FINAL Micro Minimals Flashcards
Describe the colour (in a Gram stained smear) of Gram positive and Gram negative
bacteria, respectively!
Gram positives: dark blue (purple)
Gram negatives: red (pink)
Describe the 3 important parts of the bacterial lipopolysaccharide!
lipid A + core polysaccharide + O-specific (polysaccharide) side chain
Which 2 roles are attributed to bacterial pili (fimbriae)?
adhesion; conjugation (sex fimbriae)
Mention a bacterium and its virulence factor that is encoded by a lysogenic
bacteriophage!
Corynebacterium diphtheriae – diphtheria toxin
Streptococcus pyogenes – erythrogenic toxin
Escherichia coli – verotoxin
Clostridium botulinum- botulinus toxin
List the possible shapes of bacteria. Write one example for each category!
coccus (spherical): Staphylococcus, Streptococcus
rod: Clostridium, Corynebacterium, E. coli
curved rod: Vibrio
helical: Treponema, Borrelia, Leptospira
What are the essential components of bacterial cells? Specify at least 3!
cytoplasm, nucleoid (genome), cell membrane, (cell wall)
Which part of the bacterial cell carries the endotoxin?
Outer membrane of Gram negative bacteria
What roles are attributed to the bacterial capsule in the infectious process?
antiphagocytic effect, adhesion
Describe the definition for obligate anaerobic bacteria!
They are able to replicate only in the absence of oxygen (under anaerobic conditions).
Some of them are quickly killed by oxygen, some are able to survive but do not grow
while oxygen is present.
Describe the definition for facultative anaerobic bacteria!
They are able to replicate both in the presence and in the absence of oxygen. In aerobic
conditions, they perform respiration, in anaerobic condition, they perform fermentation.
What does sterilisation mean?
Sterilisation means the killing or removal of all microorganisms (including bacterial
spores).
Mention 3 reliable methods of sterilization!
autoclaving, hot air oven, gamma-radiation, filtration (fluids), gas sterilisation
(not acceptable: boiling, pasteurisation, UV!)
Specify an exact set of parameters (temperature and time) necessary for effective
sterilization by autoclaving!
121 °C for 20 - 30 min. (at 1 bar overpressure)
Specify an exact set of parameters (temperature and time) necessary for effective
sterilization using a hot air oven (with circulation)!
160 °C for 60 min.
What does disinfection mean?
The purpose of disinfection is the killing of pathogenic microbes and to decrease the
number of viable microbial cells. Resistant microbes and spores may survive, so
disinfection does not the kill all microbes.
Mention 5 groups of disinfectants!
alcohols, phenol derivatives, detergents,
chlorine, iodine, aldehydes
Mention 2 groups of disinfectants acting on the microbial membrane structures!
a., (cationic) detergents (quaternary ammonium compounds)
b., phenol compounds (cresol, hexachlorophene, chlorohexidine)
c., alcohols (ethanol, isopropanol)
What does active immunisation mean?
It means the transfer of microbes or microbial products (vaccines) to the human body
to induce long-lasting immunity against a specific infectious disease
What does passive immunisation mean?
It means the administration of preformed antibody (immune globulins produced in
animals or humans) to the human body resulting in short-term protection against a
specific infectious disease
Mention 2 bacterial infectious diseases that can be prevented or treated by passive
immunisation!
prevention: tetanus
treatment: diphtheria, botulism, tetanus
Describe precisely what toxoid means!
Inactivated bacterial exotoxin that is not toxic but immunogenic
Mention 2 infectious diseases that can be prevented by vaccines containing toxoids!
Diphtheria, tetanus, (pertussis)
What does the DTaP vaccine contain?
diphtheria and tetanus toxoids and
acellular pertussis vaccine (toxoid and other purified antigens)
What does the vaccine against tuberculosis (BCG) contain?
live attenuated Mycobacterium bovis (Bacille Calmette-Guerin)
What is the nature of antigen in the vaccines used to prevent infections by
Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis?
capsular polysaccharide (either alone or conjugated to a carrier protein)
Specify the 4 groups of bacterial vaccines (classified according to the nature of the
bacterial component)!
a., live, attenuated vaccines
b., killed (inactivated) bacterial vaccines
c., toxoid vaccines
d., subunit vaccines (capsular polysaccharide or purified protein)
What are the main advantages and disadvantages of live attenuated vaccines as
compered to killed vaccines?
Advantages: induce not only serum antibodies but also cellular immunity and local IgA
antibodies. Some may be applied orally. Usually fewer doses are needed.
Disadvantages: Attenuated strains may revert to virulent in rare cases. They may cause
disease in immunosuppressed patients. Live attenuated microbes are usually heat
sensitive and must be refrigerated.
Mention 2 bacterial exotoxins that act by ADP ribosylation!
Diphtheria toxin, cholera toxin, pertussis toxin
What is the mechanism of action of diphtheria toxin?
Inhibition of protein synthesis in eukaryotic cells by ADP-ribosylation of ribosomal
EF-2 (elongation factor-2)
What is the mechanism of action of tetanus toxin?
It causes spastic paralysis by blocking the release of inhibitory neurotransmitters
(glycine and GABA) in synapses
Mention at least three of the physiological effects of septic shock (characterized by the
presence of large amount of bacterial endotoxin in the blood)!
fever, hypotension, disseminated intravascular coagulation (DIC), complement
activation, impaired organ perfusion, hypoglycaemia
Mention 2 non-essential bacterial organelles that enhance bacterial virulence! Describe
how their function contributes to pathogenicity!
Capsule: antiphagocytic effect, adhesion to tissues
Fimbriae: binding to tissues
Flagellae: spreading the bacteria
Mention 4 extracellular enzymes of bacterial origin functioning as virulence factors!
coagulase, streptokinase (fibrinolysine), streptodornase (DNase), hyaluronidase, IgA
protease, collagenase, elastase, urease
What is a vector? Write an example!
Vector is an arthropod that transmits infection from human to human, or from animal to
human
examples. tick – Lyme disease; louse – epidemic typhus; mosquito – malaria
Mention 2 infectious diseases that are transmitted to humans by tick bites!
tick-borne encephalitis; Lyme-disease; tularemia; Rocky-Mountain spotted fever; etc.
What is a reservoir? Write an example!
The normal host of a pathogen (human or animal) serving as a continuous source of
infection to other hosts (such as humans).
Salmonella typhi – human; Yersinia pestis - rodents
Mention at least 5 possible transmission ways of infections!
respiratory droplets (infectious aerosol)
faecal-oral
direct contact (such as sexual)
fomites (inanimate objects)
blood
vectors (blood-sucking arthropods)
What is the difference between prevalence and incidence of an infectious disease?
It can be differentiated in chronic diseases. Prevalence: total number of diseases (per
100,000 people). Incidence: number of new cases in a year (per 100,000 people).
What is the difference between mortality and case fatality rate of a disease?
Mortality: total number of deaths caused by the disease in a population of 100,000
people in a year. Case fatality rate: rate of death (in percent) among patients suffering
from the disease.
Describe the rules of collecting native urine for culturing bacteria! Describe also the
conditions for keeping the specimen before sending it to the laboratory!
A midstream specimen, taken preferably in the morning, after thorough cleaning of
the external genital area. Keep it up to 1 h at room temperature or up to 24 h at +4
oC.
Describe the rules of collecting hemoculture specimens!
It is recommended to obtain 3 specimens (with at least 30 min. between the specimens).
The specimens should be preferably taken before fever spikes (during rising fever),
from fresh peripheral venipuncture sites. If possible, both aerobic and anaerobic
bottles should be used (3 x 2 bottles altogether). The site of venipuncture and the plug of
the bottle containing the medium must be properly disinfected. The amount of blood
injected to the bottle should be about 10 % of the liquid medium. The specimen should be
taken before giving antibiotics to the patient.
Mention two clinical specimens that are heavily contaminated with bacteria belonging
to the normal body flora!
throat and nasal secretions, faeces, vaginal secretions.
Explain the purpose for using beta-lactamase inhibitors in antibacterial therapy!
Combination of beta-lactamase inhibitors (such as clavulanic acid or sulbactam) with
beta-lactamase sensitive penicillins (such as amoxicillin or ampicillin) can overcome
resistance mediated by many but not all beta-lactamases.
Mention a group of antimicrobial drugs that acts on the bacterial ribosome and usually
has bactericidal effect!
aminoglycosides
Mention 2 broad-spectrum (effective against both Gram positive and Gram negative
bacteria) penicillin derivatives.
ampicillin, amoxicillin, piperacillin, (azlocillin, mezlocillin)
Mention an antifungal and an antibacterial drug that alter the function of the cell
membrane!
antifungal: Amphotericin B; antibacterial: polymyxins
What are the possible mechanisms of acquired penicillin resistance of bacteria? Mention
at least 3 mechanisms!
- beta-lactamase production
- PBP (target) alteration
- reduced permeability
- active efflux
Mention a drug belonging to macrolides!
erythromycin, spiramycin, roxithromycin, clarithromycin, azithromycin
Mention 2 drugs belonging to aminoglycosides!
streptomycin, gentamicin, tobramycin, amikacin…
Mention 2 groups of antimicrobial drugs that act on the 30 S subunit of the bacterial
ribosome!
aminoglycosides, tetracyclines, glycylcyclines
Mention 3 antimicrobial drugs that act on the 50 S subunit of the bacterial ribosome!
chloramphenicol, erythromycin (and other macrolides), clindamycin, linezolid,
streptogramins
Mention 3 groups of antibacterial drugs inhibiting bacterial cell wall synthesis!
penicillins, cephalosporins, carbapenems, monobactams, glycopeptides
Mention 4 groups of antibiotics which have bactericidal effects!
penicillins, cephalosporins, aminoglycosides, fluoroquinolons etc.
Which antibiotics inhibit bacterial DNA gyrase/topoisomerase enzymes?
nalidixic acids, fluoroquinolons
What is the mode of action of the antibiotics sulfonamides and trimethoprim,
respectively?
They inhibit the synthesis of folic acid. Sulfonamides: inhibit the synthesis of dihidrofolate
(they are PABA analogues). Trimethoprim: inhibition of dihidrofolate-reductase.
What is the mode of action of the antibiotic vancomycin?
Inhibits cell wall synthesis in Gram positive bacteria by blocking transglycosylation /
transpeptidation
Mention 4 groups of antibiotics inhibiting protein synthesis of bacteria!
Aminoglycosides, tetracyclines, chloramphenicol, macrolides, lincosamides
Give an example of synergistic interaction between 2 antibiotics!
penicillin combined with gentamicin, or a sulfonamide combined with trimethoprim
Give an example of antagonistic interaction between 2 antibiotics!
penicillin combined with tetracycline
What does selective toxicity mean?
Selective inhibition of the growth of the microorganism without damage to the host.
In other words: the drug is highly toxic to the bacteria, but not toxic (or have very low
toxicity) to the human host.
What is the mechanism of action of lysozyme? Where is lysozyme found in the host?
It destroys bacterial cell wall peptidoglycan by hydrolysing the glycosyl bonds
between NAM (N-acetylmuramicacid) and NAG (N-acetylglucosamine). It occurs in
tear, saliva, respiratory secretions.
What roles can be attributed to specific antibodies in antibacterial immunity? Specify at
least 3!
a. neutralisation of exotoxins and enzymes
b. complement-dependent bacteriolysis (Gram-negatives)
c. opsonisation (helping phagocytosis)
d. interfering with attachment of bacteria to mucosal surfaces
Which type of hypersensitivity is involved in the tuberculin test?
late type (type IV)
Which Gram negative organelles or structures are associated with the O, H and K
antigens, respectively?
O- LPS, H-flagella, K-capsule
How can one identify the different surface antigens of Gram negative bacteria?
with slide (rarely tube) agglutination tests using antibodies of known specificity
Starting from a fixed smear, specify the main steps of Gram stain in the appropriate
order!
- Crystal violet
- Lugol solution (iodine)
- Differentiation: ethanol wash
- Counterstaining: safranin or fuchsin
(wash with tap water after each step)
Starting from a fixed smear, specify the main steps of the acid-fast stain (Ziehl-Neelsen)
in the appropriate order!
- Stain with carbol-fuchsin (with heating)
- Differentiation: wash with acid-ethanol
- Counterstaining with methylene-blue
(wash with tap water after each step)
Describe the principle of acid fast staining procedures!
Mycobacteria contain a high amount of special lipids called mycolic acids. They can be
stained by hot carbol-fuchsin, but they resist decolourisation with acid-alcohol, so they
remain red. All other cells are decolorised by acid-alcohol and then stained blue by the
counter stain (methylene blue).
What is the difference between agglutination and precipitation?
Both are serological reactions where specific binding of the antigen with the antibody
directly results in a reaction visible by the naked eye. The difference is in the nature of the
antigen. Agglutination: particulate antigen (RBC, bacteria, latex particles).
Precipitation: antigen is in solution before the reaction.
What does titer mean in serological tests?
The highest dilution of the serum sample that still gives a positive reaction in the test.
How can one differentiate between past and current infections in serological tests?
Current infections are indicated by: either IgM class specific antibodies or, in the case of
paired serum specimens (taken from the same patient at least 7-10 days apart), a
significant (at least 4-fold) rise in the titer of specific antibodies.
Specify the main steps of an ELISA test in which we detect antibodies from patients’
serum samples using known antigens!
- Binding antigen to plastic surface (in wells of a 96-well plate)
- Adding diluted serum sample (specific antibodies bind to the antigen)
3.Adding conjugate (secondary antibody conjugated with an enzyme) - Adding the substrate of the enzyme, reading the colour reaction.
(wash with buffer after steps 1-3.)
How can one determine the minimal inhibitory concentration (MIC) of an antibiotic to a
bacterial isolate?
Inoculate the bacterial isolate into a series of test tubes containing 2-fold dilution series of
the drug (prepared in appropriate liquid culture medium). After overnight incubation, the
lowest concentration of drug that prevents visible growth of the organism is the MIC.
Describe the principle of the Kirby-Bauer (disk diffusion) method used to determine
antibiotic sensitivity!
Disks impregnated with different antibiotics are placed on the surface of appropriate agar
media that has been previously inoculated with the bacterium isolated from the patient.
After overnight incubation, the antibiotics diffusing from the discs may cause zones of
inhibition around the discs. The size of the zone should be compared to standard values to
determine antibiotic sensitivity.
Mention 5 diseases that are frequently caused by Staphylococcus aureus!
folliculitis, furunculus, bullous impetigo, osteomyelitis, food poisoning, pneumonia
etc.
Mention 2 toxin-mediated staphylococcal diseases!
toxic shock syndrome (TSS), scalded skin syndrome, food poisoning
Mention 3 toxic products produced by Staphylococcus aureus!
TSST (toxic shock syndrome toxin), enterotoxin, exfoliatin, leukocidins, hemolysins
Which is the most virulent species of the Staphylococcus genus?
S. aureus
Which enzymatic virulence factor is characteristic exclusively for Staphylococcus
aureus?
exocoagulase
Which biochemical test can be used to differentiate staphylococci from streptococci?
catalase test
Which antibacterial drug is the first choice in serious infections caused by methycillin
sensitive Staphylococcus aureus (MSSA) strains?
oxacillin (cloxacillin, flucloxacillin)
Which antibacterial drug is the first choice in serious infections caused by methycillin
resistant Staphylococcus aureus (MRSA) strains?
glycopeptides (vancomycin, teicoplanin)
In which disease is Staphylococcus saprophyticus considered an obligate pathogen?
cystitis in young women
Which cell constituents determine the group-specific, and the type specific antigens of
Streptococcus pyogenes, respectively?
group specific: C- polysaccharide
type specific: M protein
Mention 3 enzymes produced by Streptococcus pyogenes that enhance the spread of
the bacterial infection in the body!
Streptokinase (fibrinolysin), hyaluronidase, streptodornase (DNAse)
List 3 diseases caused by Streptococcus pyogenes in the skin or in subcutaneous
tissues!
impetigo, erysipelas, cellulitis, necrotizing fasciitis, myonecrosis
Mention a toxin-mediated streptococcal disease; specify the name of the toxin and its
mechanism of action!
Scarlet fever - erythrogenic toxin – superantigen causing capillary destruction
Streptococcal toxic shock syndrome (TSS) – TSST - superantigen
Mention 2 poststreptococcal diseases!
Glomerulonephritis, rheumatic fever, (erythema nodosum, chorea minor)
Which product of Streptococcus pyogenes has a major pathogenic role in
poststreptococcal diseases?
M protein: may induce hypersensitivity reactions
How long does immunity against scarlet fever exist? Which immune effector
mechanism is involved?
Life-long immunity. Antitoxic antibodies are involved.
What is the drug of first choice in Streptococcus pyogenes infection?
Penicillin-G, penicillin V / amoxicillin
What is the patomechanism of post-streptococcal rheumatic fever?
type II hypersensitivity (cytotoxic antibodies)
What is the patomechanism of post-streptococcal glomerulonephritis?
type III hypersensitivity (immune complexes)
Which Streptococcus species plays major role in the meningitis of newborn babies?
Group B Streptococcus (S. agalactiae)
What is (are) the major causative agent(s) for native valve infective endocarditis?
Viridans streptococci
Mention 2 diseases that are frequently caused by enterococci!
urinary tract infections, endocarditis, intraabdominal and pelvic infections
What are the specific morphologic features of Streptococcus pneumoniae?
Gram positive diplococcus, lancet shape, capsule.
Mention 3 diseases that are frequently caused by Streptococcus pneumoniae!
Pneumonia, meningitis, sinusitis, otitis media, sepsis
What fast diagnostic procedure can be used in acute Neisseria gonorrhoeae infection?
Demonstration of bacteria (intracellular in PMNs) from urethral discharge by Gram
or methylene blue stain; PCR amplification of bacterial DNA
What kind of immunity develops after Neisseria gonorrhoeae infection?
Partial immunity of short duration; no protection from reinfection
Specify at least 2 of the most important manifestations of disseminated gonorrhoeal
infections!
arthritis, skin lesions, (endocarditis, meningitis)
What is the major manifestation of Neisseria gonorrhoeae infection in newborns?
How can it be prevented?
Blenorrhoea (ophtalmia) neonatorum; silver acetate eye drops or erythromycin
ointment
Mention at least 3 major virulence factors of Neisseria gonorrhoeae!
pilus, outer membrane proteins, LOS (lipooligosaccharide), IgA protease
Mention at least 2 major virulence factors of Neisseria meningitidis!
polysaccharide capsule, LOS, IgA protease
What is the site of entry of Neisseria meningitidis infection? Which diseases are
caused by this bacterium?
The site of entry is the nasopharynx (transmitted by airborne droplets).
Meningococcemia and acute (purulent) bacterial meningitis.
What kinds of prophylactic measures are available against Neisseria meningitidis
infections?
Chemoprophylaxis: rifampin or ciprofloxacin.
Vaccination: capsular polysaccharide (types A, C, Y and W135). Vaccine against
type B: contains different recombinant proteins.
Which rapid diagnostic methods can be used in the presumptive diagnosis of purulent
bacterial meningitis?
Gram or methylene blue stain of CSF sediment
Demonstration of bacterial capsular antigens by latex agglutination (from CSF)
Polymerase chain reaction (PCR)
What does the vaccine against Haemophilus influenzae contain?
type b capsular polysaccharide conjugated to a carrier protein
Which are the portals of entry of Bacillus anthracis?
Skin, lungs, gastrointestinal tract
Mention 3 important bacteria involved in nosocomial (hospital-acquired) infections!
Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, Escherichia
coli, Clostridioides difficile
Mention four E. coli pathogenetic groups involved in enteric diseases!
Enteropathogenic E. coli (EPEC)
Enterotoxic E. coli (ETEC)
Enteroinvasive E. coli (EIEC)
Enterohemorrhagic E. coli (EHEC)
Enteroaggregative E. coli (EAggEC)
What are the most important extraintestinal infections caused by E. coli? Mention at
least 3 of them!
urinary tract infections, neonatal meningitis, nosocomial wound infections
The most frequent causative agent of urinary tract infections is:
Escherichia coli
Which 2 diseases are caused by E. coli O157:H7?
hemorrhagic colitis +/- HUS (hemolytic uraemic syndrome)
What is the reservoir of Salmonella typhi?
humans (with disease, or healthy carriers)
Which bacteria cause most frequently typhoid fever and enteric fever, respectively?
Salmonella typhi (typhoid)
Salmonella paratyphi A, B, C (enteric fever)
When typhoid fever is suspected, what kinds of clinical samples should be used to isolate
the causative agent in the first 2 weeks of the disease?
Blood, (bone marrow)
What is the route of infection in Salmonella gastroenteritis?
Ingestion of contaminated food (such as eggs, cream, mayonnaise, creamed foods, etc.)
containing a sufficient number of Salmonella.
Which antibacterial drugs should be administered in gastroenteritis caused by
Salmonella?
Antibiotics are usually contraindicated unless the infection is generalised. In case of
extraintestinal infection (very young, very old or immunosuppressed patients):
ampicillin, gentamicin, trimethoprim/sulfamethoxazole, third generation
cephalosporins, or ciprofloxacin.
List the 4 Shigella species causing human disease!
Shigella dysenteriae, S. flexneri, S. boydii, S. sonnei
Mention 2 bacterial species belonging to different genera that cause bacillary dysentery
Shigella dysenteriae, (Shigella flexneri, Shigella boydii, Shigella sonnei), enteroinvasive
E. coli (EIEC)
Mention 3 bacterial species belonging to different genera that cause enteritis or
enterocolitis!
Campylobacter jejuni, Escherichia coli, Salmonella enteritidis, Shigella, Yersinia
enterocolitica
Mention 2 bacteria causing intestinal infections which have animal reservoirs!
Salmonella (not Typhi and Paratyphi!), Campylobacter jejuni, Yersinia enterocolitica,
Listeria monocytogenes, E. coli O157
What are the modes of transmission for the 2 different epidemiologic forms of plague?
Bubonic plague is transmitted by the bite of infected rat fleas from rats to humans.
- Primary pneumonic plague spreads directly from human to human via respiratory
droplets.
What are the possible portals of entry of Francisella tularensis? Specify at least 4!
tick bite, conjunctiva, skin abrasions, resp. tract, gastroint. tract
How do humans acquire brucellosis? Where do the bacteria replicate in the human body?
Via contaminated milk products or through skin abrasions (contact with animals).
Organisms spread to the mononuclear phagocytes of the reticuloendothelial system
(lymph nodes, liver, spleen, bone marrow).
What are the reservoirs of the different Brucella species, respectively?
B. abortus: cattle
B. melitensis: goat, sheep
B. suis: swine
(B. canis: dog)
What is the mechanism of action of cholera toxin?
Cholera toxin activates the adenylate cyclase enzyme in cells of the intestinal mucosa
leading to increased levels of intracellular cAMP, and the secretion of large amount of
water, Na+
, K+
, Cl-
, and HCO3
-
into the lumen of the small intestine.
What is the principle of the treatment for cholera?
Rapid intravenous or oral replacement of the lost fluid and ions. In severe cases:
administration of tetracycline (in addition to rehydration).
Mention 4 diseases caused by Haemophilus influenzae!
purulent meningitis
epiglottitis (obstructive laryngitis)
otitis media and sinusitis
pneumonia
(cellulitis, arthritis)
Which disease is caused by Haemophilus ducreyi?
Chancroid (soft chancre or ulcus molle), which is an STD (sexually transmitted disease)
What can serve as source of infections caused by Pseudomonas aeruginosa?
Pseudomonas species are normally present in the environment and can be isolated from
the skin, throat, and stool of some healthy persons. They often colonize hospital food,
sinks, taps, mops, and respiratory equipment.
Mention 4 diseases that are frequently caused by Pseudomonas aeruginosa!
urinary tract infections, wound infections (burns), otitis externa,
pneumonia, sepsis (immunosupression)
Mention at least 3 drugs which may be effective to treat infections caused by
Pseudomonas aeruginosa!
certain penicillins: piperacillin/tazobactam combination
a 3rd generation cephalosporin: ceftazidim
a 4th generation cephalosporin: cefepime
certain aminoglycosides: gentamycin, amikacin
carbapenems: imipenem, meropenem
What are the frequent sources of infection for Legionella pneumophila?
air conditioners, water taps, showers, evaporators, etc.
Which 2 diseases are caused by Legionella pneumophila?
legionellosis, legionnairs’ disease (atypical pneumonia)
- Pontiac fever (mild, flu like illness without pneumonia)
List 3 important virulence factors of Bordetella pertussis!
pertussis toxin, filamentous hemagglutinin, adenylate-cyclase toxin, tracheal
cytotoxin
What is the precise definition of bacterial food poisoning?
Acute disease, usually with vomiting and diarrhea, usually caused by preformed toxins
produced by bacteria contaminating the food. The period between consumption of food
and the appearance of symptoms is short (< 4-6 hours).
Mention 3 bacterium species causing food poisoning!
Staphylococcus aureus, Bacillus cereus, Clostridium perfringens, Clostridium
botulinum
Which bacterium has the highest germ number in the colon?
Bacteroides fragilis
Mention 4 bacterial genera that are obligate anaerobes!
Clostridium, Bacteroides, Prevotella, Porphyromonas, Fusobacterium, Actinomyces,
Bifidobacterium, Peptostreptococcus, Propionibacterium
Which is the most important gas gangrene Clostridium? What is its main virulence factor?
Clostridium perfringens
alpha-toxin (lecithinase)
Mention 3 Clostridium species causing gas gangrene! How are they acquired?
Clostridium perfringens, C. novyi, C. septicum, C. histolyticum, C. tertium, C.
bifermentans, C. sporogenes
The site of infection is usually a wound that comes into contact with Clostridium spores
that germinate in an anaerobic environment.
How can be tetanus prevented in patients who have wounds possibly contaminated with C.
tetani spores?
Wound should be cleaned and debrided; tetanus toxoid booster injection given;
tetanus immunoglobulin (TETIG) in previously unvaccinated patients and in case of
heavy contamination of wound; penicillin may be added prophylactically
What are the main symptoms of tetanus? Specify at least 3!
Spastic paralysis: muscle spasms; lockjaw(trismus), rhisus sardonicus (grimace of the
face), opisthotonus (spasm of the back); respiratory paralysis
What is the mechanism of action of botulinum toxin?
Blocks release of acetylcholine in peripheral nerve synapses;
What are the main symptoms of botulism? Specify at least 3!
flaccid paralysis: diplopia (double vision), dysphagia (difficulty to swallow), dysphonia
(hoarseness), respiratory paralysis.
What kind of therapy is used to treat botulism?
Treatment: respiratory support + trivalent antitoxin
Explain whether or not antibiotic treatment is useful in botulism!
Not, because antibiotics are not effective against preformed toxins.
Mention at least 2 drugs that can be used to treat diseases caused by Clostridioides
difficile!
vancomycin, metronidazole, fidaxomicin
What diseases may be associated with Helicobacter pylori? Specify at least 3!
Gastritis, peptic and duodenal ulcers, gastric carcinoma, MALT lymphoma
What is the most important virulence factor of Corynebacterium diphtheriae?
Diphtheria toxin
What is the mechanism of action of the diphtheria toxin?
Inhibits protein synthesis. Inhibits peptide elongation in eukaryotic ribosomes by
ADP ribosylation of EF-2 (elongation factor-2)
How long does immunity against diphtheria exist? Which immune effector mechanism is
involved?
long lasting immunity; antitoxic antibodies
Which assays must be performed in the laboratory diagnosis of diphtheria?
Smears of the throat swab should be stained with methylene blue or Neisser stain;
bacteria are cultured on Löffler’s or tellurite (Clauberg) medium; toxin production
must be demonstrated by agar precipitation ( ELEK-test)
What feature of Mycobacteria make them acid fast?
The cell envelope contains a high amount (60 – 70 %) of complex lipids: mycolic acid,
cord factor. Once the cells are stained (by carbol-fuchsin) they resist decolorisation by
acid-ethanol.
Mention 2 atypical Mycobacterium species!
M. kansasii, M. marinum, M. avium-intracellulare complex, M. fortuitum-chelonae
complex
How can one demonstrate the presence of Mycobacterium tuberculosis in clinical
samples?
Acid-fast staining (Ziehl-Neelsen)
Culture on selective media (Löwenstein-Jensen agar, liquid BACTEC medium)
PCR amplification of bacterial DNA
Why is multi-drug therapy used for tuberculosis?
To prevent the overgrowth of drug-resistant mutants during the long treatment
period (if bacteria resistant to one drug emerge, they are most probably inhibited by
the other drugs).
What is the main immune defense mechanism against Mycobacterium tuberculosis?
activated macrophages
Mention 3 antituberculotic drugs that are of first choice against Mycobacterium
tuberculosis!
isoniazid (INH), pyrazinamid, rifampin, (ethambutol)
What disease is caused by Mycobacterium avium-intracellulare? What patients are
characteristically susceptible to infection?
It causes tuberculosis, especially in immunosuppressed patients (e. g. AIDS).
What is the reservoir of Mycobacterium tuberculosis?
human
What is the reservoir of atypical Mycobacteria?
environment (soil, water)
What are the 2 main forms of leprosy?
Tuberculoid (paucibacillary) or lepromatous (multibacillary) form
Mention 3 Gram-negative bacteria belonging to different genera causing zoonosis!
Brucella, Francisella tularensis, Yersinia pestis, Pasteurella
Mention 2 Gram-positive bacteria belonging to different genera causing zoonosis!
Listeria monocytogenes, Bacillus anthracis, Erysipelothrix rhusiopathiae
Mention 3 bacterial species belonging to different genera that are frequent causes of
urinary tract infections!
E. coli, Klebsiella, Proteus, Pseudomonas aeruginosa, Enterococcus faecalis
Mention one aerobic and one anaerobic bacterium of the normal flora of the skin!
aerobic: Staphylococcus epidermidis
anaerobic: Cutibacterium (Propionibacterium) acnes
Give two genera for each category of bacteria!
Gram positive aerobic
Gram positive anaerobic
Gram positive aerobic: Staphylococcus, Streptococcus, Bacillus, Corynebacterium
Gram positive anaerobic: Clostridium, Actinomyces, Propionibacterium
Give two genera for each category of bacteria!
Gram negative aerobic
Gram negative anaerobic
Gram negativ aerobic: Vibrio, Neisseria, Haemophilus
Gram negativ anaerobic: Bacteroides, Prevotella, Porphyromonas, Veillonella
Give 2 genera for each category of bacteria!
Gram positive coccus
Gram negative coccus
Gram positive rod
Gram positive coccus: Staphylococcus, Streptococcus
Gram negative coccus: Neisseria, Veillonella
Gram positive rod: Clostridium, Bacillus
Give 2 genera for each category of bacteria!
Gram negative rod
Spirochetes
Gram negative rod: E. coli, Salmonella, Shigella
Spirochetes: Treponema, Borrelia, Leptospira
Describe the color and the shape of Clostridia in a Gram stained smear of gas
gangrene exudate!
Gram positive (dark blue) rod
(it usually does not form spores in vivo)
Mention 2 antibiotics which can be used in the empirical treatment against Gram
negative obligate anaerobic bacteria!
Metronidazol, amoxicillin + clavulanic acid, imipenem
Which 3 bacterial species are the most important causative agents of neonatal (< 1
month of age) meningitis?
Streptococcus agalactiae, E. coli, Listeria monocytogenes
Which 3 bacterial species are the most important causative agents of meningitis
among babies (> 1 month of age) and children?
Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae
What is the empirical antibiotic therapy of bacterial meningitis?
ceftriaxone / cefotaxime
What is the causative agent of febris undulans (undulant fever)?
Brucellae
What are the main manifestations in early (primary and secondary) syphilis?
Primary syphilis: nontender ulcer (hard chancre)
Secondary lesions: maculopapular rash on skin, and condylomata lata on mucous
membranes
What are the main manifestations in late (tertiary) syphilis?
Granulomas (gummas), central nervous system involvement (tabes dorsalis,
paralysis progressiva), cardiovascular lesions (aortitis, aortic aneurysm)
When syphilis is diagnosed in the laboratory, which antigens are used in the nontreponemal
and in the specific treponemal antibody tests, respectively?
Non-treponemal antibody tests: cardiolipin
Specific treponemal antibody tests: antigens originating from Treponema pallidum or
whole bacterial cells of Treponema pallidum
Which are the two different groups of serological tests used in the diagnosis of
syphilis? Give 2 examples for both groups of tests!
Non-treponemal tests: RPR, VDRL (flocculation tests)
Specific treponemal tests: FTA-ABS (fluorescent treponemal assay – with antibody
absorption), TPHA (T. pallidum hemagglutination), TPPA (T. pallidum particle
agglutination), ELISA, Western blot
What is the advantage and disadvantage of the specific (treponemal) syphilis serologic
tests compared to the nonspecific (nontreponemal) test?
Specific (treponemal) tests are more specific than the nontreponemal tests, but they can
not be used to follow the efficacy of treatment (because the specific antibodies persist
even after effective eradication of bacteria).
What is the drug of first choice in the treatment of syphilis?
penicillin G
What is the reservoir and what is the vector for Borrelia recurrentis?
Reservoir: human; vector: louse
What is used for the laboratory diagnosis of relapsing fever?
Direct demonstration of bacteria from peripheral blood smear by microscopy (Giemsa
stain or dark field illumination)
What is the causative agent of Lyme disease?
Borrelia burgdorferi
Mention 2 antibacterial drugs that are of first choice in early stage Lyme disease!
Doxycycline, amoxicillin
What is the first characteristic manifestation in the early phase of Lyme disease?
Erythema (chronicum) migrans
Which manifestations are characteristic for the late phases of Lyme disease?
Arthritis, cardiac manifestations (myocarditis, pericarditis) and neurological
involvement (meningitis, peripheral neuropathies)
What is the reservoir of Leptospira interrogans?
rodents, household animals (dog, swine etc.)
Mention 2 obligate intracellular bacterial genuses!
Rickettsia, Chlamydia, (Coxiella, Ehrlichia)
Mention 4 bacteria causing atypical pneumonia!
Chlamydia pneumoniae
Chlamydia psittaci
Coxiella burnetii
Mycoplasma pneumoniae
Legionella pneumophila
Which two diseases are caused by Rickettsia prowazekii?
Louse-borne epidemic typhus
Recurrent form: Brill-Zinsser disease
Mention an antibacterial drug active against rickettsial infections!
Tetracycline, chloramphenicol, (fluoroquinolones)
What is the reservoir and the vector of Rickettsia prowazekii infections?
reservoir: human; vector: louse
What is the reservoir and the vector of Rickettsia typhi infections?
reservoir: rodents; vector: flea
What is the causative agent of epidemic typhus?
Rickettsia prowazekii
What is the causative agent of endemic typhus?
Rickettsia typhi
How can be Chlamydiae and Rickettsiae cultivated?
These are obligate intracellular bacteria, can be cultured in experimental animals,
embryonated eggs, and cell culture
Mention an antibacterial drug active against chlamydial infections!
Tetracycline, erythromycin, azithromycin, fluoroquinolones
List the serotypes of Chlamydia trachomatis and the diseases caused by them!
Types A, B and C: trachoma (chronic conjunctivitis)
Types D-K: genital tract infections (NGU, PID), inclusion conjunctivitis
Types L1-L3: lymphogranuloma venereum (STD)
Mention an antibacterial drug effective against Mycoplasma pneumoniae infections!
Erythromycin, azithromycin, tetracycline, levofloxacin
Why are penicillins not effective against Mycoplasma pneumoniae infections?
Because of the absence of a cell wall, penicillins are ineffective (penicillins inhibit cell
wall synthesis)
Mention 4 bacteria frequently causing sexually transmitted diseases (STD)!
Treponema pallidum, Neisseria gonorrhoeae, Haemophilus ducreyi, Chlamydia
trachomatis, (Calymmatobacterium granulomatis)
Which bacterial species can cause hepatitis (jaundice)?
Leptospira interrogans
Mention 2 bacteria causing aseptic (serous) meningitis!
Treponema pallidum, Leptospira interrogans, Borrelia burgdorferi
Mention a bacterial pathogen which eludes the host immune response by frequent
antigenic changes!
Borrelia recurrentis, Neisseria gonorrhoeae
What is the causative agent of febris recurrens (recurrent fever)?
Borrelia recurrentis
What does fungal dimorphism mean?
The same species is capable of existing in two morphological forms (yeast or mold),
depending upon enviromental conditions (temperature, nutrients).
Which are the 4 fungal species causing endemic (systemic) mycosis?
Coccidioides immitis, Histoplasma capsulatum, Blastomyces dermatitidis, Paracoccidioides
brasiliensis
Mention 3 species causing opportunistic fungal infections!
Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, Mucor spp., Rhizopus
spp.
Mention 3 diseases caused by dermatophytons!
Tinea corporis, tinea capitis, onychomycosis, tinea barbae
Mention 3 fungal genera belonging to the dermatophytons!
Trichophyton, Microsporum, Epidermophyton
What is the route of transmission of Sporothrix schenkii?
Traumatically introduced under the skin.
Mention a Candida infection associated with mucosal surfaces!
Soor, vulvovaginitis
Which species is the most important causative agent of fungal meningitis?
Cryptococcus neoformans
Mention 2 manifestations of Candida albicans infections that are characteristic in
AIDS patients!
generalised oral candidiasis (GOC), oesophagitis
What are the different forms of pulmonary aspergillosis?
- Aspergillus ball (in preformed cavities)
- invasive aspergillosis (in immunosuppression)
- allergic bronchopulmonary aspergillosis
What is the usual source of infection in endemic (systemic) mycoses?
soil
What is the usual site of entry of fungi causing systemic mycoses?
respiratory tract (inhalation)
Which morphological form of Coccidioides immitis can be found in the human body?
spherule
Which human pathogenic fungus has a capsule?
Cryptococcus neoformans
Mention an antifungal agent that is effective against yeasts!
fluconazole, echinocandins (caspofungin, micafungin, anidulafungin, rezafungin),
amphotericin B
Mention an antifungal agent that is effective in the treatment of invasive aspergillosis!
voriconazole, isavuconazole, posaconazole, amphotericin B, echinocandins (caspofungin,
micafungin, anidulafungin, rezafungin)
Mention a Candida species with generic fluconazole resistance!
Candida krusei
How can we differentiate Aspergillus and Mucor morhologically?
Aspergillus species have septate hyphae while Mucor species have non-septate hyphae.
What is the mechanism of action of antifungal azoles?
They inhibit ergosterol synthesis by inhibiting the 14-alpha-demethylase enzyme.
What is the mechanism of action of antifungal polyenes?
Polyenes bind to ergosterol in the fungal cell membrane leading to formation of pores,
increased membrane permeability and fungal cell death.
What is the mechanism of action of echinocandins?
Echinocandins inhibit fungal cell wall synthesis in susceptible fungi by inhibition of the
beta-1,3-D-glucan synthase enzyme complex
Mention at least two antifungal triazoles!
fluconazole, itraconazole, voriconazole, posaconazole
Which triazoles have potent activity against filamentous fungi? Mention at least two!
voriconazole, posaconazole, isavuconazole
Mention at least two echinocandins!
caspofungin, anidulafungin, micafungin, rezafungin
What does ectothrix mean?
This concept is used in diagnosis of dermatomycoses. The hyphae and spores cover the
outside surface of the hair shaft, which results in destruction of the cuticle.
Which therapy is used for the treatment of Pneumocystis jirovecii?
First-line: trimethoprim-sulfametoxazol
Alternative: pentamidine, atovaquone
What is the causative agent of pityriasis versicolor?
Malassezia furfur
What is the colour of Candida albicans colonies on the surface of CHROM agar used
in Candida diagnostics?
Green
Which antifungals are used for the treatment of fungal meningitis?
Amphotericin B, fluconazole
List the clinically relevant 5 Candida species!
Candida albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei
Which diagnostic methods can be used to diagnose invasive pulmonary aspergillosis?
Chest CT and serum galactomannan antigen detection (by ELISA)
What is the therapy in case of Talaromyces (Penicillium) marneffei invasive
infections?
Amphotericin B or fluconazole.
What are the most common risk factors for invasive Candida infections? List at least
FOUR!
Abdominal or thoracic surgery, presence of central or peripheral venous catheters, very
young or old age, neutropenia, immunosuppression, previous use of broad-spectrum
antibiotics
What are the most common risk factors for Mucor infections? List at least TWO!
Previous voriconazole treatment, diabetic ketoacidosis, neutropenia, leukemia,
What is the first-line therapy in case of onychomycosis?
Terbinafine.
What is the first-line agent for the treatment of invasive Candida glabrata and C.
krusei infection?
Echinocandin (anidulafungin, caspofungin, micafungin, rezafungin).
Mention 2 protozoa that are susceptible to metronidazol!
Entamoeba histolytica
Giardia lamblia
Trichomonas vaginalis
What are the 3 modes of transmission for human Toxoplasma gondii infection?
Eating undercooked meat containing tissue cysts,
Contact with cat feces or consuming food or water containing oocysts
Transplacental transmission
Which protozoon may infect the human foetus transplacentally and cause
developmental malformations?
Toxoplasma gondii
Which species are the causative agents of malaria?
Plasmodium vivax, P. ovale, P. malariae, P. falciparum, (P. knowlesi)
What is the definitive (ultimate) host of Plasmodium species?
female Anopheles mosquito
What is the laboratory diagnosis of malaria?
Giemsa-stained blood smears. Thick smear is used to screen for the agent, thin smear is
used to identify the species.
How long is the erytrocytic cycle of Plasmodium vivax and P. ovale?
48 hours
How long is the erytrocytic cycle of Plasmodium malariae?
72 hours
What is the causative agent of malignant malaria?
Plasmodium falciparum
Which Plasmodium species may cause relapse of malaria due to presence of
hypnozoites?
Plasmodium vivax, P. ovale
Mention a potentially fatal complication of Plasmodium falciparum infections!
cerebral malaria
Mention an agent that may be effective in the treatment of acute malaria attack!
chloroquine, quinine, artemether+lumefantrine, etc.
Mention an antimalarial drug active against hypnozoites!
Primaquin
How can we diagnose African sleeping sickness?
Giemsa-stained blood smears are used for direct demonstration.
Serology may be helpful
What are the causative agents of African sleeping sickness?
Trypanosoma brucei gambiense and rhodesiense
Specify the 3 forms of leishmaniasis!
cutaneous, mucocutaneous and visceral
How can we diagnose amebic dysenetery?
Microscopic demonstration of E. histolytica cysts and trophozoites from feces
How can we diagnose Trichomonas vaginalis infection?
Direct demonstration of protozoa in wet mount or stained smear of clinical specimens
(vaginal, urethral or prostatic secretions). Polymerase chain reaction (PCR)
What is the definitive (ultimate) host of Echinococcus granulosus?
dog
How can we diagnose intestinal taeniasis?
Demonstration of characteristic proglottis and eggs (ova) in faeces.
How can we diagnose Hymenolepis infection?
Demonstration of eggs (ova) in faeces
Mention a worm species for which ab ano ad os auto-reinfection is characteristic in
childhood!
Enterobius vermicularis
Mention 2 worm species that migrate through the human lungs in the larval stage!
Ascaris lumbricoides
Ancylostoma duodenale
Necator americanus
Strongyloides stercoralis
How can we diagnose Ascaris infection?
Demonstration of eggs (ova) in faeces
How can we diagnose trichuriasis?
Demonstration of eggs (ova) in faeces
How can we diagnose Enterobius infection?
Demonstration of eggs (ova) recovered from perianal skin (Scotch tape technique). Not
from feces!
Mention 3 tissue infecting filarial nematodes!
Wuchereria bancrofti
Loa loa
Oncocerca volvulus
How is human Fasciola hepatica infection acquired?
By eating aquatic vegetation containing encysted larvae
(Rarely: by eating raw sheep liver containing adult worms)
What disease is caused if humans are infected per os with Taenia solium eggs?
human cysticercosis (encysted larvae in brain, eyes, etc.)
How is human Trichinella spiralis infection acquired?
By eating raw or undercooked meat containing encysted larvae
Mention 2 helminths whose larvae enter the human body by penetrating the intact
skin!
Schistosoma
Ancylostoma duodenale
Necator americanus
Strongyloides stercora
Which developmental form of Echinococcus granulosus can occur in humans?
Hydatid cyst
What are the definitive, and the intermediate hosts of Taenia saginata, respectively?
definitive host: human
intermediate host: cattle
What are the definitive, and the intermediate hosts of Taenia solium, respectively?
definitive host: human
intermediate host: swine (pig)
What is the infectious form of Strongyloides stercoralis?
filariform larva
What is the infectious form of Trichuris trichiura?
embryonated egg
Which form of Taenia saginata is infectious for humans?
cysticercus (in beef)
Is auto-reinfection possible in Ascaris lumbricoides infection? If yes, when?
No, the eggs must mature in the soil for several days to become infectious
(embryonated)
Is auto-reinfection possible in Strongyloide stercoralis infection? If yes, when?
yes, especially in immunosuppression (for example: AIDS)
Is auto-reinfection possible in Enterobius vermicularis infection? If yes, when?
yes, the eggs become infectious in a few hours, and ab ano ad os autoinfection may
occur (especially in children)
Mention 3 DNA virus families including non-enveloped viruses!
Parvoviridae, Papillomaviridae, Adenoviridae
Mention 3 DNA virus families including enveloped viruses!
Herpesviridae, Hepadnaviridae, Poxviridae
Mention 3 RNA virus families including non-enveloped viruses!
Picornaviriade, Caliciviridae, Reoviridae
Mention 3 RNA virus families including enveloped viruses!
Orthomyxoviridae, Paramyxoviridae, Rhabdoviridae, etc.
Which virus family is characterized by a single-stranded DNA genome?
Parvoviridae
Which virus family is characterized by a double-stranded RNA genome?
Reoviridae
Reverse transcription is involved in the replication of which DNA virus?
Hepadnaviridae – HBV
List the 5 major types of viral vaccines (classified according to the properties of the
viral component)!
live attenuated virus vaccines
inactivated virus vaccines
subunit vaccines
viral vector vaccines
nucleic acid vaccines (RNA, DNA)
Mention at least 3 diseases caused by herpes simplex viruses (HSV1, HSV2)!
oropharyngeal herpes (gingivostomatitis, herpes labialis), keratoconjunctivitis,
encephalitis, herpes genitalis
What are the serious complications of HSV infection in newborns?
disseminated infections; encephalitis; skin, eye, mouth infections
Which viruses are susceptible to acyclovir? What is the mechanism of effect of the
drug?
alpha herpesviruses – HSV1, HSV2, VZV; inhibitor of viral DNA polymerase and
DNA chain terminator
Explain why acyclovir is selectively toxic to cells infected by alpha-herpesviruses!
These viruses encode their own thymidine kinase enzymes, which are needed for
activation (phosphorylation) of the drug. Cellular thymidine kinase does not
activate the drug.
In which cells do Herpes simlex viruses establish latent infection?
Sensory ganglion cells (trigeminal or sacral ganglia)
What manifestation occurs when the virus causing chickenpox is reactivated after a
long latent period?
Herpes zoster (shingles)
What manifestations does cytomegalovirus cause in congenital infections?
cytomegalic inclusion disease – spontaneous abortion, CNS damage (deafness,
blindness, mental retardation), hepatosplenomegaly, jaundice
What disease does cytomegalovirus cause in immunocompetent persons?
mononucleosis infectiosa (heterophil-antibody negative)
Mention 2 diseases that cytomegalovirus can cause in immune compromised persons!
pneumonia, chorioretinitis, colitis
Mention 2 drugs that can be used to treat cytomegalovirus infections?
Ganciklovir, valganciklovir, foscarnet, cidofovir, letermovir
Describe the heterophil antibody test used in Epstein-Barr virus diagnostics!
Paul-Bunnel test – in mononucleosis caused by EBV, the serum of the patient
agglutinates sheep red blood cells
Which virus causes exanthema subitum (roseola infantum)?
HHV6, HHV7
Which virus causes erythema infectiosum?
Human parvovirus B19
What are the possible consequences of fetal infections caused by B19 parvovirus?
fetal death or hydrops fetalis
Which isotype of antigen-specific immunoglobulins in the newborn’s blood indicates a
congenital infection?
IgM
Which antigens of influenza viruses are recognized by neutralizing antibodies?
Hemagglutinin, neuraminidase
What is the mechanism of antigenic shift in influenza viruses?
reassortment of genome segments (between different influenza A virus subtypes)
What is the mechanism of antigenic drift in influenza viruses?
accumulation of point mutations in the hemagglutinin and neuraminidase genes of
influenza viruses
Which influenza virus types are characterised by antigenic shift?
influenza A
Which influenza virus types are characterised by antigenic drift?
Influenza A and B
Which ifluenza A subtypes cause most human infections currently?
H1N1, H3N2
Which virus(es) is(are) susceptible to amantadine?
Influenza A virus
What is the possible late complication of measles infection (several years after the
acute infection)?
SSPE – subacute sclerosing panencephalitis
What is the portal of entry of the viruses belonging to Paramyxoviridae?
Respiratory tract – aerosol infection
Which virus is the most common cause of severe viral lower respiratory tract
infections in infants and small children?
respiratory syncitial virus (RSV)
What are the possible complications of adulthood mumps virus infection? Specify at
least 2 of them!
Orchitis, meningitis, pancreatitis
What is the route of infection of rabies virus? How does rabies virus spread in the
infected body?
By the bite of a rabid animal, (rarely by infectious aerosol)
spread of the virus in the host – along the axons
What medication does a person need after exposure to rabies virus?
Active immunization – human diploid cell vaccine (killed virus)
and passive immunization – rabies immune globulin
What is the portal of entry of polioviruses? Which areas of the central nervous system
are affected by poliovirus infection?
oropharynx and gastrointestinal tract
damage in motor neurons in the anterior horn of the spinal cord + brain stem
Which human viruses belong to the Enterovirus genus?
Polioviruses, coxsackie viruses, echoviruses, enteroviruses 68 - 71
Mention at least 4 diseases caused by Coxsackie viruses!
febrile rashes, herpangina, myocarditis, pericarditis, meningitis, pleurodynia,
hand-foot-and-mouth disease
What disease do rotaviruses cause? At which age?
gastroenteritis in young children
List the 3 antigens of hepatitis B virus against which antibodies may develop during or
after the acute phase of infection?
HBsAg, HBeAg, HBcAg
Which hepatitis B-specific antibody is almost never present in chronic hepatitis?
Anti-Hbs
What are the main modes of transmission of HBV (hepatitis B virus) infection?
Sexual contact; perinatally from mother to newborn; by blood or blood products
What are the 2 serological markers that are necessary and sufficient to prove acute
hepatitis B virus infection?
HBsAg, Anti-HBc IgM
Describe the active and passive prophylaxis against hepatitis B!
active immunization: recombinant HBsAg vaccine
passive immunization: HBIG (hepatitis B immune globulin)
Which hepatitis viruses are acquired orally?
HAV, HEV
Which hepatitis viruses are acquired via parenteral routes?
HBV, HCV, HDV, (HGV)
Mention 4 diseases that can be caused by adenoviruses!
pharyngitis, pharyngoconjunctival fever, acut respiratory disease, bronchitis,
atypical pneumonia, hemorrhagic cystitis, gastrointestinal infection
What is the portal of entry of mumps virus?
Upper respiratory tract
Mention at least two viruses frequently causing pneumonia!
RSV, influenza virus A and B, parainfluenza virus, adenoviruses,
coronavirus SARS-CoV2
What is the causative agent of subacute sclerosing panencephalitis (SSPE)?
Measles virus
What is(are) the nature(s) of antigen(s) in the combined vaccine against measles,
mumps and rubella?
live attenuated viruses
What is the nature of antigen in the rabies vaccine for human use?
killed virus
Which viral variants are included in the human influenza vaccine?
The vaccine contains 2 influenza A strains (H3N2, H1N1) and 1or 2 influenza B
strain(s).
What does the vaccine against hepatitis B contain?
Subunit vaccine, containing HBsAg
What is the nature of the antigens in the different types of poliovirus vaccine?
IPV (inactivated polio vaccine): killed viruses (types 1, 2, and 3)
OPV (oral polio vaccine): live attenuated viruses (types 1, 2, and 3)
What is the causative agent of PML (progressive multifocal leucoencephalopathy)?
JC virus (Polyomaviridae)
What are the possible manifestations of fetal infections caused by rubella virus?
Specify at least 3 of them!
Congenital malformations involving the heart (patent ductus arteriosus, septum
defects), the eyes (cataract, glaucoma) and the brain (deafness, mental
reardation).
Mention 3 human prion diseases!
Kuru, Creutzfeldt-Jacob disease, Gerstmann-Straussler-Scheinker syndrome,
fatal familial insomnia
What is the nature of the immune response in diseases caused by prions?
There is no immune response, as prions are self proteins.
Mention 3 main viral targets of antiretroviral chemotherapy! Mention one antiviral
drug for each target!
HIV reverse transcriptase (e.g., abacavir) , protease (e.g., ritonavir) and
integrase (e.g., raltegravir)
What is the principle of the „highly active antiretroviral therapy” (HAART) currently
used as the first-line treatment of AIDS!
Combination of two nucleoside/nucleotide reverse transcriptase inhibitors (2
NRTI) with either a nonnucleosid reverse transcriptase inhibitor (NNRTI) or a
protease inhibitor (PI) or an integrase inhibitor (II)
2 NRTI + NNRTI / PI / II
The up-to-date antiviral drugs against hepatitis C virus are classified into 3 groups
based on the molecular target. Specify each of the three groups together with one
example!
protease inhibitors example: grazoprevir
polymerase inhibitors example: sofosbuvir
replication complex inhibitors example: velpatasvir
Mention 2 antiviral drugs used therapeutically in chronic heaptitis B infections?
entecavir, tenofovir
Which component of the influenza virus is the target of oseltamivir (Tamiflu®)?
neuraminidase
What does the term robovirus mean? Write an example for a robovirus!
Robovirus: rodent reservoir (rodent-borne)
Arenaviridae – Lassa, Junin, Machupo, LCM virus; Hantaviridae – Hantaan virus,
Puumala virus, Sin Nombre virus
What does the term arbovirus mean? Write an example for an arbovirus!
Arbovirus: arthropode vector (arthropode-borne);
Flaviviridae – yellow fever virus, Dengue virus; Nairoviridae – Crimean-Congo
hemorrhagic fever virus, etc.
Mention three viruses causing haemorrhagic fever!
yellow fever virus, Dengue virus, Crimean Congo haemorrhagic fever virus,
Marburg virus, Ebola virus
Which virus can cause haemorrhagic fever with hepatitis and nephritis?
yellow fever virus
Describe the 2 different epidemiological cycles of yellow fever!
Jungle yellow fever: reservoir: monkeys; vector: mosquitos; humans: accidental
hosts
Urban yellow fever: reservoirs: humans; vectors : mosquitos
How can we prevent tick borne encephalitis?
Active immunization: killed virus vaccine, passive: specific immune globulin
Mention at least 4 opportunistic infections characteristic for AIDS!
Viruses: HSV-1, HSV-2, VZV, HCMV, EBV, HHV-8, HPV
Protozoa: Toxoplasma gondii
Bacteria: Mycobacterium tuberculosis, atypical Mycobacteria, Salmonella
septicaemia
Fungi: Pneumocystis jiroveci, Candida, Cryptococcus neoformans
Describe the principals of the laboratory diagnosis of HIV infection!
Screening: by ELISA (demonstration of viral antigen and antibodies)
Verification: Western-blot assay
Mention at least three sexually transmitted viral infections!
HPV, HSV-1, HSV-2, HIV, HBV, molluscum contagiosum virus
Mention two viruses that are capable of causing transplacental infections!
Rubella virus, HCMV, parvovirus B19, HIV, Zika virus
Mention 2 viral diseases whose preventive strategy involves passive immunization!
Rabies, tick-borne encephalitis, HBV, VZV, measles
List at least three viruses capable of causing (meningo)encephalitis!
Rabies, HSV, VZV, tick-borne encephalitis, Japanese B encephalitis, eastern and
western equine encepahalitis, mumps, poliovirus, coxsackie virus, echovirus
What is the nature(s) of antigen in the vaccine against yellow fever?
Live attenuated virus (17D strain)
Which viruses can cause human tumors? Mention at least 4!
HPV, EBV, HHV-8, HBV, HCV, HTLV
Which non-malignant disease is caused by Epstein-Barr virus?
Mononucleosis infectiosa (heterophil positive)
Mention 3 types of human malignancies caused by EBV!
Nasopharyngeal carcinoma, Burkitt’s lymphoma, other B-cell lymphomas
What type of human cancer is caused most frequently by HHV-8?
Kaposi’s sarcoma
What types of human cancers are caused by high-risk human papillomavirus (HPV)
types?
genital cancers, most importantly cervical cancer
Which malignant disease is caused by human T-lymphotropic virus 1 (HTLV-1)?
adult T-cell leukemia/lymphoma (ATL)
Which hepatitis virus infections increase the risk of hepatocellular carcinoma?
HBV, HCV, HDV
What does the nonavalent human papillomavirus (HPV) vaccine contain?
It contains VLPs (virus like particles) composed of L1 proteins of 2 low-risk HPV
types (6 and 11), and 7 high-risk HPV types (16, 18, 31, 33, 45, 52, and 58).
Mention 2 bacterial exotoxins that are neurotoxic!
tetanus toxin, botulinum toxin
