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Block 9 Week 3 > Kozel > 2nd Tier Pathogens > Flashcards

Kozel > 2nd Tier Pathogens Flashcards

1
Q

what shape is pneumococcus?

A

lancet/ovoid

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2
Q

is pneumococcus encapsulated?

A

YES

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3
Q

older cultures of pneumococcus undergo ________ because why?

A

autolysis

autolytic enzymes are activated by surfactants (bile, detergents)

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4
Q

what conversion happens in pneumococcus?

A

rough-to-smooth conversion by transformation

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5
Q

what do you grow pneumococcus on?

A

blood agar

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6
Q

what is the major antigen of pneumococcus?

A

capsular polysaccharide

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7
Q

how many serological types of capsular polysaccharide does pneumococcus have?

A

over 90

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8
Q

is the capsular polysaccharide of pneumococcus essential for virulence?

A

YES

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9
Q

what is the quellung reaction?

A

incubation of encapsulated bacteria w/ ab makes the capsule refractile

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10
Q

is pneumococcus quellung positive?

A

YES

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11
Q

what is C polysaccharide?

A

aka teichoic acid

cell wall carb that reacts w/ acute phase protein (CRP)

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12
Q

what are the 5 pneumococcal infections?

A 
pneumonia
sinusitis
otitis media
meningitis
OTHER > peritonitis, endocarditis, arthritis
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13
Q

pneumococcal pneumonia makes up what % of bacterial pneumonia?

A

80-90%

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14
Q

where is pneumococcal pneumonia in the lung?

A

usu lobar

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15
Q

what is the most common cause of otitis media in children >3 mo?

A

pneumococcus

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16
Q

pneumococcus causes meningitis in what age groups?

A

young & elderly

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17
Q

what 4 things characterize pneumococcal disease?

A
  1. abrupt onset
  2. toxicity
  3. fulminant course
  4. DIC
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18
Q

what causes disease in pneumococcal infections?

A

inflammatory response to bacterium & its pdts

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19
Q

what is the trick for pneumococcus to be infectious?

A

produce an inflammatory response but not be killed by it

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20
Q

what are the 3 virulence factors for strep pneumo?

A

polysaccharide capsule
pneumolysin
peptidoglycan & lipoteichoic acid

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21
Q

what virulence factor of strep pneumo is essential for virulence?

A

polysaccharide capsule

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22
Q

what fxn does the polysaccharide capsule serve?

A

prevents phagocytosis

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23
Q

what does anticapsular ab do?

A

protects by opsonization

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24
Q

what is pneumolysin?

A

a porin

similar to streptolysin O

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25
Q

what does pneumolysin do?

A

contributes to inflammation

multiple effects

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26
Q

where are peptidoglycan & lipoteichoic acid found?

A

cell wall

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27
Q

what do peptidoglycan & lipoteichoic acid do?

A

activate the alternative pathway
elicit production of IL-1 & TNF-alpha
inflammatory response

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28
Q

what virulence factor of strep pneumo is largely responsible for the inflammatory response?

A

peptidoglycan & lipoteichoic acid

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29
Q

is natural resistance to strep pneumo high or low?

A

VERY HIGH!

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30
Q

what % of people carry pneumococci around in their nasopharynx?

A

40-70%

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31
Q

what are the 4 natural defensive barriers that people have against pneumococcus?

A

cough & epiglottal reflex
mucus & cilia
phagocytosis by alveolar macrophages
splenic clearance from blood

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32
Q

what is the most important condition altering resistance to pneumococcus?

A

sickle cell disease

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33
Q

what are the things that can lead to a depressed epiglottal reflex?

A

alcohol
morphine
anesthesia

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34
Q

what can lead to depressed action of cilia?

A

viral infection like influenza

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35
Q

what can happen if a pt has hyposplenia or asplenia?

A

decreased clearance from blood

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36
Q

what 5 things can alter resistance to pneumococcus?

A 
depressed cilia action
depressed epiglottal reflex
hypo/asplenia
malnutrition
SICKLE CELL DISEASE
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37
Q

what are the sx of pneumococcal pneumonia?

A 
sudden onset
shaking chill
fever
sharp pleural pain
bloody rusty sputum
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38
Q

where does pneumococcal pneumonia localize?

A

lower lobes

lobar pneumonia

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39
Q

what is pneumonic crisis?

A

occurred in pre-abx era

dramatic recovery 5-10 days after initial chill

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40
Q

how do you isolate pneumococcus (like what do you grow it on)?

A

blood agar

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41
Q

how do you differentiate strep pneumo from strep viridans?

A

pneumo is…
alpha hemolytic
optochin sensitive
bile soluble

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42
Q

what does interpretation of pneumococcal lab diagnosis depend on?

A

clinical picture

source of specimen

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43
Q

what serological test can you do for pneumococcus?

A

test for FREE AG in bodily fluids > pneumococcal C polysaccharide

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44
Q

how does pneumococcus enter a person?

A

upper respiratory tract

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45
Q

T/F: most pneumococcal infections are endogenous

A

true

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46
Q

what is the incidence of pneumococcus assoc w/?

A

predisposing factors

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47
Q

do most adults have the capsular ab for pneumococcus?

A

NO

you have it for N meningitidis & Hib

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48
Q

what are the 3 things important for prevention & control of pneumococcus?

A

prevent primary damage
immunize
isolate to prevent transmission to at-risk pts

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49
Q

what is PPSV23?

A

pneumovax
pnu-imune
purified polysaccharide vaccine

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50
Q

how many serotypes does PPSV23 cover?

A

23

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51
Q

what % of bacteremic cases does PPSV23 cover?

A

94%

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52
Q

what is the composition of PPSV23?

A

purified capsular polysaccharide

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53
Q

what is the action of PPSV23?

A

induction of opsonic ab

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54
Q

what is the efficacy of PPSV23?

A

60-80%

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55
Q

how long do PPSV23 titers persist?

A

at least 5 years

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56
Q

is there a booster effect w/ PPSV23?

A

no

little to no booster effect

57
Q

for whom is the T-independent ag effective?

A

> 2yo pts

58
Q

who should get PPSV23?

A

all adults over 65 yo in series w/ PCV13

anyone 6-18yo w/ specific risk factors

59
Q

what is the composition of PCV13?

A

polysaccharide protein conjugate

60
Q

what is prevnar 13?

A

PCV13

polysaccharide protein conjucate vaccine

61
Q

how many serotypes does prevnar cover?

A

13

62
Q

how many serotypes does pneumovax cover?

A

23

63
Q

what % of bacteremic cases does PCV13 cover?

A

> 80%

64
Q

what % of acute otitis media among kids <6yo does PCV13 cover?

A

65%

65
Q

does PCV13 have T-dependent ag?

A

yes

66
Q

who should get PCV13?

A

all children 2-59mo
65yo+ in series w/ PPSV23
at risk kids 6-18yo

67
Q

what is the point of PCV13?

A

reduce carriage

produce herd immunity

68
Q

what are the 2 drugs of choice for pneumococcus IF SUSCEPTIBLE?

A

penicillin

ceftriaxone

69
Q

T/F: there are increasing reports of abx-resistant pneumococcus

A

TRUE

as high as 35% in some regions

70
Q

what is the resistance mechanism of pneumococcus?

A

acquisition of PBP w/ reduced affinity for abx

71
Q

what are alternative meds for pneumococcus?

A

vancomycin
macrolides
doxycycline
quinolone

72
Q

what shape is staph aureus?

A

cocci in clusters

73
Q

what is on the surface of staph aureus?

A

protein A

74
Q

what is the only catalase positive, coagulase positive bacterium?

A

staph aureus

75
Q

what are the virulence factors for staph aureus?

A

adhesive & antiphagocytic factors, toxins, & enzymes

76
Q

what is MRSA?

A

methicillin resistant staph aureus

77
Q

what is the mutation in MRSA?

A

altered PBP (PBP2’) encoded by mecA gene

78
Q

what are the toxin-mediated staph aureus diseases?

A

food poisoning
TSS
scalded skin syndrome

79
Q

what are the suppurative infections of staph aureus?

A 
impetigo
folliculitis
furuncles/boils
carbuncles
bacteremia
endocarditis
osteomyelitis
septic arthritis
pneumonia & empyema
brain abscess
80
Q

what shape is bacillus anthracis?

A

rod

81
Q

what does bacillus anthracis form?

A

spores

82
Q

what is the capsular polypeptide of bacillus anthracis?

A

poly-glutamic acid

83
Q

what is the fxn of poly-glutamic acid?

A

antiphagocytic

84
Q

what are the 3 exotoxins of bacillus anthracis?

A

PA > protective ag
EF > edema factor
LF > lethal factor

85
Q

what is the treatment for bacillus anthracis?

A

ciprofloxacin

86
Q

what does cutaneous anthrax look like?

A

black eschar formation

87
Q

what does GI anthrax look like?

A

ulcers at site of invasion

88
Q

what does the clinical course of inhalational anthrax look like?

A

non-specific signs then severe sepsis

89
Q

which form of anthrax is a biothreat?

A

inhalational

90
Q

what color is pseudomonas aeruginosa?

A

green!

aerugula

91
Q

what shape is pseudomonas aeruginosa?

A

rod

92
Q

T/F: pseudomonas aeruginosa is nosocomial

A

TRUE

93
Q

what bacterium is the mucoid polysaccharide capsule assoc w/?

A

pseudomonas aeruginosa

94
Q

T/F: pseudomonas aeruginosa is highly abx-resistant

A

TRUE

requires abx combos!

95
Q

what 5 diseases does pseudomonas aeruginosa cause?

A 
pulmonary infection
burn wound infection
UTI
otitis externa
bacteremia
96
Q

what does pseudomonas aeruginosa infect to cause UTI?

A

long-term indwelling catheters

97
Q

what are the strains of pulmonary infection caused by pseudomonas aeruginosa?

A

mucoid

98
Q

how does pseudomonas aeruginosa cause bacteremia?

A

opportunistic infection (e.g. neutropenia)

99
Q

what shape is burkholderia?

A

rod

100
Q

what 3 species of burkholderia do you need to know?

A

cepacia
pseudomallei
mallei

101
Q

what does B. cepacia cause?

A

pulmonary infection in pts w/ underlying lung disease (CF)

102
Q

what does B. pseudomallei cause?

A

melioidosis

103
Q

where does melioidosis occur?

A

environmental sites in Thailand & N. Australia

104
Q

what is melioidosis clinically?

A

pulmonary infection & sepsis

105
Q

T/F: melioidosis is a biothreat

A

true

106
Q

what does B. mallei cause?

A

glanders in horses

107
Q

T/F: B. mallei & B. pseudomallei are both biothreats

A

true

108
Q

what shape is acinetobacter baumanii?

A

coccobacillus

109
Q

acinetobacter baumanii is a ubiquitous ______ in many environments

A

saprophyte

110
Q

T/F: acinetobacter baumanii is nosocomial & abx- resistant

A

TRUE

111
Q

is acinetobacter baumanii opportunistic?

A

yes

112
Q

what disease does acinetobacter baumanii cause in ICUs?

A

ventilator-assoc pneumonia

113
Q

what does acinetobacter baumanii do w/ wounds?

A

infects them, esp on battlefield or w/ repeated exposure to diff medical environments

114
Q

what shape is H. influenzae?

A

coccobacilli

115
Q

what are the nutritional requirements for H. influenzae?

A 
factor X (hemin)
factor V (NAD)
116
Q

what type of H. influenzae is most important?

A

type b

117
Q

is Hib encapsulated?

A

yep

118
Q

what is the Hib vaccine?

A

protein conjugate of type b polysaccharide

119
Q

what 3 (kind of 4) diseases does Hib cause?

A

meningitis
epiglottitis
acute & chronic otitis media & sinusitis

120
Q

who gets Hib meningitis?

A

unimmunized kids

121
Q

is epiglottitis life-threatening?

A

yep

122
Q

T/F: the strains of h. influenzae that cause sinusitis & otitis media are nontypeable

A

true

e.g. they are acapsular

123
Q

what are the 2 most common causes of otitis media & sinusitis?

A

strep pneumo

h. flu

124
Q

what does franciscella tularensis require for growth?

A

cysteine! it’s special & dangerous!

125
Q

T/F: franciscella tularensis is facultatively intracellular

A

TRUE

126
Q

what animal primarily gets franciscella tularensis?

A

rabbits

127
Q

what are the insect vectors for franciscella tularensis?

A

hard ticks & biting flies

128
Q

what disease does franciscella tularensis cause?

A

tularemia

129
Q

what is the most common form of tularemia?

A

ulceroglandular

130
Q

what does ulceroglandular tularemia follow?

A

insect bite or direct inoculation

131
Q

what causes oculoglandular tularemia?

A

inoculation of eye (rubbing)

132
Q

what causes pneumonic tularemia?

A

inhalation

biothreat!

133
Q

what is psittacosis?

A

parrot fever

134
Q

what causes psittacosis?

A

chlamydophila psittaci

135
Q

what are the clinical manifestations of psittacosis?

A

respiratory infection

spread to reticuloendothelial (RES) cells of liver & spleen

136
Q

what is the natural reservoir for psittacosis?

A

birds

137
Q

what does chlamydophila pneumoniae cause?

A

respiratory infection > sinusitis, pharyngitis, pneumonia

possibly atherosclerosis

138
Q

what shape is chlamydophila?

A

rod or coccoid

Block 9 Week 3 (8 decks)

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