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Disease Exam 2: Infections
infections
125
Anatomy
Graduate
04/04/2011

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Term
are viral or bacterial infections more common?
Definition
bacterial
Term
first 2 clues of identity of bacteria are:
Definition
- shape
- gram stain
Term
gram staining:
- fixation> crystal violet> iodine treatment> decolorization> counter stain safarin
Definition
Term
gram positive is purple
gram negative is pink
Definition
Term
Enterococcus faecalis is gram ___ ___ in ___.
Definition
- positive cocci in chains
Term
Escherichia coli are gram __ __.
Definition
- gram negative rods
Term
Arthropod infections apply to __ and ___. List the possible culprits.
Definition
- ticks and mites

- bed bug
- body lice
- mosquitos
- tick
- mite
Term
Many ___, ___, __, and ___ diseases are transmitted in the bite of an athroprod. In the U.S. this is usually from a __ or __. But arthropods can also cause direct infestations like that cause itch mites and head lice.
Definition
- bacterial, rickettsial, parasitic, and viral diseases
- mosquito or tick
Term
Opportunistic infections include (4):
Definition
- Bacteria
- Viruses
- Fungi
- Parasites
Term
Normal flora:
Definition
Population of microorganisms that usually reside in the body.
It can be a relatively fixed population that will repopulate if disturbed or transient and derived from the environment.
Term
Moist skin areas like the axilla, perineum, and toe webs harbor a large diversity of normal skin flora. List 3:
Definition
- Staphylococcus aureus
- Corynebacterium
- some Gram-negative bacteria
Term
Bulk of human skin surface is drier and primarily inhabited by ___ __ and ____.
Definition
- Staphylococcus epidermidis
- Propionobacterium
Term
2 most common normal flora on skin:
Definition
- staph aureus
- staph epidermididis
Term
The skin microbes found in the most superficial part of the epidermis and upper parts of hair follicles are ___ __ ___ like __ ___ and ___ __, or___ like ___ ___. These are generally nonpathogenic and considered ___, although __ and ___ roles have been assigned to them.
Definition
- gram positive cocci like Staphylococcus epidermidis and Micrococcus sp.
- corynebacterium like Propionibacterium sp.
- comensals
- parasitic and mutualistic
Term
descriptions of normal skin flora:
Definition
- nonpathogenic
- commensal
- mutualistic
- parasitic
Term
Staphylococci and propionobacterium are normal ___ flora that produce __ __ that inhibit the growth of __ and yeast. But if normal ___ ___ becomes trapped in a hair follicle, it can grow rapidly and cause inflammation and acne.
Definition
- normal skin
- produce fatty acids that inhibit growth of fungi and yeast
- Proprionibacterium acnes
Term
What is the normal skin flora that can cause acne if trapped in a hair follicle?
Definition
- Proprionibacterium acnes
Term
The upper respiratory tract also has normal flora. What structures encompasses the upper respiratory tract:
Definition
- nasal and oral passages
- nasopharynx
- oropharynx
- trachea
Term
Normal flora of the nares/nostrils:
Definition
- Staphylococcus epidermidis
- Corynebacterium
- Staphylococcus aureus in 20% of people
Term
Main carrier site for Staphylococcus aureus?
Definition
- nares/nostrils
Term
Healthy sinuses are ___.
Definition
sterile
Term
The pharynx/throat has ___ and various __ __ ___ as its normal flora.
Definition
- Streptococci
- various gram negative cocci
Term
Pathogens that sometimes colonize in the pharynx (4):
Definition
- Streptococcus pneumoniae
- Streptococcus pyrogenes
- Haemophilus influenzae
- Neisseria meningitidis
Term
___ and other gram __ organisms are frequent normal flora inhabitants of the upper respiratory tract, mainly the pharynx.
Definition
- Neisseria and other gram negative
Term
___ ___, an important cause of bacterial meningitis can also colonize in the pharynx as part of the normal flora, until the host develops active immunity to it.
Definition
Neisseria meningitidis
Term
Structures that encompass the lower respiratory tract:
Definition
- trachea
- bronchi
- pulmonary tissues
Term
The lower respiratory tract is virtually __ of organisms, b/c of the __ __ called __ __ of the bronchi.
Definition
- free of organisms
- ciliated epithelium called the mucocilliary blanket of the bronci
Term
A viral upper respiratory tract infection may lead to a __ __ __ __ __ if the __ __ is impaired.
Definition
- bacterial upper respiratory tract infection (URI)
- mucociliary blanket is impaired
Term
LIKE WITH VIRAL BRONCHITIS OR VIRAL PNEUMONIA> IMPARIED MUCOCILIARY BLANKET> SECONDARY BACTERIAL INFECTION. SMOKERS MORE SUSCPETIBLE TO BACTERIAL INFECTIONS B/C IMPAIRED BLANKET.
Definition
Term
To check for a lower respiratory tract infection, have to obtain a __ __.
Definition
sputum culture
Term
If the respiratory tract epithelium becomes damaged like it may with __ or __ __, the individual is more susceptible to infection by __ __ and __ __ descending from the nasopharynx.
Definition
- bronchitis
- viral pneumonia
- Haemophilus influenzae
- Streptococcus pneumonia
Term
sputum culture ordered to determine cause of ___ __ or other __ __ __ __.
Definition
bacterial pneumonia
bacterial lower respiratory tract infections
Term
A fresh sputum sample should be collected first thing in the ___ and cannot contain ___, since this would contaminate the sample with oral bacteria. All sputum samples are __ stained. More than __ __ cells at low enlargement indicates salivary contamination.
Definition
- morning
- cannot contain saliva
- gram stained
- more than 25 squamous cells
Term
__ __ is present in the upper respiratory tract of half of the population. If it descends to the lower respiratory tract it can cause pneumonia.
Definition
- Streptococcus pneumonia
Term
__ ___ causes 95% of all pneumonia.
Definition
Streptococcus pneumonia
Term
3 areas of the body that is not normal to have flora in:
Definition
- sinuses
- lower respiratory tract
- stomach (acid)
Term
normal flora of the oral cavity:
Definition
- Viridans streptococcus (dental plaques)
- Actinomyces sp
- Anaerobes
Term
normal flora of the stomach:
Definition
none, acid should kill it all
Term
___ ___ is the normal cause of dental plaques and is part of the normal flora.
Definition
Viridans streptococcus
Term
__ __ is the primary bacterium involved in plaque formation and the formation of dental carries. This is viewed as an __ infection. Dental disease is one of the most prevalent and costly infectious diseases in the United States.
Definition
- Streptococcus mutans
- opportunistic infection
Term
main cause of dental carries:
Definition
Streptococcus mutans
Term
Normal flora are __ in the small intestine.
Definition
scant
Term
normal flora of the colon:
Definition
- Bacterioides (predominant organism)
- Clostridium sp.
- Escherichia
- Anaerobes (assorted gram negative anaerobes )

May also see these in the small intestine, but flora in small intestine are scant.
Term
2 flora in colon that are clinically important:
Definition
- Bacterioides
- Gram negative Anaerobes

(also have Escherichia and Clostridium)
Term
___ are gram __, non-___ forming, __ __ bacteria. They are described as the __ bacteria in the __ of humans.
Definition
- Bifidobacteria
- gram-positive, non-spore forming, lactic acid bacteria
- friendly bacteria in the intestines of humans
Term
___ ___ is the predominant bacterial species in the intestines of breast-fed infants, where it prevents __ by __.
Definition
- Bifidobacterium bifidum
- prevents colonization by pathogens
Term
___ are sometimes incorportated yogurts a probiotics.
Definition
Bifidobacterium
Term
___ __ is a regular component of intestinal flora that many European countries use as a marker of fecal pollution of water, the same way __ __ is used in the U.S.
Definition
- Enterococcus faecalis
- the same way E. coli is used in the U.S. (these are 2 different bacteria though)
Term
Even though __ __ is a normal part of the GI flora, in recent years it has emerged as a significant, antibiotic resistant, ___ infection.
Definition
- Enterococcus faecalis
- nosocomial
Term
Clostridium ___ is commonly isolated from feces.
Definition
- Clostridium perfringens commonly found in feces- part of normal flora
Term
Clostridium ___may colonize the bowel and cause ___ __ __ or ___ __.
Definition
- Clostridium difficile
- antibiotic induced diarrhea
- pseudomembranous colitis
Term
Clostridium difficile, the cause of __ __, is too difficult to cutlure, thus it is not cultured. Instead it is identified by finding its __.
Definition
- pseudomembranous colitis
- toxin
Term
normal flora of the urethra:
Definition
- Staphylococcus epidermidis
Term
Normal flora of the vagina:
Definition
- Lactobacillus
- yeasts
- Streptococcus species
Term
__ _ ___ colonize the vagina in 15-20% of women and may infect the infant during delivery.
Definition
- Group B Streptococcus
Term
One of the most common causes of neonatal infection:
Definition
Group B Streptococcus from woman's vagina infects baby during delivery
Term
A lactobacillus species, possibly ___ ___, in association with the vaginal epithelial cell, has a protective effect on the female host.
Definition
- Doderleins baccilus
Term
__ ___ colonizes the vaginal epithelium during child bearing years and establishes the low pH that inhibits growth of pathogens.
Definition
Lactobacillus acidophilus
Term
Lactobacillus lower the pH to __ or __, which is ideal for them, but too acidic for pathogens. Loss of this protective effect by antibiotic therapy can lead to infection by __ aka a __ __.
Definition
- 4 or 5
- Candida aka yeast infection
Term
The urethra may contain predominantly skin microorganisms, like __, __, and ___. This is why have to be careful when getting urine sample.
Definition
- streptococci, staphylococci, diptheroids
Term
The flora of the anterior urethra, as indicated principally by urine cultures, suggests that the area my be inhabited by a relatively consistent normal flora consisting of Staphylococcus epidermidis, Enterococcus faecalis and some alpha-hemolytic streptococci.
Their numbers are not plentiful.
In addition, some enteric bacteria (E. coli, Proteus) and corynebacteria, which are probably contaminants from the skin, vulva or rectum, may occasionally be found at the anterior urethra.
Definition
Term
urine culture is a __ procedure.
Definition
quantitative
Term
Definitive diagnosis of a UTI is based on isolation of significant numbers of bacteria on urine culture. Traditionally, growth of ____ has been used as the statistically significant number for the presence of UTI.
Definition
- 10^5 CFUs/mL
Term
clean catch urine sample technique:
Definition
- clean genital area
- urinate a little into toilet bowl to clear urethra of contaminants
- urinate into sample cup
Term
In more than 95% of true UTIs, a __ __ species is responsible.
Definition
- single bacterial species
Term
True polymicrobial UTIs occur uncommonly and are observed in a few clinical situations, including:
Definition
- long term catheter or foreign body (calculi, necrotic tumor)
- when pt has stagnant pool of urine due to inadequate bladder emptying, especially with repeated instrumentation
- fistula communicating with GI tract or female genital tract

OTHERWISE A URINE CULTURE WITH 2 OR MORE BACTERIAL SPECIES INDICATES CONTAMINATION
Term
The organsims that cause UTIs generally arise from ___ flora that colonize the patients __ and ___. __ __ is the dominant pathogen in 80% of first infections in women,men,and children, as well as 50% of nosocomial infections.
Definition
- enteric
- perineum and urethra
- Escherichia coli
Term
Some patients will have strange organisms causing their UTIs. These patients have a history of __ __ or __ __ _ __ given for other diseases. These settings predispose the patient to alterations in the normal GI flora.
Definition
- frequent hospitalizations
- multiple courses of antibiotics
Term
The majority of UTIs are caused by __ __ __ __ that arise from the GI tract. E. coli is the dominant cause in 80% of cases.
Definition
- gram negative aerobic bacilli
Term
___ ___, is a coagulase __ gram __ organism and is the second most common cause of UTIs and accounts for 11% of cases. This species is present in normal __ flora including the ___, but only in low numbers. It does not appear to be of fecal origin.
Definition
- Staphylococcus saprophyticus
- coagulase negative, gram positive
Term
Other less common bacteria responsible for UTIs include:
Definition
- Proteus
- Klebsiella
- Enterobacter
Term
blood, urine, and cerebrospinal fluid should always be ___.
Definition
sterile!!
Term
usually don't do fecal culture unless patient has ___.
Definition
diarrhea
Term
3 main portals of entry for bacterial pathogens:
Definition
- mucous membranes
- skin
- parenteral
Term
Entry into the Host: must access and adhere to host tissues, penetrate or evade host defenses, and damage tissue to cause disease.
Definition
Term
___ and __ enter through respiratory tract.
Definition
Histoplasmosis and TB
Term
Fecal oral route common mode of contamination. __ _ and __ __ transmitted this way.
Definition
Hepatitis A
Oyster bacteria
Term
Unbroken skin is impenetrable to most microbes. Some microbes gain access through hair follicles and sweat glands. ___ ___ aka ___ can bore through intact skin.
Definition
Necator americanus aka hookworm, it then attaches to GI tract and causes iron deficient anemia
Term
Certain fungi, ___, grow on skin and produce enzymes that breakdown keratin.
Definition
dermatophytes
Term
real name of hookworm:
Definition
Nectator americanus
Term
Many organsims have a preferred portal of entry that is a prerequisite to cause disease. ___ __ needs to be inhaled to cause disease, if swallowed it does not cause disease.
Definition
Streptococcus pneumoniae
Term
Streptococcus pneumoniae is __ __ pneumonia.
Definition
community acquired
Term
LD50 defined:
Definition
- lethal dose for 50% of hosts
- number of microbes that would kill 50% of inoculated test animals
Term
ID50 defined:
Definition
- infectious dose for 50% of hosts
- number of microbes that would demonstrate infection in 50% of inoculated animals
Term
Adherence is attachment b/w microbes and host organism. __ or __ are surface molecules on the pathogen that bind specifically to host cell surface molecules.
Definition
adhesions and ligands
Term
locations of adhesions and ligands on microbe:
Definition
- glycocalyx
- fimbriae
- viral capsid
Term
__ on the host tissues bind the __ or __ of the pathogen.
Definition
- receptors
- adhesions or ligands
Term
Capsules are used by many bacteria to penetrate the host. A capsule makes the pathogen more virulent. Examples of bacteria with capsids:
Definition
- Streptococcus pneumoniae
- Klebsiella pneumoniae
- Hemophilus influenzee
- Bacillus anthracis
- Yersinia pestis
Term
Capsules resist host defenses by impairing ___.
Definition
phagocytosis
Term
The host can make __ to a capsule which attack to the capsul and allow phagocytosis to occur.
Definition
antibodies
Term
other capsule functions:
Definition
- mediate adherence to cell surface
- protect bacterial cells from engulfment by predatory protozoa or WBCs
Term
___ protein are found on cell surface of of fimbriae of Streptococcus pyogenes and mediates the attachment and helps resist phagocytosis.
Definition
- M protein
Term
Mycobacterium tuberculosis cell wall has __ that help resist digestion after phagocytosis. This is a type __ hypersensitivity reaction.
Definition
- waxes
- type IV
Term
Extracellular enzymes called ___ lyse cells, form or dissolve clots, and dissolve materials in tissues.
Definition
- exoenzymes
Term
roles of exoenzymes:
Definition
- lyse cells
- form/dissolve clots
- dissolve materials in tissues
Term
name 5 exoenzymes:
Definition
- Leukocidins
- Hemolysins
- COAGULASE
- BACTERIAL KINASES
- HYALURONIDASE
- Collagenase
- Necrotizing factors
- Lecithinase
- Proteases
Term
Luekocidins are ___ that destroy __ __ __ that are ___. This enzyme is produced by __ and ___.
Definition
- exoenzymes
- destroy white blood cells that are phagocytes
- staphylococci and streptococci
Term
Hemolysins destroy __ __ __ and are produced by __ ___ aka __ and ___.
Definition
- red blood cells
- Clostridium perfringens aka gangrene
- streptococci
Term
Coagulase is an __ produced by some ___ which produces __ __ which may wall off infection from immune response.
Definition
- exoenzyme produced by staphylococcus
- produces blood clots
Term
Bacterial kinases are __ made by __ and __ that break down __ __ produced by __ __ in attempt to isolate infection. Thus they prevent the host from isolating infection.
Definition
- exoenzymes made by streptococci and staphylocci
- break down blood clots
- produced by host body
Term
Hyaluronidase is an __ made by some __ and __ ___ aka __. This enzyme breaks down __ __, a component which holds cells together in connective tissue.
Definition
- streptococci and Clostridium perfringens (gangrene)
- hyaluronic acid
Term
clostridium perfringens is ___.
Definition
anaerobic
Term
35 year old man with knife wound, didn't get treated, later there was extreme tenderness of arm and radiograph shows gas in the soft tissues. What bacteria is causing this?
Definition
Clostridium perfringens
Term
Collagenase is produced by many ___.
Definition
clostridia.
Term
Necrotizing factors are enzymes pathogens have that kill __ __.
Definition
body cells
Term
Lecithinase destroys __ __ of cells.
Definition
plasma membranes
Term
Proteases break down __ in tissue.
Definition
proteins
Term
___ ___ is a flesh eating bacteria.
Definition
Streptococcus pyogenes
Term
Invasins and 2 examples of bacteria with invasins:
Definition
- surface proteins that alter the actin filaments of host cell cytoskeleton, allowing microbes to enter the cell
- Salmonella typhinurium
- E. coli
Term
3 ways bacterial cells damage host cells:
Definition
- direct damage
- toxins (most bacterial damage is carried out by toxins)
- hypersensitivity reactions
Term
Bacteria that cause direct damage by inducing cells to engulf them and then kill the host by microbial metabolism and multiplication :
Definition
- E. coli
- Shigella
- Salmonella
- Neisseria gonorrhea
Term
other microbes enter the cell by excreting enzymes or through their own motility.
Definition
Term
Exotoxins are produced inside gram ___ bacteria.
Definition
gram positive
Term
Endotoxins are part of the cell wall of gram ___ bacteria. They are liberated as the bacteria die and the cell wall breaks apart.
Definition
negative
Term
Exotoxins:
Definition
Soluble in body fluids, rapidly transported throughout body in blood or lymph.
Produced mainly by gram-positive bacteria.
Most genes for toxins are carried on plasmids or phages.
Produced inside bacteria and released into host tissue.
Term
Exotoxins are responsible for disease symptoms/death. List 3 types of exotoxins.
Definition
- Cytotoxins- kill or damage host cells
- Neurotoxins- interfere with nerve impulses
- Enterotoxins- affect lining of GI tract
Term
Antibodies called ___ provide immunity.
Definition
antitoxins
Term
Toxoids are toxins that have been altered by __ or ___. These are used in the vaccines for ___ and ___.
Definition
- altered by heat or chemicals
- diphtheria and tetanus
Term
Clostridium botulinum produces botulinum ___ that inhibits the release of the neurotransmitter ____ and prevents transmission of nerve impulses to muscles, causing __ __.
Definition
- neurotoxins
- inhibit release of acetylcholine
- flaccid paralysis
Term
Clostridium tetani produces the __ ___ that blocks ___ of skeletal muscle, causing uncontrollable muscle spasms (lockjaw) and convulsions.
Definition
- tetanus toxin
- blocks relaxation
Term
Corynebacterium diptheria produces the ___ ___ that inhibits __ synthesis in ___ cells. It has two polypeptides, the A (active) and B (binding).
Definition
- diptheriae toxin
- inhibits protein synthesis in eucaryotic cells
Term
Streptococcus pyogenes produces __ __ ___ which damage blood capillaries causing a red rash.
Definition
- 3 erythrogenic cytotoxins
Term
Pharynx of a 39-year-old woman with bacteriologically confirmed diphtheria. The photograph was taken 4 days after the onset of fever, malaise, and sore throat. Hemorrhage caused by removal of the membrane by swabbing appears as a dark area on the left. Corynebacterium diphtheriae is not very invasive and organisms remain in the superficial layers of the respiratory mucosa or skin. Its major virulence is the result of the exotoxin, which inhibits protein synthesis in , leading to collection of necrotic debris.
Definition
Term
DIPTHERIA IS ONLY SEEN NOW IN PATIENTS WHO HAVE NOT BEEN VACINNATED: COMMUNE, FROM OUT OF COUNTRY, OR POPULATION THAT DOES NOT GET IMMUNIZED.
Definition
Term
Scarlet fever is caused by erythrogenic toxins of ___ ___.
Definition
Streptococcus pyogenes
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