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Principles of Disease > Infection > Flashcards

Infection Flashcards

1
Q

What are the main agents of infection?

A 
Bacteria
Viruses
Parasites
Fungi
Prions
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2
Q

What are common tests used for viral detection?

A

PCR (ie molecular methods)
serology
antigen detection

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3
Q

What are common tests for bacterial detection?

A

Microscopy (+ or - staining)

Culture (selective or non-selective)

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4
Q

What are common bacterial features used for identification?

A

Morphological
Physiological
Biochemical

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5
Q

What common tests used for parasitic detection?

A

Microscopy of parasitic life stages

Serology

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6
Q

What are some of the basic infection control measures?

A

Handwashing
Decontamination (eg stethoscope, surfaces)
PPE
Isolation

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7
Q

List some of the common samples collected for culture

A 
Faecal specimen 
Throat swab
Wound swab
Urine sample
Sputum sample
Blood sample
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8
Q

What are the main mechanisms of action of antibacterial drugs?

A

Inhibit cell wall synthesis
Affect protein synthesis
Affect nucleic acid synthesis

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9
Q

What are the main classes of drugs to affect cell wall synthesis in bacteria?

A
  • beta lactams

- glycopeptides

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10
Q

What are the main types of beta lactams?

A

penicillins and cepharlosporins

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11
Q

What are the main classes of drugs that affect protein synthesis in bacteria?

A
  • aminoglycosides
  • macrolides
  • tetracyclines
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12
Q

What are the properties and risks associated with cephalosporins?

A

broad spectrum antibiotics

can cause C. Difficile infections

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13
Q

What are some of the macrolide drugs used in bacterial infections and when are they often used?

A

clarythromycin, erythromycin

alternative for penicillin if allergic

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14
Q

What are the main classes of antibacterials which affect nuclear acid synthesis?

A
  • trimethoprim and sulphamethoxazole (co-trimoxazole combined)
  • fluoroquinolones
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15
Q

What are examples of fluoroquinolones and their limitations?

A

Ciprofloxacin, levofloxacin

Ciprofloxacin affects cartilage growth, can’t be used in children

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16
Q

What drug group is vancomycin part of, and what class of bacteria does it act on?

A

glycopeptide

Gram +ve bacteria

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17
Q

What drug group is gentamycin part of, and what class of bacteria does it act on?

A

aminoglycoside

Gram -ve bacteria

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18
Q

What are nitrofurantoin and nalidixic acid used for?

A

UTIs

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19
Q

What is the main advantage of nitrofurantoin over nalidixic acid?

A

It is effective on some gram +ve and -ve organisms

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20
Q

What class of bacteria does nalidixic acid act on?

A

gram -ve

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21
Q

What drugs are known to cause liver and renal toxicity?

A

Aminoglycosides (gentamycin) and glycopeptides (vancomycin)

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22
Q

What drugs are reserved for MRSA infections?

A

Linezolid and daptomycin

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23
Q

What antibacterials are safe to give to pregnant women?

A

penicillins, cephalosporins, nitrofurantoin

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24
Q

What are the main mechanisms of bacterial resistance?

A
  • beta lactamase production
  • PBP alteration
  • vancomycin resistance (protein alteration)
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25
Q

What classes of drugs produce extended spectrum beta lactamases?

A

Gram -ve bacteria

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26
Q

What is the concern with carbapenemase producing bacteriaceae (CPE)

A

carbapenem is a broad spectrum antibiotic used for multi-drug resistant bacteria
if bacteria resistant to carbapenem, potentially no other drugs available to treat

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27
Q

What is the mechanism of action of penicillins?

A

they affect the synthesis of the peptidoglycan cell wall

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28
Q

What is the mechanism of action of glycopeptides?

A

they affect the synthesis at a stage prior to penicillins

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29
Q

What is the mechanism of action of nucleic acid inhibiting antibacterials, and give examples of drugs for each

A
  • purine synthesis (trimethopriim, sulphamethoxaxole)

- DNA affected directly (fluoroquinolones eg ciprofloxacin))

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30
Q

What is a commonly used drug for anaerobic bacterial infections?

A

Metronidazole

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31
Q

What are the properties of piperacillin?

A

It is a broader spectrum version of penicillin which is also active against pseudomonas

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32
Q

What are the main types of antifungal drugs?

A

Polyenes
Azoles
Echinocandins
Allylamines

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33
Q

What are the main types of polyene drugs and their properties? (administration, when it’s used)

A
  • Amphotericin B (toxic, IV for serious infections)

- Nystatin (topical, non-serious infections)

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34
Q

What are the main actions of antifungal drugs and what are examples of drug classes for them?

A
  • target ergosterol (polyenes, allylamines, azoles)

- target glucan polysaccharide (echinocandins)

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35
Q

What is the mechanism of action of polyenes?

A

Target ergosterol on cell wall and make it permeable

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36
Q

What is the mechanism of action of allylamines and azoles?

A

Inhibit ergosterol synthesis

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37
Q

What is the effect of antiviral drugs on viruses?

A

Always virustatic, there are no virocidal drugs

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38
Q

What is the main drug for Herpes Simplex Virus?

A

Aciclovir

Famciclovir

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39
Q

What is aciclovir used for?

A

Herpes simplex virus

varicella zoster virus

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40
Q

What are the aciclovir analogues used to treat?

A

Ganciclovir - CMV

Famciclovir - HSV and shingles

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41
Q

How is aciclovir activated, and what type of molecule is it?

A

Nucleoside analogue

Prodrug - activated by thymidine kinase

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42
Q

What is the mechanism of action of Zidovudine?

A

Nucleoside analogue - acts on reverse transcriptase

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43
Q

What is Zidovudine used to treat?

A

HIV

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44
Q

What is commonly used to treat HIV?

A

A combination of different reverse transcriptase inhibitors
nucleoside reverse transcriptase inhibitors
non-nucleoside reverse transcriptase inhibitors
protease inhibitors

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45
Q

When is Foscarnet used?

A

Treating CMV, HSV, VZV infections resistant to aciclovir/ganciclovir/famciclovir
Foscarnet toxic for kidneys, only IV

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46
Q

What are examples of drugs used to treat Hepatitis B and C?

A

Interferon alpha

Lamivudine

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47
Q

What are examples of Herpes viruses?

A

Cytomegalovirus
Herpes Zoster virus
Varicella Zoster virus
Epstein-Barr virus

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48
Q

What are the main classes of viruses treated with drugs?

A

Severe/life threatening viral infections

  • HIV
  • chronic hepatitis B/C
  • Herpes viruses
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49
Q

What is lamivudine used for?

A

chronic hepatitis B

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50
Q

What is interferon alpha used for?

A

Hepatitis B and C

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51
Q

What is the combination of drugs often used for treating chronic hepatitis infections?

A

Interferon alpha + ribavarin

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52
Q

What is ribavarin used for?

A

combination with interferon alpha for chronic hep C

may be used for respiratory RSV infection

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53
Q

What can be used to treat Influenza A or B in early stages?

A

Zanamavir

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54
Q

What is Zanamavir used for?

A

Treating Influenza A or B in early stages

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55
Q

What are the most common methods used to analyse the sensitivity of an organism to an antibiotic?

A
  • automated methods

- E test

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56
Q

How do trimethoprim, suxamethoxazole and co-trimoxazole act?

A

Affect purine synthesis

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57
Q

How do fluoroquinolones act and when are they used?

A

Directly affect nucleic acid synehtsis

Pseudomonas infection, strep pneumoniae LRTI

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58
Q

What class of bacteria are always resistant to which type of drug?

A

Gram +ve streptotoccus - always resistant to gentamycin (aminoglycoside)
Gram -ve bacteria - always resistant to vancomycin (glycopeptide)

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59
Q

What are the main genetic mechanisms which allow bacteria to become resistant?

A
  • spontaneous mutation of genetic code

- spread of resistance (through transposons or plasmids)

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60
Q

How do cephalosporins change in properties with generations?

A

Newer generations have

  • better gram -ve action
  • worse gram +ve action
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61
Q

Can someone with a penicillin allergy also be allergic to cephalosporins?

A

Yes, about 10% of those allergic to penicillin

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62
Q

What antibiotic is associated with pseudomembranous colitis?

A

Clindamycin
Cephalosporins
Fluoroquinolones

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63
Q

What can pseudomembranous colitis be caused by?

A

A drug induced increase of C Difficile in the colon

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64
Q

What can be used to treat early stages of Influenza A and B

A

Zanamavir

Oseltamivir

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65
Q

What are azoles often used for?

A

Yeast infections and some filamentous infections

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66
Q

What are allylamines often used for?

A

Dermatophytic infections

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67
Q

What are polyenes used for?

A

Amphoterycin B - serious infections (IV)

Nystatin - yeast

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68
Q

What are echinocandins used for?

A

Serious fungal infections - expert advice only

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69
Q

What is flucloxacillin mostly used for?

A

Staphylococcal infections

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70
Q

What class of bacteria is amoxycillin most effective for?

A

Gram -ve

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71
Q

What is the main difference between Gram +ve and Gram -ve bacteria?

A

Gram +ve: thick peptidoglycan layer + inner membrane (2 layers)
Gram -ve: lipopolysaccharide layer + thin peptidoglycan layer + inner membrane (3 layers)

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72
Q

What is the main function of the bacterial capsule, what is its structure and what is it made of?

A

Stops the bacterium from being phagocytosed and digested.
slimy, forms biofilm
made of glycosaminoglycans (GAG)

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73
Q

What are the different terms for flagella and what ist their function?

A

Monotrichous
Amphitrichous
Lothotrichous
Peritrichous

used for motility

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74
Q

What is the purpose of fimbriae on a bacterium?

A

Stickiness - helps to adhere to surfaces

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75
Q

What is a plasmid?

A

A piece of bacterial DNA which can be injected into other bacteria

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76
Q

What is normal genetic division in bacteria called, and what does it result in?

A

Binary fission - two identical copies

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77
Q

What is a bacteriophage?

A

It’s a virus that kills bacteria by injecting its DNA into them

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78
Q

What are the methods of DNA transfer among bacteria?

A
  • Conjugation
  • Transformation
  • Transduction
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79
Q

What is the function of spores in bacteria?

A

they are produced by bacteria to survive in difficult environments

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80
Q

How are bacteria classified?

A

Genus - staphylococcus, streptococcus etc

Species - aureus, epidirmidis, pneumoniae etc

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81
Q

What are the possible structures of a virus?

A

helical
icosahedral (20 sides)
complex

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82
Q

What are the ideal factors for eradication of a virus?

A 
easy method for virus detection
effective treatment
effective prophylaxis (vaccines)
remove possible hosts
economical/political support
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83
Q

What are the aspects of a virus used to identify it?

A

mode of replication
shape/size
genome structure
envelope

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84
Q

What are the outcomes of a viral infection?

A

Resolution (plus or minus immunity)
latency
chronic infection
genetic changes (eg cancer)

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85
Q

What is the mode of replication of viruses?

A

Infect host cell
inject own DNA in host cell nucleus to make viral proteins and new viral nucleic acid strands
new viral nucleic acid/proteins assembled and leave the cell

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86
Q

Do all viruses have a lipid envelope?

A

No

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87
Q

What is a viral capsid?

A

a membrane that contains the viral genome

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88
Q

What are spike projections on viral lipid envelopes used for?

A

target for treatment

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89
Q

What is viral latency?

A

it’s a stage after the initial infection during which the virus is dormant but can reactivate to cause disease

90
Q

Does viral infection resolution always result in immunity?

A

no

91
Q

what can be the result of genetic changes from a viral infection?

A

cancer (eg cervical from HPV)

92
Q

How can a virus induce cancer in cells?

A
  • induced cell proliferation
  • reduced apoptotic measures
  • damage from reactive oxygen species
93
Q

How are viral infections prevented?

A 
vaccination
prophylactic and post-exposure treatment
infection control
antenatal screening
blood/tissue/organ screening
94
Q

What are the main three classes of fungi?

A

mushrooms
yeasts
moulds

95
Q

What is the main difference between yeasts and moulds?

A

Yeasts grow as uni-cellular organisms

Moulds have hyphae and are filamentous

96
Q

What is dermatophytosis and what can it also be called?

A

ringworm infection

tenia

97
Q

what are examples of opportunistic fungal pathogens?

A

candida spp
aspergillus spp
dermatophytes
cryptococcus neoformans

98
Q

which fungal infections are normally more serious?

A

candida infections

aspergillus infections

99
Q

what host factors contribute to fungal growth?

A

moist/warm environment
low immune system
broad spectrum antibiotic use

100
Q

Are candida spp moulds or yeasts?

A

Yeasts

101
Q

What is a unique feature of candida albicans?

A

it can grow hyphae in some environments

102
Q

are aspergillus spp moulds or yeasts?

A

Moulds

103
Q

Are cryptococci yeasts or moulds?

A

Yeasts

104
Q

What are the main types of cryptococcus?

A

cryptococcus neoformans

cryptococcus gattii

105
Q

which main types of fungi are moulds?

A

aspergillus spp

dermatophytes

106
Q

Which main types of fungi are yeasts?

A

candida spp

cryptococcus spp

107
Q

Are dermatophytes moulds or yeasts?

A

moulds

108
Q

What is a unique feature of aspergillus spp?

A

can invade blood vessels

109
Q

What is a unique feature of cryptococcus?

A

it has a capsule

110
Q

What is a unique feature of dermatophytes?

A

use skin keratin for nutrition

111
Q

What is pityriasis versicolor caused by and what kind of fungus is it?

A

Malassezia spp - yeast

112
Q

What are the main classes of parasites?

A

Protozoa
Helminths
Arthropods

113
Q

What are the types of protozoa?

A

malaria
amebae
flagellates

114
Q

What are the types of helminths?

A

Flatworm
roundworm
tapeworm

115
Q

What are the types of arthropods?

A

mites
ticks
lice

116
Q

What causes malaria?

A

Plasmodium spp

117
Q

Which type of plasmodium is most fatal?

A

plasmodium falciparum

118
Q

What is the lifecycle of the plasmodium spp?

A

sexual reproduction in mosquito gut

injected in human blood, mature in liver, multiply in RBC

119
Q

What are the most common protozoal infections?

A

malaria
amoebic dysentery
leishmaniasis

120
Q

What is schistosomiasis caused by?

A

schistosomes that penetrate through skin

121
Q

Where is schistosomiasis contracted?

A

swimming in fresh water

122
Q

What immune reaction can helminth infections cause?

A

Eosinophilia

elevated IgE

123
Q

What is microscopy used for in diagnosing helminth infections?

A

identifying PCO (parasites, cysts, ova) in faeces

124
Q

What causes an infection of leishmaniasis?

A

Sandfly bite

125
Q

What does schistosomiasis affect?

A

Skin, urinary tract and intestine

126
Q

What can leishmaniasis affect in terms of where in the body it can cause damage?

A

skin

internal organs

127
Q

Which type of bacteria are haemolytic?

A

Streptococci

128
Q

What are the differences in haemolytic bacteria?

A

Alpha haemolytics - partially lyse blood

beta haemolytics - fully lyse blood

129
Q

What is the main feature to distinguish between staphylococci?

A

Coagulase test

130
Q

Are coagulase negative bacteria harmful, are there exceptions?

A

No, but staph ludgunensis can cause infections if it gets into cannulas

131
Q

What is the difference between staphylococcus and streptococcus?

A

Staphylo - clusters

strepto - chains

132
Q

What are the main shapes of gram positive bacteria?

A

Cocci

Bacilli

133
Q

What differentiates clostridium difficile from streptococci and staphylococci?

A

bacillus

anaerobic

134
Q

Which bacillus has a drumstick appearance?

A

clostridium tetanii

135
Q

What are examples of bacteria which can’t be identified from Gram stains?

A

AAFB

spirochaetes

136
Q

What is the only anaerobic Gram +ve bacterium?

A

Clostridium spp

137
Q

Where can Staph aureus be found as a commensal?

A

Nose
Axilla
Genitaln/anal area

138
Q

How can Staph aureus be identified?

A

Gram staining

Coagulase test

139
Q

What bacterium forms blue chains and creates a green hue in culture?

A

Strep pneumoniae

partial (alpha) haemolytic

140
Q

What bacterium forms blue chains and creates a seethrough area in culture?

A

Strep pyogenes

total (beta) haemolytic

141
Q

Which bacteria Gram -ve and also coagulase -ve?

A

Staph epidirmidis, staph lugdunensis

142
Q

Where is staph lugdunensis normally found?

A

skin

143
Q

What beta hemolytic group of bacteria does strep pyogenes class under?

A

Group A

144
Q

What beta hemolytic group of bacteria does strep agalactiae class under?

A

Group B

145
Q

What classes as Group D streptococci, but have now been renamed?

A

Enterococci

146
Q

What is strep pneumoniae also known as?

A

Pneumococcus

147
Q

What is strep viridans and what does it cause?

A

alpha hemolitic Gram +ve

infective endocarditis

148
Q

What is strep agalactiae known for?

A

serious neonatal infections

149
Q

Where is clostridium difficile normally found?

A

In gut

150
Q

Why is it called that, and why is that?

A

Difficile - difficult to culture

because it’s anaerobic

151
Q

How do clostridium difficile and clostridium tetani cause damage?

A

Through toxin release

152
Q

Where can clostridium perfringens be found normally and where can it be pathogenic?

A

Normally in gut

can cause wound infections and gastroenteritis

153
Q

Is clostridium spore forming?

A

Yes

154
Q

What do neisseria spp, campylobacter, salmonella and pseudomonas aeruginosa have in common?

A

All gram -ve

155
Q

What does neisseria meningitidis cause?

A

Meningitis

156
Q

What does moraxella catarrhalis cause?

A

RTI

157
Q

What do neisseria and moraxella have in common?

A

Gram -ve cocci

158
Q

What are examples of gram negative bacilli?

A 
Salmonella
E Coli
Shigella
Krebsiella
Pseudomonas
159
Q

What are examples of curved bacilli?

A

Campylobacter

Helicobacter

160
Q

What does campylobacter cause and why?

A

Main cause of diarrhoea

Found in chickens

161
Q

What is the appearance of haemophylus influenzae?

A

mixed appearance (cocco-bacilli)

162
Q

What can be used as a preliminary test for gram negative bacilli?

A

Lactose fermentation

163
Q

Is E Coli a lactose fermenter?

A

Yes

164
Q

Is Salmonella a lactose fermenter?

A

No

165
Q

What is another name for gram negative bacilli?

A

Coliforms

166
Q

What diseases can spirochaetes cause?

A

Leptospirosis
Lyme disease
Syphilis

167
Q

can chlamydia spp be cultured?

A

no

168
Q

what is the method used to identify chlamydia?

A

serology

169
Q

where is porphorymonas found and what are its properties?

A

dental/periodontal abscess

anaerobic gram -ve bacillus

170
Q

How are mycobacteria identified?

A

ZN/auramine stain

culture

171
Q

How are spirochaetes identified?

A

serology

nucleic acid amplification

172
Q

What are some of the symptoms of malaria?

A

Flu-like
fever
rigors

173
Q

What can be a symptom of entamoeba histolytica?

A

GI infections

Liver abscess

174
Q

What are some symptoms of leishmaniasis?

A

Skin/mucocutaneous lesions

Visceral: fever, malaise, weight loss, enlarged spleen and liver

175
Q

What can schistosomiasis cause?

A 
itching 
urinary and gastrointestinal infections
bladder cancer
haematuria
delayed fever
176
Q

where in the body are nematodes found?

A

intestine and lungs

177
Q

What are potential symptoms of nematode infection?

A

asymtomatic

some respiratory symptoms

178
Q

What type of worms are ascaris lumbricoides?

A

Nematodes

179
Q

What is an exotoxin?

A

A toxin produced and released outside of the bacterium

180
Q

What is an enterotoxin?

A

A toxin which is produced by a bacterium and is released into the GI tract

181
Q

What is an endotoxin and where can it be found?

A

A toxin which makes up part of the bacterial structure (eg LPS complex in Gram -ve bacteria)

182
Q

What are the two properties a pathogen needs to cause disease?

A

Infectivity

Virulence

183
Q

What is meant by bacterial infectivity and how is it achieved?

A

The ability to settle in an organism
“stickiness”
resistance to acid (capsule)

184
Q

What is meant by bacterial virulence, and what are some factors which contribute to it?

A

the ability to cause disease once settled into a host
invasiveness
toxin production
ability to evade immune system

185
Q

Which class of bacteria contains endotoxins?

A

Gram -ve bacteria

186
Q

What are the main ways viruses cause disease?

A
  • killing the cells they infect
  • changing the cells they infect (eg tumour inducing)
  • causing an immune reaction
187
Q

Why is Staph aureus a likely secondary bacterial RTI after a viral infection?

A

Because it’s a nose commensal, and viral infections can destroy respiratory epithelium allowing S aureus to get into the airways

188
Q

What is an enterovirus and what can it cause?

A

A virus that only gets in through GI tract but can spread to any organ, causing infections in other parts of the body

189
Q

Where does Herpes virus stay during its latency period?

A

Ganglia

190
Q

How can viruses get into the body?

A 
skin
respiratory
arthropod
GI
genital
urinary
191
Q

What are the roles of complement and when is it activated?

A

activated by combination of IgM with IgG

  • opsonization
  • kill gram -ve bacteria
  • chemotaxis
192
Q

What is the role of antibodies?

A

destroy bacteria/viruses
opsonization
stops organisms from attaching

193
Q

Where does humoral immunity occur?

A

extracellularly

194
Q

Where does cell mediated immunity occur?

A

intracellularly

195
Q

What is the difference between T4 and T8 cells?

A
  • T4 are helper cells

- T8 are cytotoxic cells

196
Q

What are the subtypes of adaptive immunity and what lymphocytes do they involve?

A 
Humoral immunity (B cells)
cell-mediated immunity (T cells)
197
Q

What types of infections is the humoral immune system good for?

A

Bacterial infections

extra-cellular infections

198
Q

What types of infections is the cell-mediated immune system good for?

A

viral/fungal infections

intra-cellular infections

199
Q

What is antigenic drift and shift?

A

Drift - slow changes to virus strain

Shift - sudden change in virus strain

200
Q

What is the principle of giving passive immunity?

A

Giving someone premade antibodies/immunoglobulins to fight infection

201
Q

What is the principle of giving active immunity?

A

Giving someone mild version of antigen, so the body will produce their own antibodies/immunoglobulins against it

202
Q

What is an advantage of giving passive immunity?

A

Immediate effect

203
Q

What is a disadvantage of giving passive immunity?

A

body may cause immune reaction to the injected foreign antibodies (serum sickness or arthus reaction)

204
Q

What are the types of vaccine available?

A

live attenuated
killed
toxoid
subunit

205
Q

What is a subunit vaccine and what are available examples?

A

particles from virus or resembling virus

  • HPV vaccine
  • Hep B surface antigen vaccine
206
Q

How is an attenuated vaccine made?

A

Grown in animals so that when it’s injected back into humans it doesn’t thrive as well

207
Q

What is a toxoid vaccine?

A

It’s a toxin that has been treated with formalin so it’s not toxic anymore

208
Q

What are some contraindications to vaccines?

A

immunocompromised
fever
pregnancy (no live vaccine)
allergy

209
Q

What is the concept of herd immunity?

A

individuals who cannot be vaccinated will benefit from the immunity of others around them

210
Q

In which vaccine are T cells essential?

A

BCG (anti TB)

211
Q

What are checkpoint inhibitors and why could they be targeted in cancer?

A

proteins that stop T cells from attacking other cells

they could be used for the body to elicit an immune response against cancer cells

212
Q

What is POCT and what is it useful for? What are examples of POCT?

A

Point of care Testing

Useful for immediate test results (eg glucose, blood gas, urine tests)

213
Q

What is the disadvantage of POCT?

A

Not always accurate

214
Q

What are some of the common methods of identification which can help to determine the identity of a body?

A 
Sex
Age
Height
Medical/dental records
Tattoos/scars
Finger prints
DNA
Hair/eye colour, facial hair
215
Q

What is rigor mortis and when does it occur?

A

Stiffening of muscles after death 5-12 hours after death

216
Q

What is hypostasis and what causes it?

A

Areas of pallor with bruising around them

Caused after death by blood pooling with gravity

217
Q

What is saponification and what is it caused by?

A

Adipoceres formation by fat cells invading tissue after death

218
Q

What are the different types of decomposition?

A 
Putrefaction
Saponification
Mummification 
Maceration
Skeletonisation
219
Q

What can putrefaction be caused by?

A

Bacterial infestation

Autolysis

220
Q

What is a general rule of thumb which can be used to estimate time of death?

A

Temperature drop - 1C per hour

Principles of Disease (3 decks)

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