodies from bird droppings.
4) Earliest epidemics had very high mortality
5) Reorganizes into reticulate body after being
phagocytized.
6) Diagnosis: by culturing bacteria in eggs or cell
culture
7) Treatment: tetracyclin

157
Q

Viral diseases - Common cold viruses

A
  1. Types
    1) Rhinoviruses (picornaviruses) 50%.
    2) Coronaviruses 20%.
    3) Adenoviruses and other viruses 10%.
    4) Unknown 20%.
  2. Infects nose and throat - upper respiratory tracts,
    slow below normal body temperature.
  3. Common cold virus is different from Flu virus
    (Influenza virus with segmented RNA genome).
  4. Symptoms
    1) Common cold: runny nose, nasal congestion,
    sneezing, and throat irritation. No myalgia
    (muscle aches).
    2) Influenza: fever, myalgia, pharyngitis (sore
    throat), and headache.
158
Q

Viral diseases-Respiratory syncytial virus (RSV)

A
  1. A paramyxovirus (RNA genome)
  2. Causes cell fusion (syncytium) in cell culture.
  3. Infant lower respiratory infections (4,500 deaths
    annually). The most common cause of bronchiolitis
    and pneumonia among infants. Mortality about 1%
159
Q

Viral diseases-Influenza virus

A
  1. The orthomyxoviruses
    1) Three types A, B, and C
    Type A: Causes most epidemics, H3N2, H1N1, H2N2
    Type B: Moderate, local outbreaks
    Type C: Mild disease
    2) Current vaccines have two A and one B strains
  2. Influenza virus
    1) Eight separate, single strand, minus RNAs
    2) Spikes (peplomers)
     H spike-hemagglutinin
     N spike-neuraminidase
     Define viral strains-eg. H1N1
160
Q

In Influenza, what are the H spikes made of that are used for attachment to host cells?

A

Hemagglutinin (H) spikes

161
Q

In Influenza, what are the N spikes made of and what is their purpose?

A

N spikes are made from Neuraminidase and they are used to release the virus from the cell.

162
Q

Influenza is capable of antigenic drift and antigenic shift. What do these abilities allow?

A

Antigenic drift are mutations in genes encoding H or N spikes that may only involve a single change in an amino acid. This allows viruses to avoid mucosal IgA antibodies.

Antigenic Shift are changes in H and N spikes possibly due to genetic recombination between different strains infecting the same cell.

163
Q

Influenza viruses cause a pandemic every _____ to _____ years.

A

15-25 years

164
Q

What does SARS stand for?

A

Severe Acute Respiratory Syndrome

165
Q

SARS is a highly contagious viral disease caused by the SARS associated corona virus (SARS-CoV). Transmitted by

A

Droplet spread.

166
Q

Which organism produces a tough grayish membrane in the throat?
a. Streptococcus pneumoniae
b. Corynebacterium diphtheriae
c. Mycobacterium tuberculosis
d. Haemophilus influenzae

A

B. C. diptheriae

The tough-gray membrane is made up of dead cells killed by the released toxins, bacteria, and other substances.

167
Q

Mycoplasmal pneumonia can be distinguished
from viral pneumonia in that
A) Viral pneumonia is treated with tetracyclines.
B) The symptoms are distinctly different.
C) It doesn’t have any known etiologic agent.
D) It is treatable with antibiotics.
E) None of these.

A

D. It is treatable with antibiotics

168
Q

The mycolic acids of the cell wall are an
important factor in the pathogenicity of the
organisms that cause

a. influenza.
b. diphtheria.
c. pertussis.
d. tuberculosis.

A

D. Tuberculosis. This is because mycolic acids are major and specific lipid components of the mycobacterial cell envelope. Both TB and Leprosy causing agents have mycolic acid in their envelopes.

169
Q

In influenza viruses, minor annual variations in the antigenic makeup are called

a. antigenic drift.
b. antigenic shift.
c. mutation.
d. recombination.

A

A. Antigenic drift

170
Q

The disease caused by Streptococcus
mutans is______.

A. trachoma.
B. dental decay or caries.
C. plague.
D. atypical pneumonia.

A

B. Dental decay or caries

171
Q

Which of the following viruses has DNA
genome but its replication involves
reverse transcription?
A. Hepatitis A.
B. Hepatitis B.
C. Hepatitis C.
D. Hepatitis D.
E. Hepatitis E.

A

B. Hepatitis B

172
Q

Which of these bacteria are usually responsible
for digestive system disease due to
intoxication rather than infection?
A) Salmonella enterica
B) Shigella species
C) Salmonella typhi
D) Staphylococcus aureus
E) Escherichia coli

A

D. Staphylococcus aureus