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Host and Defense > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What makes up the triad of infectious disease?

A

Host
Environment
Pathogen

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2
Q

True or false, you need a chest radiograph in order to diagnose pneumonia

A

True

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3
Q

What is pneumonia?

A

Inflammation of one or both of the lungs. Usually due to infection

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4
Q

What are the four different types of pneumonia?

A

Typical
Atypical
Viral
Aspirational

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5
Q

Typical acute pneumonia is usually CAP. What does this mean?

A

Typical acute pneumonia is usually community acquired pneumonia

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6
Q

How long do symptoms of typical acute pneumonia usually last?

A

Hours to days

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7
Q

Describe the signs and symptoms of pneumonia

A

Onset with chills, fever, and wet cough

Lobar consolidation or segmental or sub-segmental bronchopneumonia

Pleura often involved giving chest pain with inspiration

Micro-aspiration of upper respiratory tract colonizing bacteria (can be as far up as the oral cavity!)

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8
Q

What bacterial species is the most common cause of typical acute pneumonia?

A

Streptococcus pneumoniae

Pneumococcus

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9
Q

What is the second most common bacteria to cause pneumonia? (Yet this species has largely disappeared)

A

Haemophilus influenzae

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10
Q

True or false.. gram negative species are the most common types of bacteria to cause pneumonia

A

False. Gram positive are the most common

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11
Q

Viral pneumonia is most often seen in ____ and during ____ epidemics

A

Children

Influenza

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12
Q

What is the most common bacterial species to cause atypical (walking) pneumonia?

A

Legionella species

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13
Q

What is lung hepatization?

A

When the the lobes of the lung get so condensed with neutrophils due to inflammation that it is solid-like. Like the liver

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14
Q

Bacterial infection in the pleural space is called ____

A

Empyema

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15
Q

Acute, atypical pneumonia that is environmentally acquired is likely to be caused by what three species?

A

Legionella pneumophilia
Coxiella burnetii
Chlamydophila psittaci

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16
Q

What two bacterial species are the most likely causes for acute atypical pneumonia (walking pneumonia)?

A

Mycoplasma pneumoniae

Chlamydophila pneumoniae

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17
Q

Treatment for atypical acute pneumonia requires ____ antibiotics such as ____, ____, and _____.

A

Non-beta-lactam

Macrolides

Fluroquinolones

Tetracyclines

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18
Q

Describe aspiration pneumonia

What kind of bacteria cause this?

A

This is when you inhale bacteria due to stupor, coma, or seizures. Focal infiltrates.

Oropharyngeal bacteria aspired into lung. Coughing prevents this.

Due to gram + cocci (CAP)

Due to gram negatives (S. Aureus) (micro of hospital-acquired)

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19
Q

What does asthenic mean?

A

Skinny, chronically ill-appearing

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20
Q

What are sulfur granules?

A

Bacterial colonies in vivo

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21
Q

True or false.. the immune system keeps everything sterile below the vocal cords

A

True

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22
Q

Name some viruses responsible for viral pneumonia

A

Human respiratory viruses (influenza, parainfluenza, RSV, adenovirus..(common in children, rare in adults)
Hantavirus
Coronavirus
Bacterial pneumonia with or in the wake of influenza

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23
Q

True or false… lung tissue affected by necrotizing pneumonitis can be revived

A

False

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24
Q

How long does chronic pneumonia usually last?

A

Weeks to months. Not days like acute

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25
Q

True or false… chronic pneumonia is always caused by an infection of some sort

A

False. There are many non-infectious diseases such as neoplasia, chemical/drug exposure, radiation, etc.

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26
Q

What is the empiric treatment for chronic pneumonia?

A

There is none

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27
Q

True or false.. TB replicates relentlessly and spreads to lymph nodes and then systemic circulation

A

True

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28
Q

What is the difference between an antibiotic and an antimicrobial?

A

An antimicrobial is the umbrella term. It is any substance of natural, semisynthetic, or synthetic organ that kills or inhibits the growth of microorganisms. Antibiotics, on the other hand, are more specific in that they are antimicrobial products actually produced by a microorganism.

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29
Q

What is the difference between bacterostatic and bacterocidal?

A

Bacterostatic - slow or stop growth

Bacterocidal - actually kill microorganisms

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30
Q

What is the difference between 1, 2, and 3 patterns of activity for antimicrobials?

A

Type 1 - deals with concentration

Type 2 - deals with duration of exposure

Type 3 - deals with long term affects after drug has been removed

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31
Q

What is the difference between a drug’s spectrum of action and the therapeutic range?

A

Spectrum of action - how many different types of bacteria does it affect?

Therapeutic range - how big is the difference between the minimum therapeutic dose and toxic dose?

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32
Q

Are tetracyclines broad spectrum or narrow spectrum? What about isoniazid?

A

Tetracycline - broad spectrum

Isoniazid - narrow spectrum (only one against one genus)

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33
Q

True or false… some antimicrobials are effective against all microbes

A

False

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34
Q

What should you do before giving a patient antimicrobials?

A

Culture and test the infection to see what is the best antimicrobial to give the patient

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35
Q

With an AIDS patient, should you give them bactericidals or bacterostatics?

A

Bactericidals

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36
Q

If the infection is very serious, what should you do?

A

Always take specimens and culture. But since this takes a while to get the results, make an educated guess and give the patients antimicrobials. Or do a shotgun approach and give them a ton of antimicrobials at once

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37
Q

What is MIC?

A

The minimum concentration of antimicrobial that will inhibit the growth of a bacterial strain

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38
Q

Name in order or smallest to largest, which will have the largest halos in a disc diffusion test. Intermediately susceptible, moderately susceptible, susceptible, and resistant

A

Resistant
Intermediate
Moderate
Susceptible

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39
Q

In a disc diffusion test, is the plate covered in bacteria first, or are the discs placed first?

A

The bacteria is covered first

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40
Q

The broth dilution test determines both the ___ and the ____

A

MIC
MBC

(Minimum bactericidal concentration)

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41
Q

Describe the relationship of MIC and MBC with bactericidals vs bacteristatics

A

Bactericidal - antibiotics usually have very similar MIC and MBC

Bacteristatic - antibiotics have much higher MBC than MIC

42
Q

What is the difference between prophylactic and definitive antimicrobial treatment?

A

In definitive, you have successful identification of the infectious agent. In prophylactic, you do not.

43
Q

In pharmacokinetics, it involves the relationship of the ___ on the ____

A

Body on the drug

44
Q

Although MIC is compared to ____ concentrations, these concentrations may or may not reflect drug concentration at the _____

A

Plasma

Site of infection

45
Q

True or false….antimicrobial doses should provide “overkill” without causing toxicity to the host

A

True

46
Q

What are the two goals of antimicrobial dosing?

A

Goal one: achieve a bacterocidal concentration at the site

Goal 2: discourage resistance of bacteria

47
Q

Which phase of growth is most sensitive to antimicrobial intervention?

A

The log phase

48
Q

Describe the persistent post antibiotic affect

A

These drugs providesuppression of bacterial growth following antibiotic exposure

49
Q

Name 5 key rules for treating serious infections

A

Begin treatment asap

Use the safest effective drug

Use the largest reasonable dose

Monitor the plasma concentration of antibiotic if it is needed to guide the dose

Must continue treatment at least two days after apparent cure, but some infections take much longer

50
Q

When drug selectivity is ____, the risk of adverse effects are reduced

A

High

51
Q

The ideal

AMT is defined by….

A

Itspecificity of action in host vs pathogen

52
Q

Many, but not all,adverse effects are ___ - dependent

A

Dose

53
Q

The _____ the therapeutic range the safer the antibiotic

A

Wider/higher

54
Q

True or false…. the adverse effects of the AMT is analogous to the antimicrobial action

A

False. Some are analogous, some are independent (such as allergies)

55
Q

Name four mechanisms of actions of antimicrobial drugs

A

Inhibition of….

Cell wall synthesis/permeability

Protein synthesis by inhibiton the 50s or 30s ribosome subunits

Nucleic acid synthesis (DNA or RNA)

56
Q

Why use combination therapy?

A

Treatment of mixed infections

Improve efficacy (synergism)

For initial empiric therapy of uncharacterized serious infection

To lower drug concentration

To delay emergence of resistance

57
Q

What is a super infection and what causes them?

A

The over growth of pathogen due to the use of antimicrobials. This can be caused by…

Use of broad spectrum antimicrobial agent (destroying normal flora)

Use of a higher than normal concentration of even a narrow spectrum antimicrobial drug

58
Q

Upper Respiratory infections are also known as ____

A

Colds

59
Q

Name 5 upper respiratory infection syndromes. Out of these 5, which one is different from the others? Why?

A 
Bronchitis 
Otitis
Sinusitis
Pharyngitis 
Epiglottitis

Epiglottitis is different than the others because it is due to a bacterial infection and is a medical emergency

60
Q

The three most important etiologies of URI are what? Name some other etiologies.

A

Rhinoviruses
Coxsackie virus A (enteroviruses)
Coronavirus

Influenza and RSV (most severe in children)

Adenovirus 
Echovirus
EBV
Parainfluenza
HSV
61
Q

Nearly all upper respiratory infections are ____ infections. True or false, these are spread mostly by direct contact by our hands.

A

Viral

True

62
Q

How long do most colds (URI) last? When do most people go to the doctor?

A

7-10 days (although coughs with colds can take a month or longer to recover)

Since colds are 3 days in, 3 days of, and 3 days out, many people will go to the doctor on the 4th or 5th day of the sickness

63
Q

What is pharyngitis? What causes it most of the time?

A

Sore throat

Most of the time is due to virus

64
Q

What is group A strep? What causes it?

A

Strep throat caused by bacteria. (Note that it occurs in kids more than adults)

Streptococcus pyogenes, diphtheria, pertussis, gonococcus, archanobacteria, tularemia, chlamydia, anaerobic bacteria (anaerobic cause tonsillitis)

65
Q

What is the main chracteristic of group A pharyngitis that sets it apart from viral pharyngitis? What are some other features of group A?

A

Sudden onset

Fever, headache, pharyngeal inflammation, discrete exudate
Tender cervical nodes
Most likely in winter-spring
Most likely ages 5-15
NOT cough, congestion, conjunctivitis
66
Q

True or false… nearly all cases of otitis (ear infections) are viral infections

A

False. Half are viral half are bacterial

67
Q

What are some bacterial species that can cause otitis?

A

Pneumo, H. Flu, moraxella

68
Q

Name some features of otitis

A 
Follows URIs
Ear pain/pulling
60% no fever 
Antibiotics little value
(Virus closes the eustacian tube, trapping the bacteria.  The bacteria then can replicate more than they're supposed to)
69
Q

Name some features of sinusitis

A

More common in adults
Follows URIs
Most viral, but same bacteria as otitis

Symptoms include facial pain, head ache, upper teeth pain, opacity by transillumination

X-rays not specific

Antibiotics little value

70
Q

Epiglottitis is a bacterial infection most likely due to _____. Its symptoms are….

A

Haemophilis influenzae

Dysphagia, drooling, stridor (difficulty breathing)

You can diagnosis this by a lateral neck X-ray

71
Q

It is best to not treat all of the URIs besides two. You can treat with antibiotics for these two. What are these two?

A

Group A strep

Epiglottitis

72
Q

What is the difference between live attenuated vaccines and inactivated vaccines?

A

Live attenuated vaccines - made from weakened viruses or bacteria. Must replicate to work. Replication mimics natural infection, stimulates immune response. (You should not give these to pregnant women or immunocompromised pts)

Inactivated vaccines - made from various fractions of viruses or bacteria (subversions, subunits, polysaccharides, toxoids). These do not replicate because they are killed

73
Q

How are live attenuated or inactivated vaccines administered?

A

Live attenuated vaccines - subcutaneously

Inactivated vaccines - intramuscularly

Note that inactivated vaccines result in less side effects

74
Q

Name four other ways in which live attenuated vaccines and inactivated vaccines differ

A

Storage requirements (live is more difficult to store)

Duration of protection (live last much longer)

Adverse effects (live might have more adverse effects)

Contraindications/precautions

75
Q

True or false… you should ALWAYS follow ACIP recommendations

A

True

76
Q

True or false… if you go too long between the vaccine doses, you do not need to restart the series

A

True

77
Q

True or false.. if live vaccines are not administered simultaneously, you must wait four weeks for the next immunization

A

True

78
Q

Patients must be offered a ____ with every immunization

A

Vaccine information statement

79
Q

You should report adverse reactions to vaccines to ____

A

Vaccine adverse event reporting system (VAERS)

80
Q

Technique is critical to vaccine administration. Name four techniques to keep in mind when administering the vaccine

A

IM vs SC
Diluents
Shaking vaccines
Storage

81
Q

How long is the incubation time for influenza. (During this time the patient remains asymptomatic). Then, the virus continues to shed ___ days after symptoms begin

A

1-2 days

5-10 days

82
Q

True or false.. about 20% of influenza cases are asymptomatic

A

True

83
Q 
Match each of the following bacteria to their types, either G+ cocci, G+ bacilli, G- cocci, or G- bacilli. 
Peptostreptococcus
Actinomyces
Veillonella
Prevotella
Eubacterium
Leptotrichia
Fusobacterium 
Porphyromonas
A

G+ cocci: peptostreptococcus

G+ bacilli: Actinomyces, eubacterium, leptotrichia

G- cocci: veillonella

G- bacilli: fusobacterium, prevotella, porphyromonas

84
Q

Is actinomyces aerobic or anaerobic?

A

Anaerobic

85
Q

Viral pneumonia is ___ children and ____ in adults

A

Common

Rare

86
Q

How do you treat empyema?

A

Drainage of pleural space

87
Q

Which is more common, bronchopneumonia or lobar pneumonia?

A

Bronchopneumonia is more common

88
Q

If you have a case of lobar pneumonia, what two bacteria are the most likely cause?

A

Strep. Pneumoniae or klebsiella. These can also cause bronchopneumonia

89
Q

Name some symptoms of anaphylaxis

A 
Increased itchiness
Erythema
Urticaria (hives)
Angioedema (swelling of lips, face, throat)
Severe bronchospasm
Shock
90
Q

What are the signs and symptoms of influenza?

A

Fever, chills, cough, sore throat, fatigue, body aches, headache, runny nose, sometimes nausea

91
Q

All enterics are gram ___, oxidase ____, ____ glucose, do not grow on CNA,

A

Negative bacilli

Negative

Ferment

92
Q

Streptococcus pneumoniae is gram ___, catalase ____, and is bile ____

A

Positive

Negative

Soluble

93
Q

Haemoplilus influenzae is gram ___’ and only grows on ____ agar, meaning that…

A

Negative, pleomorphic

Chocolate

It requires X and v factors

94
Q

Pseudomonas is gram ____, _____ glucose, smells like corn chips, oxidase ____, and produces _____.

A

Negative bacilli

Does not ferment

Positive pyocyanin

95
Q

Legionella is gram ____, grows on ___ agar,

A

Negative bacilli

Byce

96
Q

True or false… enteric species grow on macconkeys and are lactose fermenters (meaning that the media turns pink)

A

True

97
Q

True or false… enterics can grow on SBA and chocolate agar

A

True

98
Q

True or false… pseudomonas can grow on SBA, chocolate agar, and MacConkey’s agar. Pseudomonas is a lactose fermenter

A

The first statement is true, the second is false. (Pseudomonas will cause MacConkey’s agar to turn yellowish)

99
Q

True or false… pseudomonas prefers to grow at warmer temperatures, 42 degrees Celsius

A

True

100
Q

True or false… legionella pneumophila grows on SBA and MacConkeys agar

A

False

101
Q

BCYE is used to grow legionella because it contains ___ which is required for its growth

A

L-cysteine

Host and Defense (17 decks)

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