Pathologies of Bacterial Diseases Flashcards
1
Q
Rank the following causes of morbidity in the Philippines
A. Acute Respiratory Infection
B. Pneumonia
C. Bronchitis
A
ABC
2
Q
Give the ranking of the ff top ten leading causes of mortality in the Philippines
a. Diseases of the Heart and Vascular System
b. Pneumonia
c. Malignant Neoplasms
d. TB
A
a. 1 and 2
b. 4
c. 3
d. 6
3
Q
Three most common infectious causes of morbidity
A
Schistosoma
Malaria
TB
4
Q
Two related aspects in studying disease
A
Pathogenicity
host response
5
Q
4 aspects to be considered in Pathology
A
Etiologic agent
Pathogenesis
Morphology
Clinical significance
6
Q
When can you say that there is a disease based on the antibody titre?
A
when there’s a 4x rise
7
Q
Bacterial Virulence is characterized by ability to
A
ADHERE to host cells
INVADE cells and tissue
deliver TOXIC moieties
8
Q
[Virulence gene:induction]
Vibrio cholerae adherence toxin genes:________
Salmonella genes:_________
A
induced by iron deprivation
induced by acidic environment
9
Q
What is Cag?
A
Virulence gene converting H. pylori to gastritis producing pathogen
10
Q
[Bacterial adhesin: Gram stain]
Fibrillae:_______
Fimbriae or pili:______
A
Gram (+) Cocci
Gram (-) Cocci and rods
11
Q
The following infect macrophages EXCEPT
a. M. tuberculosis
b. E. coli
c. Shigella
d. S. typhi,
e. all except a
A
E
12
Q
What is responsible for most biologic activities of LPS? e.g. feer, macrophage activation, B cell mitogenicity, all cytokine mediated)
A
Lipid A (+ sugar)
13
Q
What is used to serotype bacteria?
A
O antigen
14
Q
Which definitely has endotoxin?
a. Gram -
b. Gram +
A
A
15
Q
The ff. are exotoxins EXCEPT
a. diphtheria txin
b. alpha toxin of C. pefringens
c. anthrax toxin
d. AOTA
e. NOTA
A
E
16
Q
[Identify Diagnostic Technique to be used]
Most bacteria (except M.
tuberculosis)
A
Gram stain
17
Q
[Identify Diagnostic Technique to be used]
Mycobacteria, nocardiae
A
Acid fast stain
18
Q
[Identify Diagnostic Technique to be used]
Fungi, legionellae,
pneumocystis
A
Silver stains
19
Q
[Identify Diagnostic Technique to be used]
Fungi, amebae
A
Periodic AcidSchiff
20
Q
[Identify Diagnostic Technique to be used]
Cryptococci
A
Mucicarmine
21
Q
[Identify Diagnostic Technique to be used]
Campylobacteria, leishmaniae,
malaria parasites, herpes
A
Giemsa
22
Q
[Identify Diagnostic Technique to be used]
Viruses, rickettsiae
(done using ELISA)
A
Antibody probes (most important)
23
Q
[Identify Diagnostic Technique to be used]
All classes (~90%)
*others more difficult to culture
(e.g. Salmonella typhi)
A
Culture (can be
used for anything
24
Q
[Identify Diagnostic Technique to be used]
Viruses, bacteria, protozoa
A
DNA probes
25
neutrophilic attraction to the site of infection in response to chemoattractants (In blood, neutrophilia is indicative of
bacteria even w/o Gram staining)
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation
A
26
cell-mediated response of the host -- lymphocytes and
macrophages; viruses, intracellular bacteria and arasites, spirochetes and helminths. → TB
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation
D
27
absent host inflammatory response, virus-mediated
damage to host cells
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation
E
28
Various classes of organisms with powerful toxins that cause extensive tissue damage(abcess). This also indicates destruction of the underlying tissues. → severe form of suppurative inflammation
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation
C
29
end stage of many infections
a. Suppurative inflammation
b. Chronic inflammation and scarring
c. Necrotizing inflammation
d. Mononuclear and Granulomatous inflammation
e. Cytopathic-Cytoproliferative Inflammation
B
30
characterized by antibody production and excretion of leptospires in the urine, intense jaundice; 2nd week of illness
a. Acute septicemic phase
b. Immune Phase
B
31
How long does leptospirosis acute septicemic phase last?
1 week
32
in leptospirosis, antibodies appear during
1st week - anicteric syndrome/acute septicemic phase
33
What is the coagulase reaction for?
To test for Staphylococcus
34
Which Staph virulence factor is responsible for degrading lipids on skin surface allowing quick abcess formation
lipase
35
Which Staph virulence factor binds with FC portion of immunoglobulins to escape antibody-mediated killing?
Protein A
36
```
Which Staph virulence factor attacks desmosomes, which cause keratinocytes to detach → barrier
function of skin lost?
```
Exfoliative toxin A and B
37
[Which Staph clinical feature?]
Focal suppurative inflammation of the skin and subcutaneous tissue; solitary or
multiple, or recurrent in successive crops; most frequent in moist hairy areas; from a single hair
follicle --> deepening abscess --> thinning and rupture of skin
Furuncle or boil
38
[Which Staph clinical feature?]
Deeper suppuration spread laterally beneath the deep subcutaneous fascia erupt
in multiple adjacent skin sinuses; found typically in fascial planes favoring their spread (skin of upper
back and posterior neck)
Carbuncle
39
[Which Staph clinical feature?]
| small red raised lesions, each associated with a hair follicle
Folliculitis
40
[Which Staph clinical feature?]
| persistent abscess formation of the apocrine glands, often in the axilla; furuncle
Hydradenitis suppurativa
41
[Which Staph clinical feature?]
lesions on finger and wrist usually found in children
o Impetigo- often characterized by yellow to brown crusts; restricted to the superficial epidermis
(fingers, wrist, face, scalp)
Bullous impetigo
42
[Which Staph clinical feature?]
| nail bed infection
Paronychia
43
[Which Staph clinical feature?]
| Infection on the palmar sides of the fingertips\
Felon
44
[Which Staph clinical feature?]
| often characterized by yellow to brown crusts; restricted to the superficial epidermis(fingers, wrist, face, scalp)
Impetigo
45
[Identify]
o caused by the exfoliative A and B toxins
o an exfoliative dermatitis that most frequently occur
in children with Staphylococcal infections of the
nasopharynx or skin
o rash, bullae, partial or total skin loss
o skin is split in the granulose laye
Staphylococcal Scalded Skin Syndrome a.k.a Ritter disease
46
[Identify]
Staphylococcal infection Secondary to drug hypersensitivity, characterized by Desquamation of the skin at the epidermal-dermal junction
Lyell's Disease a.k.a Toxic Epidermal Necrolysis
47
[Identify]
o mediated by one or more of the exotoxins produced by S. aureus
o occurs predominantly in menstruating females using tampons (the Staphylococcus colonizes the
vagina or cervix - the tampon probably promotes superficial ulceration and easy entry for the toxin)
o rash is a diffuse, blanching, macular erythema particularly affecting the hands and feet, which
desquamates 1-2 weeks after it appears.
TSS
48
What mediates methicillin resistance of MRSA? what genes carry it?
mecA carried by Staphylococcal cassete chromosome (SCCmec)
49
MRSA a.k.a "________ eating bacteria"
flesh eating bacteria
50
Gram positive, B-hemolytic, facultative anaerobic cocci
a. Streptococcus
b. Staphylococcus
c. Diplococcis
d. Gonococcus
A
51
T/F patients with S. aureus usually have brain abcesses
T
52
[Identify pathogen]
Symptoms: chills, headache, myalgia, abdominal pain, conjunctival suffusion, a transient skin rash (<24
hrs, if present)
Leptospira sp.
53
Gram positive non-motile cocci with a large number of plasmids
a. Streptococcus
b. Staphylococcus
c. Diplococcis
d. Gonococcus
B
54
What do Streptococci have that allows them to avoid phagocytosis?
M protein
55
C5a
a. degrades chemotactic peptide
b. allows adhesion
c. prevents bacteria from being recognized by the immune system
d. NOTA
e. AOTA
A
56
Which makes more damage to tissues and more pronounced abcesses?
a. Staph
b. Strep
A
57
[Identify]
Occurs when Group A streptococci infection spreads
through the epidermis to cause `punched out' ulcers
that extend into the dermis
Ecthyma
58
[Identify]
o Spreading superficial infection of the skin occuring at
any age
o often develops abrupt onset of malaise, fever, chills and headache and the involved skin becomes tender, red, warm and swollen
o occasionally bullous; inflammation spreads with poorly
defined margins (as compared to erysipelas)
o found in lower extremitie
Cellulitis
59
[Identify]
o a characteristic variant of cellulitis, almost
always caused exclusively by S. Pyogenes
o painful, bright red, shiny lesion with a raised,
sharply demarcated, advancing edge (“butterfly-wing
rash” with erythema and induration)
o common in the legs and face
Erysipelas
60
[Which Streptococcus strain?]
| Pharyngitis, scarlet fever, erysipelas, impetigo, rheumatic fever, TSS, and glomerulonephritis.
S. pyogenes (Group A)
61
[Which Streptococcus strain?]
o Colonizes the female genital tract
o Sepsis and meningitis in neonates, chorioamnionitis in pregnancy.
S. agalactiae (Group B)
62
[Which Streptococcus strain?]
o Community-acquired pneumonia and meningitis in adults
o Pneumolysin – inserts into host cell membranes and lyses them
S. pneumonia
63
[Which Streptococcus strain?]
o Dental caries
o Metabolizes sucrose to lactic acid → demineralization of tooth enamel
o Glucans – promote aggregation of bacteria and plaque
S. mutans
64
[Which Streptococcus strain?]
| Endocarditis
Viridans group streptococci
65
[Which Pathogen?]
Aerobic, non-spore forming, non-motile bacilli with a waxy coat that causes retention of the red dye in
acid treatment of acid-fast stains.
20-100x slower growth than most bacteria
M. tuberculosis
66
```
[Which Pathogen?]
Gram negative, pleiomorphic
Encapsulated and unencapsulated forms
Capsule prevents opsonization
Pili mediate adherence to respiratory epithelium, also a factor that disorganizes ciliary beating, protease
that degrades IgA, capsule
```
H. influenza
67
[Which Pathogen?]
Acid fast obligate intracellular organism that grows very poorly in culture but can be propagated in
armadillo
Slender, aerobic rods that grow in straight or branching chains
Affects skin and peripheral nerves and results in disabling deformities
M. leprae
68
What can H. influenza cause?
LRTI and meningitis in young children
69
What is the great triad symptoms of pneumonia?
fever, cough, dyspnea
70
In meningitis caused by H. influenza, what causes inflammation and what causes blood brain barrier disruption?
endotoxin causes inflammation, cell wall peptidoglycan damages endothelium
71
Which H. influenza serotype is the most usual cause of disease?
serotype B
72
Why is M. tuberculosis destructive?
Escapes killing by macrophage + induce type IV hypersensitivity
73
Unique waxy cell wall of M. tuberculosis is composed of mycolic acid and contains
Cord factor
Lipoarabinomannan
complement
HSPs
74
M. tuberculosis surface glycolipid causing it to grow in serpentine cords in vitro
Cord factor
75
M. tuberculosis lipopolysaccharide, inhibits macrophage activation by interferon gamma and induces macrophages to secrete IFN gamma and IL10
Lipoarabinomannan
76
component of M. tuberculosis that opsonizes the organism & facilitates its uptake by the macrophage complement
receptor
Complement
77
Component of M. tuberculosis that induce autoimmune reactions
HSPs
78
What forms caseation in TB?
lysed macrophages
79
What test shows resistance to M. tuberculosis?
Tuberculin test; Positive
80
What causes hemoptysis in lung TB?
caseous necrosis and cavities rupture into blood vessels
81
Miliary TB occurence favors the ff EXCEPT
a. bone marrow
b. liver
c. lung
d. spleen
e. retina
C
82
TB of the skin is called
lupus vulgaris
83
TB of the skin, characterized by an indolent, slowly spreading, reddish-brown plaque-like lesion
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy
A
84
regarded as allergic reactions to tuberculosis elsewhere in the body
tuberculids
85
involves the skin, peripheral nerves, anterior chamber of the eye, upper airways, testes, hands, & feet; contain large aggregates of lipid-laden macrophages often filled with masses of acid-fast bacilli
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy
C
86
begins with localized flat, red skin lesion that enlarge and develop irregular shapes with indurated, elevated, hyperpigmented margins, & depressed pale centers (central healing)
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy
B
87
anesthetic, dry, scaly skin lesions; asymptomatic involvement of large peripheral nerves, T-cell mediated immune response, with granuloma formation. Damage to
peripheral nerves is mediated by DTH reactions to mycobacterial antigens in the sheaths and fibers.
Nerves of predilection- ulnar, median, radial, lateral popliteal, great auricular
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy
B
88
diffuse lesions containing foamy macrophages teeming with mycobacteria, includes symmetric skin thickening & nodules; called anergic leprosy because of unresponsiveness of the host immune system. There could be numerous nodular skin lesions and
thickening of the pinna. Loss of eyebrows, atrophic rhinitis, testicular atrophy, & ocular damage are
common as well.
a. Lupus vulgaris
b. Tuberculoid leprosy
c. Lepromatous leprosy
C
89
More severe
a. Tuberculoid leprosy
b. lepromatous leprosy
B
90
What determines whether individual has tuberculoid or lepromatous leprosy?
T helper cell lymphocyte response to M. leprae
91
CD8+ suppressor T cells at the margins of lepromatous lesions secrete
IL-10,IL-4
92
inhibit helper T cells and mediate the anergy seen in lepromatous leprosy
IL-10
93
induces antibody production by B cells, these are not protective, but rather form antigen antibody complexes that lead to erythema nodosum leprosum, life-threatening vasculitis and glomerulonephritis
IL-4
94
How can you differentiate Borderline tuberculoid leprosy from fungal infection?
BT leprosy is anesthetic
95
T/F leprosy is highly communicable
F
96
Leonine facies is found in
a. lepromatous leprosy
b. tuberculoid leprosy
A
97
T/F M. leprae usually found in nasal passages because they prefer cool areas
T
98
Shigella is
a. Gram negative facultative anaerobe
b. Gram positive anaerobe
c. Gram negative anaerobe
d. Gram positive facultative anaerobe
A
99
Escapes from phagolysosome
a. M. tuberculosis
b. Shigella
c. both
d. neither
C
100
diarrhea with blood or mucoid stool with fresh blood
a. Reiter syndrome
b. Bacillary dysentery
B
101
chronic arthritis in HLA-B27 individuals due to S. flexneri, bacterial antigen reacts with the HLA-B27 protein
a. Reiter syndrome
b. Bacillary dysentery
A
102
How do you differentiate shigellosis from infection with Entamoeba histolytica?
The pseudomembrane and long segment are apparent in shigellosis while Entamoeba histolytica
infections have focal lesions.
103
```
[Which pathogen?]
Gram negative
Comma-shaped, flagellated
Flagella for penetrating mucus
covering of epithelial surfaces
From contaminated food especially
undercooked meat and
unpasteurized milk
Can be caused by contact with
infected dogs
```
Campylobacter jejuni
104
acute inflammatory demyelinating polyneuropathy that results as a post-infectious complication of Campylobacter jejuni
Guillain-Barre syndrome
105
[Which pathogen?]
Gram-negative, facultative
Intracellular
Affects distal ileum and colon, pharynx and tonsils
Intestinal ulcers, diffuse enteritis with villus shortening
crypt hyperplasia, microabscesses in mucosa and submucosa
Hyperplasia of lymphoid tissue in terminal ileum
Yersinia
106
[Which Pathogen?]
Gram-negative
Comma-shaped
cholera causing
Vibrio cholerae
107
```
[Which Pathogen?]
Gram-negative
Flagellated
Invasion of epithelial cells and macrophages by invasion genes induced by low oxygen tension in the
gut
Typhoid-causing
```
Salmonella (S. typhii)
108
S. typhi shed in the ff EXCEPT
a. urine
b. vomittus
c. oral secretions
d. NOTA
e. AOTA
D
109
T/F S. typhii infect chickens
F; they only infect humans. only non-typhi Salmonella infect chickens
