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D2 Summer > Microbio Week 2 (Exam 1) > Flashcards

Microbio Week 2 (Exam 1) Flashcards

1
Q

Ideal antibacterial agents are __________, which means it will _____ the bacteria

A

bacteriocidal; kill

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2
Q

The ideal antibacterial agent comes as _______ and _______ preparations

A

oral; injected

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3
Q

An ideal antibacterial agent has a ___ half-life in plasma and ___ binding to plasma proteins

A

long; low

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4
Q

T/F We want the ideal antibacterial agent to be wide spectrum

A

FALSE, we want it to be narrow spectrum

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5
Q

Which antibiotic is described as “narrow” spectrum?

A

Penicillin V

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6
Q

Isolation of clinical strains of bacteria resistant to specific antibiotics typically occurs within ________ _______ of introduction of specific antibiotic therapy

A

several years

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7
Q

Which beta-lactam antibiotic has broad spectrum activity against bacteria resistant to penicillins and cephalosporins?

A

Carbapenem

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8
Q

(MRSA) methicillin-resistant S. aureus describes…

A

a group of antibiotic resistant strains of S. aureus

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9
Q

What experiment proved that genes that code for antibiotic resistance were in the gene pool before humans began to produce antibiotics?

A

‘Replica Plate’ experiment

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10
Q

T/F: the number of companies in the US researching/developing antibiotics has steadily increased since 1990

A

FALSE, it has declined

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11
Q

Due to resistance, we now have ‘carbapenemase’ producing bacteria like _______ ________

A

Klebsiella pneumoniae (KPC)

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12
Q

ID of bacteria can combine ___________ sensitivity and _______________ reactions

A

antibiotic; biochemical

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13
Q

What is this describing?

Bacteria streaked on plate, then antibiotic-impregnated discs put on plate and incubated overnight to allow growth

A

Laboratory antibiotic sensitivity test

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14
Q

Lowest concentration of antibiotic needed to inhibit growth of bacteria

A

Minimum inhibitory concentration (MIC)

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15
Q

Lowest concentration of antibiotic needed to kill bacteria

A

Minimum Bactericidal Concentration

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16
Q

Bacteria in ________ may be up to 1000x less sensitive to antibiotics than bacteria in ________

A

biofilms; solution

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17
Q

What test is used to determine the MIC (inhibit growth) and MBC (bacteriocidal)?

A

Inoculum test of bacteria

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18
Q

What % of antibiotics are prescribed by dentists according to Dr Graham?

A

10%

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19
Q

Antibiotics should NOT be prescribed for upper respiratory tract infections EXCEPT when…

A

Lab confirmed strep throat
Cough lasting 10 days
Advanced sinusitis

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20
Q

Half of all upper respiratory tract infections are _______

A

viral

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21
Q

T/F: For the best practice and answers, bacteria should be isolated, identified, and tested for antibiotic susceptibility profiles

A

True (but this takes time)

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22
Q

If you do not have time to isolate, identify, and test the bacteria for antibiotic susceptibility, then antibiotics must be selected based on __________ bacterial species for common clinical syndrome and _________ knowledge about antibiotic susceptibility

A

presumed; current

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23
Q

What are common infections in dentistry that must be treated with antibiotics?

A
  1. Facial cellulitis
  2. Aggressive acute necrotizing ulcerative gingivitis
  3. Lateral perio abscess
  4. Acute periocoronitis w/ systemic signs
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24
Q

What are 2 other indications for antibiotics in dentistry?

A

Oral infection with increased body temp
Evidence of systemic spread (trismus, lymphadenopathy)

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25
Q

Most orofacial infections are ________ _________ of normal flora and (are/are not) resistant to beta lactams.

However, __________ of lesions will often be all that is needed (no antibiotic)

A

mixed anaerobes; are NOT

draining

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26
Q

Facial cellulitis (soft tissue infection) must be treated ASAP with antibiotics because of a potential to develop ______

A

septicemia

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27
Q

How does facial cellulitis spread to cause septicemia?

A

Through the blood and lymph

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28
Q

T/F: drainage of dental infections without medication may often be sufficient to solve the infection

A

True

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29
Q

Antimicrobials are used prior to surgery/procedures (prophylaxis) in dentistry only when…

A
  1. Risk of post-op infection is high
  2. Wounds are contaminated and there is risk of infection
  3. Consequences of infection are serious or life threatening
  4. The pt’s defenses against infection are compromised (elderly, fragile, etc)
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30
Q

What 4 conditions indicate routine antibiotic prophylaxis to prevent infective endocarditis from dental procedures?

A
  1. Artificial heart valves/parts
  2. History of infective endocarditis
  3. Some congenital heart conditions
  4. Heart transplant recipients with valve problem
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31
Q

T/F: all patients with a prosthetic joint should have antibiotic prophylaxis

A

false - this was changed in 2021 to only patients with a history of infection

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32
Q

Which antibiotic is no longer indicated for a patient with penicillin allergy?

A

Clindamycin

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33
Q

What antibiotics are most commonly used by dentists?

A

Beta-lactam

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34
Q

Beta-lactam antibiotics have activity against bacterial species often present in infections of the head and neck, especially ___________ bacteria

A

Gram +

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35
Q

T/F Many people are allergic to beta-lactams

A

FALSE, only about 3% of people are allergic

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36
Q

________ _________ is acid labile, so it is best administered parenterally (IM injection), and can be inactivated by gastric acid

A

Benzyl penicillin (penicillin G)

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37
Q

What forms of penicillin are relatively acid stable and therefore more appropriate for oral administration?

A

Penicillin V
Amoxicillin

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38
Q

Which antibiotic is an alternative to Beta-lactams?

A

Metronidazole

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39
Q

__________ is an antibiotic which targets anaerobic bacteria (obligate, not facultative) and can be used for periodontal disease and complications

A

Metronidazole

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40
Q

Metronidazole should be considered when there is no improvement with _________ or _________ for ___ hours

A

penicillin; amoxicillin; 48

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41
Q

T/F: Patients are allowed to drink alcohol when taking Metronidazole

A

FALSE!!!! It is known to have major reaction issues!!

He said this many times in lecture too

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42
Q

Which antibiotic is the treatment of choice for acute uclerative gingivitis, rapidly progressive perio disease, and patients with serious anaerobic infections?

A

Metronidazole

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43
Q

For juvenile periodontitis, which medication is preferred?

A

Doxycycline

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44
Q

Diarrhea is a common side-effect of oral __________ and can be a risk for ___________ _________

A

Clindamycin; Clostridium difficile (4x)

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45
Q

What are some other alternative antibiotics for beta-lactam allergies (penicllin)?

A

Macrolides: Erythromycin, Azithromycin, Clarithromycin

Lincosamides: Clindamycin (only in tx of high risk or bone involvement)

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46
Q

What do macrolides and lincosamides inhibit?

A

Protein synthesis at ribosome

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47
Q

____________ are an equally good 3rd option as alternative for beta-lactams, but only when Gram - resistance is known or suspected

A

Quinolones

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48
Q

Which antibiotic causes permanent discoloration of developing teeth?

A

Tetracycline

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49
Q

Chlorhexidine diacetate is a chemical _________ that has bacteriocidal activity against many ______ and ______ oral bacteria

A

antiseptic; Gram +; Gram -

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50
Q

Fluoride has an antimicrobial effect of inhibiting _________

A

enolases

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51
Q

What are bacterial glycolytic enzymes called?

A

Enolases

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52
Q

Fluoride reduces cavities by ____

A

20-60%

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53
Q

What are 3 conditions where antibiotics are no longer recommended because they may do more harm than good?

A
  1. Mitral valve prolapse (MVP)
  2. Rheumatic heart disease
  3. Bicuspid valve disease
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54
Q

Staph aureus usually has a _____________ pigmentation but clinical isolates have a ___________ pigmentation

A

golden; creamy

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55
Q

Is Staph aureus coagulase positive or negative?

A

Coagulase positive

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56
Q

What color are the colonies that Staph epidermis produces?

A

White

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57
Q

Is Staph epidermis coagulase positive or negative?

A

Coagulase negative

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58
Q

What unique characteristic does Staph aureus have on blood agar plates?

A

Beta hemolytic

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59
Q

How do Staph aureus and Staph epidermis inhabit humans?

A

Staph aureus = anterior nares
Staph epidermis = skin

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60
Q

Which bacteria are the largest cause of a variety of hospital acquired infections?

A

Staph aureus and Staph epidermis

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61
Q

Which bacteria is a major cause of food poisoning?

A

Staph aureus

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62
Q

_______ ___________ is more limited in causing foreign body colonization (shunts, catheters, joint prostheses), leading to local pathology - occasionally bacteremia and endocarditis

A

Staph epidermis

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63
Q

Staph aureus and Staph epidermis are increasingly _________ _________

A

antibiotic resistant

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64
Q

Both Staph aureus and Staph epidermis produce _________ and inhibit ________________, which allows __________

A

capsules; phagocytosis; bacteremia

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65
Q

What does Staph epidermis produce that helps it adhere to smooth surfaces such as catheters?

A

Slime

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66
Q

Common skin infections caused by Staph aureus

A

Boils
Pimples
Scalded skin syndrome (babies)
Sialidentitis aka parotitis (infection of salivary gland)
Sinusitis

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67
Q

More serious infections caused by Staph aureus

A

Endocarditis
Osteomyelitis
Pneumonia
Septicemia
Toxic shock

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68
Q

Infection or swelling of the salivary glands is called?

A

Sialidentitis (parotitis)

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69
Q

Lip irritation caused by infection, irritation, or allergies is called?

(can be infected by Candida albicans or Staph aureus)

A

Angular cheilitis

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70
Q

Dental infection w/ rapid onset where the floor of the mouth is raised and there is difficulty swallowing saliva

A

Ludwig’s angina (facial cellulitis)

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71
Q

What are 3 metastatic infections of Staph aureus (bloodstream invasion capable of spreading to any area of body)?

A

Osteomyelitis
Arthritis
Endocarditis

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72
Q

Most common bone infection caused by wound infection with trauma to the bones

A

Osteomyelitis

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73
Q

Dissemination from skin via blood to joint, destruction of cartilage and permanent joint deformity

A

Arthritis

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74
Q

Infection of innermost layers of the heart and can occur in pts w/ congenital valve disease

A

Endocarditis

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75
Q

What bacteria is most commonly associated with endocarditis?

A

Staph aureus

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76
Q

What are the most common valves affected in endocarditis?

A

Aortic and mitral valves

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77
Q

What are the 4 most widely known virulence factors for Staph aureus?

A

Adhesins
Exported toxins/enzymes
Coagulase
Catalse

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78
Q

What virulence factor of Staph aureus causes clotting and bacterial adherence?

A

Coagulase

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79
Q

What virulence factor of Staph aureus detoxifies neutrophil oxygen radical killing?

A

Catalase

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80
Q

What parts of Staph aureus act as virulence factors?

A

Peptidoglycan
Techoic acid

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81
Q

Like Gram negatives, Staph cell wall components are _________

A

inflammatory

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82
Q

Which Staph aureus cell wall virulence factor is antigenic, has endotoxin-like activity, and is inflammatory?

A

Peptidoglycan

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83
Q

Which Staph aureus cell wall virulence factor is a major surface antigen and inflammatory?

A

Teichoic acid

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84
Q

Major protein component of cell wall that is antigenic and has non-specific interaction with Fc of immunoglobulins, interfering with opsonization (ex: anti-phagocytic)

A

Protein A

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85
Q

What are the 5 exotoxins that are part of Staph aureus’s virulence?

A

Hemolysins
Leukocidans
Entertoxins
Exfoliative
TSST-1

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86
Q

Which pore-forming hemolysin of Staph aureus produces the most extensive tissue damage?

A

Alpha toxin

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87
Q

What do alpha toxins lyse?

A

WBCs, RBCs, other tissue cells

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88
Q

Important in immune evasion as they act exclusively on immune phagocytes

A

Leukocidans

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89
Q

Staph aureus _____________ are related to _________ poisioning

A

enterotoxins; food

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90
Q

Which Staph aureus secreted toxin cleaves the upper layer of the epidermis resulting in “scalded skin syndrome”?

A

Exfoliative

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91
Q

Which Staph aureus secreted toxin causes fever, erythroderma, and enhances susceptibility to endotoxin shock from Gram - LPS?

A

TSST-1

(toxic shock syndrome - 1)

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92
Q

What are adhesins?

A

Cell bound proteins

(virulence factor for Staph aureus)

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93
Q

How do you treat a Staph aureus infection?

A

Clean wounds, drain abscess, remove foreign bodies, topical antibiotics (ex: neosporin)

If it’s serious -> beta-lactams or vancomycin

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94
Q

What do Staph aureus and Strep pyogenes have in common?

A

Both Gram + cocci

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95
Q

Streptococcus is a Gram ____________ cocci that grows in pairs and chain using ____________

A

+ ; fermentation

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96
Q

The pathogenic species of strep have ___________ and __________ which are used to evade ___________

A

capsules; M protein; phagocytosis

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97
Q

Group A strep (Strep pyogenes) causes?

A

Strep throat
Scarlet fever
Necrotizing fascitis
Rheumatic heart disease

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98
Q

What bacteria is Group A strep?

A

Strep pyogenes

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99
Q

What bacteria is responsible for the most common visit to the doctor (upper respiratory) and most common for meningitis?

A

Strep pneumonia (‘mitis’)

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100
Q

What bacteria plays a role in dental caries and periodontal disease?

A

Strep mutans (‘mutans’)

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101
Q

Which Strep bacteria are in the ‘viridans’ group?

A

Strep pneumonia (‘mitis’)
Strep mutans (‘mutans’)

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102
Q

How do we differentiate different Streps?

A
  1. Hemolysis on blood agar plate
  2. rRNA
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103
Q

What type of hemolysis is Strep pyogenes?

A

Beta hemolytic

104
Q

What type of hemolysis is Strep pneumonia?

A

Alpha hemolytic (also called alpha green)

105
Q

What type of hemolysis is Strep mutans?

A

Alpha hemolytic (also called alpha green)

106
Q

These bacteria have the most identifiable gene coding capacity for virulence factors of known bacterial pathogens

A

Strep pyogenes (Group A strep)

107
Q

Strep are a clear example of __________ in bacterial disease in relatively recent lifetimes

A

evolution

108
Q

T/F: Strep evolve quickly and exchange DNA by transformation among many Strep ssp that live on and in the body

A

True

109
Q

_______ ________ causes even more diverse infectious diseases than Staph aureus

A

Strep pyogenes

110
Q

If a pt comes in with a rash and red tongue aka scarlet fever, which strep are they infected with?

A

Strep pyogenes

111
Q

Examples of skin and soft tissue infections caused by Step pyogenes

A

Impetigo/cellulitis
Erysipelas (similar to Staph aureus)
Necrotizing fasciitis
Streptococcal toxic shock syndrome (STSS)

112
Q

Examples of respiratory infections caused by Strep pyogenes

A

Strep throat
Scarlet fever
Pneumonia

113
Q

Pneumonia caused by Strep pyogenes is often preceded by what?

A

A viral infection

114
Q

What is Strep pyogenes TSS caused by?

A

Bacteria enter the bloodstream and secrete super antigen proteins

115
Q

What do the super antigen proteins do in Strep pyogenes TSS?

A

Lock T-cells onto antigen presenting cells

116
Q

Name some components of the cell wall that are virulence factors of Strep pyogenes

A

Since it’s gram + it will have:
Peptidoglycan
Teichoic acid

117
Q

What is the KEY virulence factor in Strep pyogenes that extends out from the surface of the cell?

A

M protein

118
Q

This protein belonging to Strep pyogenes inhibits complement fixation and opsonization, thereby inhibiting phagocytosis

A

M protein

119
Q

What does the M protein of Strep pyogenes bind to?

A

Host peptides with roles in immunity

120
Q

M proteins are long, ________ molecules

A

fibrillar

121
Q

T/F The M protein is variable, and is the basis for >200 serotypes

A

True

122
Q

Another Strep pyogenes virulence factor is the conventional capsule. What is it made of and what is its purpose?

A

Made of polysaccharides
Purpose = inhibits phagocytosis (but less important than M protein)

123
Q

Name 2 exotoxins that serve as Strep pyogenes virulence factors

A
  1. Cytolytic exotoxin = “streptolysin” O and S -> beta lysis on blood agar
  2. Pyrogenic exotoxin = superantigens that cause scarlet fever
124
Q

Name 2 superantigens of Strep pyogenes that are inflammatory. Where are they encoded?

A
  1. SpeA
  2. SpeC

Encoded on phages

125
Q

This protein of Strep pyogenes allows for non-specific binding to Fc of immunoglobulins, interfering w/ opsonization (inhibits phagocytosis)

A

Protein G

126
Q

What is Protein G of Strep pyogenes similar in function to?

A

Protein A of Staph aureus

127
Q

How is Strep pyogenes transmitted?

A

Direct skin contact
Respiratory droplets
Exchanging secretions via close physical contact

128
Q

How do we treat Strep pyogenes?

A

Topical antibiotics for skin (neosporin)
PENICILLIN!!

for invasive disease and STSS use injectable penicillin G, but you may have to add clindamycin

129
Q

T/F There is a vaccine for Strep pyogenes

A

FALSE!

130
Q

What did Griffith observe when he injected a mixture of heat-killed, disease-causing bacteria and live harmless bacteria into mice?

A

Nonvirulent bacteria turned into virulent and the mice died

131
Q

T/F: In Griffith’s experiment, the bacteria that had a capsule were responsible for killing the mice

A

True

132
Q

What do Staph aureus and Strep pyogenes have in common?

A

They both cause toxic shock syndrome (TSS)

133
Q

Strep pneumoniae is usually isolated from what area in healthy individuals?

A

upper respiratory tract

134
Q

Strep pneumoniae is the most frequent cause of what disease in infants and children?

A

Otitis media (ear infection)

135
Q

What is the major cause of community-acquired pneumonia with half a million cases per year in the US?

A

Strep pneumoniae

136
Q

What is the most common cause of bacteremia and meningitis in all ages, and the most common cause of meningitis in adults?

A

Strep pneumoniae

137
Q

Which bacteria might get released into the bloodstream during a cleaning and land on a heart valve?

A

Strep oralis

(‘mitis’/’oralis’ group)

138
Q

What group do Strep pneumoniae and Strep oralis fall under?

A

‘Mitis’

139
Q

Strep pneumoniae, Strep oralis, and Strep mutans undergo __________ hemolysis

A

alpha

140
Q

What does alpha hemolysis indicate?

A

Incomplete lysis of RBC’s (partial hemolysis)
Zone of “greening” under & around colonies
ONLY in streptococci

141
Q

Which bacteria are in the ‘Mitis’ (aka oralis) group?

A

Strep oralis
Strep (para) sanguis
Strep mitis
Strep gordonii
Strep pneumoniae

142
Q

Strep pneumoniae have a unique morphology when examined microscopically.

Describe their appearance

A

Gram + diplococci - they do NOT form chain

143
Q

T/F: Pneumonia is the #1 community acquired disease

A

True

144
Q

Strep pneumoniae are potentially invasive, although they can live without __________ in the upper respiratory tract

A

tissue

145
Q

Name the disease:

Rapid onset, shaking chills fever, cough with copious “rusty” sputum
X-ray shows heavy consolidation - lobar

A

Pneumococcal pneumonia

146
Q

T/F: There is only 5% fatality when treated for pneumonia

A

True

147
Q

There is a potential for pneumococcal pneumonia to lead to ?

A

Bacteremia, and then endocarditis, septic arthritis, and meningitis

148
Q

An adult w/ pneumonia has an additional risk of meningitis. How does the fluid travel to the meninges?

A

Spread from pleura via lymphatics to bloodstream to meninges

149
Q

How to diagnose strep pneumonia

A

Gram stain of normally sterile specimens such as:

Blood
CNS fluid
Sputum

150
Q

T/F: Strep pneumonia is very sensitive to penicillin

A

False! it used to be, but now there is increase in % of penicillin-resistant strains

151
Q

Major virulence factor of Strep pneumoniae

A

Polysaccharide capsule

152
Q

What are the 2 exotoxin virulence factors for Strep pneumoniae?

A
  1. Pneumolysin
  2. IgA1 protease
153
Q

This exotoxin for Strep pneumoniae is:

Oxygen labile (only observed anaerobically)
Cross-reacts with streptolysin O
Beta hemolytic (anaerobic only); kills phagocytes

A

Pneumolysin

154
Q

This exotoxin for Strep pneumoniae is:

Thought to aid in colonization of mucosal surfaces

A

IgA1 protease

(cleaves sIgA)

155
Q

Is there a vaccine for Strep pyogenes?

A

NO

156
Q

What is unique about the new heptavalent vaccine for preventing bacteremia, meningitis, and pneumonia?

A

It’s conjugated to a diptheria toxin mutant protein (safe for infants)!

157
Q

What is the pneumococcal conjugate vaccine called?

A

PCV7

158
Q

As of 2010, which vaccine is preferred from PCV7?

A

PCV13

(has 6 added purified capsules to cover more serotypes)

159
Q

Name 3 Gram - respiratory pathogens that all have vaccines

A

Neisseria meningitidis
Haemophilus influenzae
Bordetella pertussis

160
Q

These bacteria are very distinctive for their Gram - diplococci in classic kidney bean shape

A

Neisseria

161
Q

Only reservoir for Neisseria

A

Humans

162
Q

What do Neisseria live on in the human body?

A

Mucosal surfaces

163
Q

Are Neisseria catalase positive or catalase negative?

A

Catalase +

164
Q

Two main Neisseria groups

A

1) N. meningitidis
2) N. gonorrhea

165
Q

This bacteria is closely related to Neisseria and is now a common cause of otitis media in children

A

Moraxella catarrhalis

166
Q

For Neisseria, the _________ _________ is important in transmission (asymptomatic)

A

carrier state

167
Q

What is the susceptible age group for N. meningitidis?

A

College students

(and anyone else living in close quarters - military recruits, boarding schools, etc)

168
Q

How is N. meningitidis spread?

A

Large respiratory droplets

(you have to be pretty close to a person to get it)

169
Q

Where is a N. meningitidis infection located in the body? What are 2 routes it can take?

A

Upper respiratory tract

Person can become a carrier or have severe disease (systemic inflammation and/or meningitis)

170
Q

T/F: N. meningitidis is intracellular

A

False! It’s extracellular

171
Q

How is gonorrhea transmitted? is it intracellular or extracellular?

A

Direct genital contact

Always extracellular! It attaches to epithelial cells on surface

172
Q

T/F: Gonorrhea rarely spreads to the bloodstream

A

True, it typically remains localized in one part of the body

173
Q

What can N. gonorrhea lead to in women?

A

Pelvic inflammatory disease

174
Q

Why is it difficult to treat gonorrhea with antibiotics?

A

It is drug resistant to beta-lactams and tetracyclines

175
Q

Why is it difficult to make a vaccine for N. gonorrhea?

A

It has variable LPS/LOS

176
Q

What is the septicemia stage of N. meningitidis called?

A

Meningococcemia

177
Q

How is Meningococcemia spread to the bloodstream?

A

Via lymph

178
Q

What is LPS/LOS endotoxin shock, as seen in Meningococcemia?

A

When there are large numbers of N. meningitidis (Gram -) bacteria in the bloodstream, and it is exposed to LPS/LOS

(this causes a big inflammatory rxn that is multi-organ systemic shock)

179
Q

How does someone get meningitis?

A

N. meningitidis spreads to the meninges and causes inflammation

180
Q

What could happen if a young child develops meningitis?

A

Neuromotor disabilities
Seizure disorders
Learning difficulties

181
Q

Virulence factors of N. meningitidis include something called LOS. What is different about LOS compared to LPS? (on exam)

A

LOS has no O-antigen!!!

182
Q

Name the N. meningitidis virulence factors

A

Capsule
LOS
Pili (fimbriae)
Exo-enzymes (IgA1 protease)

183
Q

What exo-enzyme does N. meningitidis make? What does it aid in?

A

IgA1 protease; aids in colonization

184
Q

What does LOS mimic?

A

Human carbohydrate patterns

185
Q

LOS is considered an __________

A

endotoxin

186
Q

Which virulence factor is used in the vaccine against N. meningitidis?

A

Capsule

187
Q

How do you treat N. meningitidis infections?

A

Penicillin G

Supportive care for septic shock, DIC, meningitis (antibiotics alone not sufficient bc it doesn’t get rid of the endotoxin)

188
Q

2 vaccines that help prevent N. meningitidis

A

1) Menomune ACY/W - purified capsule polysaccharide (works on adults only)

2) New ACY/W Conjugate vaccine - purified capsule polysaccharide conjugated to protein (works on children + adults)

189
Q

The US now sees mostly _____ capsule strains for N. meningitidis, where there is now a recently available vaccine

A

B

190
Q

What are the 4 components of the 4CMenB vaccine?

A

2 outer membrane proteins
1) Neisseria adhesin (NadA)
2) Heparin binding antigen (NHBA)
3) Factor H binding protein (fHbp)
4) Outer membrane vesicles (OMV)

191
Q

All Gram - bacteria release ______ or ________ _________ _________

A

blebs; outer membrane vesicles

192
Q

What do bacteria of the Haemophilus genus and Bordetella genus look like?

A

Small Gram -
Coccobacilli

193
Q

Major Haemophilus pathogen

A

H. influenza

194
Q

H. influenza is most similar to

A

Strep pneumoniae

195
Q

Non-invasive infections of H. influenzae usually originate from __________ ________ ______ strains (no capsule)

A

existing normal flora

196
Q

What does H. influenzae cause?

A

Ear infection
Sinusitis
Pink eye
Pneumonia

197
Q

Invasive infections of H. influenzae spread _________ by type _____ capsule strains (this is uncommon because of vaccine)

A

systemically; B

198
Q

What can invasive infections of H. influenzae cause?

A

Septicemia
Meningitis

199
Q

Who is most at risk for developing Septicemia and Meningitis from an invasive H. influenzae infection?

A

6 month - 2 yr olds

200
Q

Name the virulence factors of H. influenzae. Which one is the major virulence factor?

A

Capsule (major virulence factor)
LOS
Exo-enzymes (IgA1 protease)

201
Q

Which bacteria all share the exo-enzyme, IgA1 protease?

A

H. influenzae
N. meningitidis
Strep pneumoniae

202
Q

Which bacteria share the virulence factor LOS?

A

H. influenzae
N. meningitidis

203
Q

Describe the first conjugate vaccine for H. influenzae

A

Type B capsule covalently linked to a protein

204
Q

What 2 other pathogens is N. meningitidis (Gram -) often compared to because they cause blood infection, then meningitis?

A

H. influenzae (Gram -)
Strep pneumonia (Gram +)

205
Q

Which bacteria are the termed “the triplets”? What do they all do?

A

The triplets = N. meningitidis + H. influenzae + Strep pneumoniae

Respiratory, encapsulated -> bloodstream -> meningitis

206
Q

T/F: H. influenzae, N. meningitidis, and Strep pneumoniae all cause meningitis

A

True

207
Q

What bacteria is Bordetella similar to?

A

Haemophilus

(Recall they are both small Gram - coccobacilli)

208
Q

T/F: B. pertussis is in the normal flora

A

FALSE

209
Q

T/F: People can be carriers of B. pertussis

A

FALSE, you can only get infection, not be a carrier

210
Q

Where is B. pertussis found in humans?

A

Nasopharynx (only when the disease is present)

211
Q

Newborns are very susceptible to B. pertussis because due to lack of __________ __________

A

maternal antibodies

212
Q

B. pertussis attaches to _______ and secrete exotoxins that kill epithelial cells

A

cilia

213
Q

The toxins produced by B. pertussis inhibit _________

A

phagocytosis

214
Q

Describe the paroxysmal stage of B. pertussis

A

Repeated coughing w/o breathing with an inspirational “whooping” sound when a breath is taken

215
Q

What are the virulence factors of B. pertussis?

A

LPS
Outermembrane proteins
3 secreted extracellular toxins

216
Q

What are the 3 extracellular toxins secreted by B. pertussis?

A
  1. Pertussis toxin
  2. Adenylate cyclase toxin
  3. Tracheal cytotoxin
217
Q

The pertussis toxin (virulence factor of B. pertussis) inhibits phagocytosis by inhibiting which specific cells?

A

Monocytes and neutrophils

218
Q

What is the major component of the acellular B. pertussis vaccine?

A

Pertussis toxin

219
Q

What does the tracheal toxin (virulence factor of B. pertussis) inhibit and trigger?

A

Inhibits ciliated epithelial cells
Triggers inflammation

220
Q

What is the tracheal toxin (virulence factor of B. pertussis)?

A

A peptidoglycan monomer

221
Q

What are the components of B. pertussis vaccine? What pathogens are covered?

A

FHA + pertussis toxoid + minor components

(DTaP = Diptheria, Tetanus, acellular Pertussis)

222
Q

T/F: We have a fairly stable (60-70%) microbiota over time (usually 5 years)

A

True

223
Q

What is the stability of our microbiota largely due to?

A

Bacteriodetes firmicutes
Actinobacteria

(proteobacteria come and go)

224
Q

4 major sites of colonization

A

GI tract
Mouth/upper respiratory
Skin
Urogenital tract

225
Q

This bacteria is acquired in the birth canal by the fetus

A

Bifidobacterium

(Gram +, anaerobic rods)

226
Q

How do fetuses obtain microbiota?

A

Through maternal milk

227
Q

Disruption of early microbiota predisposes to what 3 things?

A

Allergy
Asthma
Obesity

228
Q

In the GI tract, the epithelial surfaces of the small and large intestines are colonized. Describe the amount in each

A

Small intestine: low numbers
Large intestine: high numbers

229
Q

Most abundant bacteria found in the intestine

A

Bacteroides (Gram - rods)
Clostridium

230
Q

T/F: Bacteroides are strict aerobes.

A

False! They’re strict ANAEROBES

231
Q

Bacteroides make up ____% of gut bacteria

A

30%

232
Q

What is the major role of bacteroides in the gut?

A

Process complex molecules
Break down plant glycans/carbohydrates!!

233
Q

Most abundant species of bacteria in the human gut is Bacteroides ____________

A

thetaiotamicron

234
Q

Where do oral bacteria colonize?

A

Lip
Cheek
Palate
Tongue
Teeth
Gingiva
Saliva

235
Q

T/F: The areas of colonization in the oral cavity all have their own flora.

A

True

236
Q

Abundant types of bacteria in the mouth

A

Streptococcus
Many obligate anaerobes
Diptheroids
Lactobacillus
Neisseria

237
Q

What are the important obligate anaerobes that are found in tooth plaque and gingiva?

A

Porphyromonas gingivalis
Tannerella forsythia
Treponema denticola
Fusobacterium
Prevotella
Peptostreptococcus
Actinomyces

238
Q

Predominant obligate anaerobes in periodontal disease

A

Porphyromonas gingivalis
Tannerella forsythia
Treponema denticola

239
Q

Predominant obligate anaerobes in ulcerative gingivitis

A

Treponema denticola
Fusobacterium
Prevotella

240
Q

What is the flora in the respiratory tract very similar to?

A

Mouth

241
Q

Sites of colonization in upper respiratory tract

A

Epithelial surface of nasal cavity, nasopharynx, and oropharynx

242
Q

Sites of colonization in lower respiratory tract

A

Trachea, bronchi, lungs (kinda controversial due to transient inhaled bacteria)

243
Q

Abundant types of bacteria in the upper respiratory tract (7)

A

Streptococcus
Haemophilus
Neisseria
Moraxella
Staphylococcus
Diptheroids
Mycoplasma

244
Q

Name 3 aerobic Gram + cocci found on the skin

A

Staph epidermis
Staph aureus
Micrococcus

245
Q

Name 2 diptheroids found on the skin

A

Cornyebacterium
Propionibacterium

246
Q

Which diptheroid is found in hair follicles?

A

Propionibacterium

247
Q

Propionibacterium feed on oil in hair follicles and cause what?

A

Acne

248
Q

T/F: The flora on your left hand can be different from your right hand

A

True

249
Q

Sites of colonization in the genitourinary tract

A

Epithelial surface of anterior urethra, vagina, cervix

250
Q

Where can intestinal microbiota spread to?

A

Adjacent areas such as vagina and urinary tract

251
Q

Normal, healthy bacteria found in the vagina/cervix

A

Lactobacillus

252
Q

Name the predominant bacteria found in the vagina/cervix

A

Lactobacillus
Intestinal bacteria: streptococci, E. coli, intestinal anaerobes
Skin bacteria: staph, diphtheroids

253
Q

Clinical dentistry indicates the use of antibiotics in all of these situations. Choose the one where antibiotics are not routine:

A. anaerobic soft tissue abscess in a healthy patient
B. oral infection with elevated temperature or swollen lymph node
C. recognized named clinical infection syndrome or lesion type
D. otherwise fragile or patient with multiple co-morbidities
E. soil in a oral wound

A

A. anaerobic soft tissue abscess in a healthy patient

254
Q

Guidelines on the prophylatic use of antibiotics in routine dental procedures have changed through the years, resulting in confusion about this. Indicate which of these REMAINS on of the instances where antibiotics are used prior to invasive dental procedures:

A. history of infective endocarditis
B. heart murmur
C. mitral valve prolapse
D. bicuspid valve disease
E. prosthetic joint replacement

A

A. history of infective endocarditis

255
Q

T/F B-lactams are simply never an option when it comes to someone indicating they may have had an allergy to penicillin as a child

A

False

D2 Summer (37 decks)

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