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Microbiology for Healthcare Workers Exam 2
Microbiology and Public Health
182
Microbiology
Graduate
02/21/2018

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Term
Prokaryotes
Definition
-Free DNA
-Cell wall (peptidoglycan)
-No organelles
Term
Eukaryotes
Definition
-DNA in nucleus
-Maybe cell wall
-organelles
Term
Flagella
Definition
motility
Term
amphitrichous
Definition
flagella at both ends
Term
chemotaxis
Definition
Flagella allow bacteria to move towards attractants (like nutrients) and away from repellants (like antibiotics), a process known as
Term
pilus/pili
Definition
long, rigid tubular structure.
can be used to transfer DNA from one bacteria to another in a process called conjugation
Term
Fimbriae
Definition
small bristle-like fibers found on the surface of many bacteria that are used for adhesion. Biofilm formation.
Term
S layer
Definition
hardened structure composed of thousands of copies of a single protein linked tightly together.
They are produced in hostile environments to protect the cell and in some cases may be used for attachment.
Term
Glycocalyx
Definition
composed of polysaccharide or glycoprotein which provides protection to the cell and helps the cell adhere to its environment.
There are two types:
Slime layer – loose shield
Capsule – denser, thicker, and more tightly bound.
Term
cell wall
Definition
Shape, prevents rupture due to changes in osmotic pressure.
Term
Peptidoglycan
Definition
macromolecule that makes cell walls strong. target for antibiotics
Term
Cytoplasmic membranes
Definition
Site of energy reactions. Nutrient processing. Synthesis.
Regulating transport into and out of the cell.
Term
Gram + vs Gram - stain color
Definition
+ stain purple
- stain pink
Term
Acid fast microorganisms
Definition
Mycobacterium
Nocardia
Special lipids in cell wall
Term
Gram - have
Definition
-outer membrane
-lipopolysaccharide (LPS) also known as endotoxin which causes fever and shock reactions in Gram negative infections.
-extra layer of strength against some dyes and disinfectants making them harder to kill.
Term
Plasmids
Definition
circular extrachromosomal DNA which can carry some protective traits including antibiotic resistance and toxin genes.
These contribute to the spread of antibiotic resistance as they can be spread
Term
Ribosomes
Definition
site of protein synthesis in prok & euk
Term
endospores
Definition
dormant bodies produced by bacteria that are highly resistant to environmental conditions.
Term
Glycocalyx in eukaryotes is often called
Definition
extracellular matrix and it has several functions:
Protection
Adherence
Reception of signals from other cells (many organisms can “talk” to each other).
Term
Protozoa and helminths do not have
Definition
cell walls
Term
The cell walls of fungi are made of
Definition
chitin and cellulose.
Term
Cell membranes in eukaryotes contains
Definition
sterols
Term
Chromatin
Definition
linear DNA found in the nucleus (euk)
Term
endoplasmic reticulum (ER)
Definition
series of tunnels use in transport and storage.
shuttle materials from the nucleus to the cytoplasm.
Term
Golgi apparatus
Definition
site in the cell in which proteins are modified (sugars and lipids are added), packaged, and sent to their final destinations.
Term
mitochondria
Definition
powerhouse of the cell. provide a constant supply of energy needed for cellular activity.
Protein synthesis, movement, reproduction, etc.
Term
chloroplast
Definition
powerhouse of algae and plant cells. It is here that photosynthesis takes place
Term
mitochondrial DNA comes from which parent?
Definition
Mother
Term
Tetracycline works by
Definition
binding to the 30S subunit of the prokaryotic ribosome.
Eukaryotic ribosome doesn’t have a 30S subunit (it has a 40S and a 60S). Therefore, it does not affect protein synthesis in eukaryotes.
Term
gene
Definition
fundamental unit of heredity responsible by itself (or with one or more additional genes) for a given protein in an organism.
Term
chromosome
Definition
cellular structure composed of neatly packaged DNA (containing many genes).
Term
genome
Definition
sum total of all of the organism’s genetic material (includes chromosomes, plasmids, etc.)
Term
DNA to protein
Definition
replication
transcription
translation
Term
recombinant
Definition
Any organism that contains genes from another organism is called a
Term
Recombination has clinically importance relevance as it can result in the following:
Definition
Resistance to drugs.
Resistance to metabolic poisons.
New nutritional and metabolic capabilities
Increased virulence
Adaptation to the environment
Term
genes are acquired by
Definition
plasmid, bacteriophage, and large pathogenicity islands
Term
Horizontal gene transfer
Definition
refers to any transfer of DNA that results in an organism acquiring new genes that did not come directly from parent organisms. Euk & Prok
Term
Genetic recombination occurs in bacteria by three methods:
Definition
Conjugation, Transduction, Transformation
Term
conjugaton
Definition
requires the attachment of two bacteria via the pilus bridge and transfer of DNA.

antibiotic resistance

donor cell does not lose the trait it transferred, it retains a copy and the recipient gets a copy
Term
transformation
Definition
entails the transfer of “free” DNA and requires no special vehicles.

called transfection in euk (genetic engineering)
Term
transduction
Definition
transfer of DNA from one bacterium to another via a bacterial virus (phage)

Both bacteria (the donor and the recipient) must be of the same species because bacteriophage are highly specific in which type of bacteria that they attack.

Some pathogens have acquired virulence factors via transduction including Corynebacterium diphtheriae, Clostridium, and Streptococcus pyogenes.
Term
transposons
Definition
have the ability to move from one part of the genome to another.
They can move from a site on a chromosome to another site on a chromosome or they can move to plasmids.
Moving to plasmids gives them the ability to move to different bacteria.
an transfer antibiotic resistance genes as shown in the figure at right.
Term
spontaneous mutation
Definition
a random change in the DNA arising from errors in replication that occur randomly.
Term
Induced mutations
Definition
result from exposure to known mutagens.
Physical or chemical agents that interact with DNA in a disruptive manner.
Includes UV light, X rays, certain chemicals.
Term
point mutations
Definition
Small mutations involving addition, deletion, or substitution of single bases are called
Term
silent mutation
Definition
When the bases are changed but the amino acid doesn’t change, this is called a
Term
missense mutation
Definition
Any change in the code that leads to placement of a different amino acid is called a
Term
nonsense mutation
Definition
changes a normal codon to a stop codon (stop codons cause protein synthesis to stop).
Term
bacteriophage
Definition
viruses that attack bacteria, harmless to humans, used in genetics and medicine to target specific bacteria
Term
Both bacteria and yeast can be genetically engineered to produce
Definition
insulin
Term
three current vaccines that used genetic engineering in their production:
Definition
hepatitis B vaccine is produced by cloning surface antigen into yeast.

The human papillomavirus vaccine is produced by recombinant DNA technology

rotavirus vaccine consists of reassortant rotaviruses
Term
adoptive cell transfer (ACT)
Definition
engineering patients’ own immune cells to recognize and attack their tumors.
Term
normal flora benefits
Definition
is microbial antagonism
Term
Some of the factors that increase susceptibility to infections are:
Definition
Old age
Extreme youth (infancy, premature)
Genetic defects in immunity.
Surgery and organ transplants
Co-morbidities (diabetes, cancer, etc)
Chemotherapy/immunosuppressive drugs
Physical/Mental stress
Pregnancy
Other infections
Term
pathogen
Definition
microbe that causes infection and disease
Term
pathogenicity
Definition
ability to cause disease
Term
Virulence
Definition
the degree of pathogenicity and it is determined by the ability of an organism to establish itself in the host and cause damage.
Term
Process of Infection
Definition
Enter the host
Attach firmly to host tissues
Survive the host defenses
Cause disease
Vacate the host
Term
virulence factors
Definition
To cause damage, microbes produce____.These include toxins, adhesins, extracellular enzymes, etc.
Term
Is it better to be more virulent or less virulent
Definition
Less- so that you can spread more
Term
If pathogens enter the wrong portal, they are
Definition
not infectious
used for vaccine development
Term
Signs
Definition
objective evidence of disease (fever, rash, runny nose).
Term
Symptoms
Definition
subjective evidence of disease (headache, malaise)
Term
syndrome
Definition
when disease can be identified by the presence of signs and symptoms it is called a
Term
latent infections
Definition
Organisms that can hide from the immune response can cause

opportunists

Herpes simplex, chickenpox, hepatitis B, HIV, tuberculosis, malaria
Term
acute disease
Definition
serious
short infection
Diphtheria
Meningitis
Term
subacute disease
Definition
disease that is present before signs or symptoms are exhibited

bacterial endocarditis
Term
Incubation period
Definition
time from initial contact to the appearance of symptoms
Term
Stages of infection
Definition
Prodromal
Period of invasion
Convalescent period
Term
prodromal stage
Definition
The earliest symptoms of disease usually include a vague feeling of discomfort which is known as the
Term
period of invasion
Definition
the microbe multiplies to high numbers during which symptoms are most severe.
Term
convalescent period
Definition
the patient begins to respond to the infection and symptoms decline
Term
zoonosis
Definition
An infection indigenous to animals but naturally transmissible to humans is known as a
Term
A disease is communicable
Definition
when an infected host can transmit the infectious agent to another host and establish infection in that host.
Term
contagious
Definition
A microbe that is highly communicable is considered
Term
R0 (reproductive number)
Definition
Diseases that are communicable are often described using a mathematical number known as

Higher= more contagious
Term
The R naught for measles is approximately
Definition
15, making it one of the most contagious diseases on the planet.
Term
95%
Definition
% of the population must be vaccinated for herd immunity against measles to be successful.
Term
Very high R0 means that
Definition
a large percentage of the population has to be vaccinated
Term
community-associated/community-acquired.
Definition
If the patient enters the hospital with apparent signs and symptoms the disease is considered

MRSA
Term
First line of defense
Definition
physical barriers
-skin
-mucous membranes

chemical barriers
-Lysozyme which destroys peptidoglycan.
-Sebaceous gland secretion which are antimicrobial.
-High lactic acid concentration in the skin.
-High pH in the vagina.
Etc.
Term
markers
Definition
help the immune system distinguish self vs non-self
Term
pathogen-associated molecular patterns (PAMPs)
Definition
Markers that many different pathogens have in common are called
Term
pattern recognition receptors (PRRs)
Definition
The immune cells use a receptor known as____ to recognize PAMPs.

important for phagocytosis
Term
mononuclear phagocytic system (MPS)
Definition
provides a passageway within and between tissues and organs

loaded with white blood cells (WBCs) known as macrophages (a type of phagocyte) which attack foreign invaders at multiple sites.

found in the thymus, lymph nodes, tonsils, spleen, and lymphoid tissues of the gut and respiratory tract.
Term
lymphatic system
Definition
is crucial for returning extracellular fluid to the circulatory system

removing inflammatory response mediators (discussed later in this lecture)

and to perform immune system surveillance, recognition, and protection against foreign invaders.
Term
Thymus
Definition
site of T cell maturation
Term
Lymph nodes
Definition
filter materials from lymph, site of immune reactions.
Term
Spleen
Definition
filters blood (removed old red blood cells (RBCs)and pathogens, site of immune reactions.
Term
hematopoiesis
Definition
The production of blood cells is called______

The process begins in the bone marrow with pluripotent stem cells.
Term
Second line of defense
Definition
phagocytosis,
inflammation
fever
antimicrobial proteins
Term
3 types of phagocytes
Definition
neutrophils
monocytes
macrophages
Term
Neutrophils
Definition
general killers of bacteria

elevated count is a good sign of infection.
Term
Monocytes
Definition
blood phagocytes that rapidly leave the circulation to mature into macrophages.
Term
Macrophages
Definition
Large phagocytes that ingest and kill foreign cells. These cells process foreign substances and prepare them for reactions with B and T lymphocytes (antigen presentation)
Term
Phagocytosis process
Definition
phagocytes migrate to the region of inflammation (chemotaxis), adhere to the pathogen (PAMP-PRR adhesion), engulf the pathogen, destroy the pathogen, and eliminate it.
Term
Second line of defense
Definition
Inflammation
Term
Cytokines
Definition
chemical mediators produced by several cells that regulate, stimulate, suppress, and otherwise control the many aspects of cell development, inflammation, and immunity.
Term
Steps of inflammation
Definition
Injury/Immediate Reactions
Vascular Reactions
Edema and Pus Formation
Resolution/Scar Formation
Term
fever
Definition
Inhibits replication of some microbes

Reduces circulating iron which bacteria need to grow.

Increases metabolism and stimulates immune reactions

speeds up hematopoiesis, phagocytosis, and helps lymphocytes home in on the site of infection.
Term
Interferons
Definition
cytokines that mediate various immune reactions including:

Inhibiting viral replication

Inhibiting expression of cancer genes

Acting as tumor suppressors

Stimulating immune cell functions including those of phagocytes and lymphocytes.
Term
Third line of defense
Definition
specific immunity
Term
specific immunity
Definition
sometimes called acquired immunity as it results from previous immune activation such as prior infection.

triggered by antigens
Term
epitope
Definition
The immune response is so precise that lymphocytes (T and B cells) only respond to a small portion of the antigen molecule known as an
Term
Specificity
Definition
refers to the fact that antibodies against a specific antigen respond only to that antigen (mostly, cross-reactivity)
Term
Memory
Definition
refers to the ability of specialized cells to “remember” a pathogen and respond quickly if it is encountered again.
Term
Bone marrow
Definition
B-cells mature in
Term
Lymphocyte types
Definition
B-cell
T-cell
Term
MHC (major histocompatibility complex)/ HLA (Human Leukocyte Antigen) and CD (cluster of differentiation)
Definition
Cell surface markers including _______
activate specific responses.
Term
MHC recognizes ___ and rejects____
Definition
self
foreign tissue
Term
When B cells are activated, they give rise to
Definition
plasma cells, each of which makes the same antibody.
Term
When T cells are activated they give rise to
Definition
Helper T cells
Regulatory T cells
Cytotoxic T cells
Term
Helper T cells
Definition
activate macrophages, assist B cells, and activate cytotoxic T cells.
Term
Regulatory T cells
Definition
control T cell response
Term
Cytotoxic T cells
Definition
destroy infected host cells and other “foreign” cells.
Term
All T cells express
Definition
antigen-specific T cell receptors (TCR) and coreceptors called CD3
Term
T helper cells also express
Definition
CD4 which binds to MHC class II molecules.
Term
T cytotoxic cells
Definition
express CD8 which binds to MHC class I molecules.
Term
B cell receptor genes code for
Definition
immunoglobulins which are the antigen receptors of B cells and, or when secreted, antibodies.
Term
T cell receptors
Definition
are similar to B cell receptors in that they can respond to most antigens but they are never secreted (always membrane-bound as shown in 13.3).
Term
Rituximab
Definition
drug that binds to a B cell surface marker making the B cell a target for destruction by natural killer cells. The result is, all of the B cells expressing this marker are destroyed.
Term
superantigens
Definition
potent stimuli for T cell activation and in some cases over-activation.

Toxins produced by S. aureus are
Term
cell-mediated immunity (CMI)
Definition
The T cell response is often referred to by the term

T cells which when stimulated mobilize other T cells, B cells, and phagocytes.

T cells are activated by an antigen/MHC complex contacting their receptors.
Activated T cells divide into subsets of effector cells (T helper, T regulatory, etc).
Term
T helper cells (CD4)
Definition
activate CMI, secrete cytokines, drive B cell proliferation, and promote inflammation.
Term
T regulatory cells (CD4).
Definition
control specific immune responses and prevent autoimmunity
Term
T cytotoxic cells (CD8)
Definition
target and destroy infected cells, cancer cells, and cells from other animals and humans.
Term
Gamma-Delta T cells
Definition
respond like macrophages in that attack a wide variety of invaders (non-specific) but like T cells in that they produce memory cells (specific).
Term
regulatory B cells
Definition
regulate T cell response through cytokine production.
Term
memory B cells
Definition
circulate, looking for the same antigen.
Term
plasma cells
Definition
produce antibodies.
Term
Agglutinate
Definition
cross-link cells causing clumping and increasing visibility to immune system.
Term
Opsonize
Definition
make microbes more visible to the immune system.
Term
IgG
Definition
most prevalent antibody in the blood, neutralizes toxins, opsonizes, and triggers complement pathway.
Term
IgA
Definition
secretory antibody present at mucous membranes, and in tears, saliva, and colostrum. Very active against viruses.
Term
IgM
Definition
first antibody produced.
Term
IgD
Definition
activate B cell response.
Term
IgE
Definition
antibody of allergy, worm infections, mediates anaphylaxis and asthma.
Term
titer
Definition
the concentration of antibodies present in serum is called the
Term
Immunopathology
Definition
the study of disease states associated with overreactivity or underreactivity of the immune response
Term
Hypersensitivity Type I
Definition
allergy and anaphylaxis and atopy
usually ingested (food allergy)
IgE production-> mast cells-> cytokines
2nd exposure= allergic response
Term
Hypersensitivity Type II
Definition
IgG and IgM mediated cell damage
cell lysis
Includes blood group incompatibilities, pernicious anemia and myasthenia gravis.
target-> RBC
Rh factor
Term
Hypersensitivity Type III
Definition
immune complex
neutrophils cause tissue destruction
include SLE (systemic lupus erythematosus), rheumatoid arthritis, serum sickness, rheumatic fever, and arthus reaction.
Term
Hypersensitivity Type IV
Definition
cell-mediated (delayed)
usually allergens that enter through skin
T-cell
infectious allergy, contact dermatitis, and graft rejection
Term
atopy
Definition
chronic local allergy such as hay fever or asthma.
Term
Histamine
Definition
cytokine-most abundant, fast acting, constricts smooth muscle layers of the bronchi, relaxes vascular muscle layers
Term
Bradykinin
Definition
cytokine-prolonged smooth muscle contraction of the bronchioles, increased mucus secretions, etc.
Term
Leukotriene
Definition
cytokine- gradual contraction of smooth muscle.
Term
Prostaglandins
Definition
cytokine-vasodilation, increased vascular permeability, bronchoconstriction.
Term
pollens
Definition
may be inhaled which result in IgE that cross-reacts with proteins found in fruits and vegetables
Term
most common allergies
Definition
Penicillin
Sulfa drugs
Aspirin
Opiates
Contrast Dye used in X-rays
Term
RAST (radioallergosorbent test)
Definition
is the most widely used blood test for allergies.
Term
Drugs that treat allergic reactions
Definition
Corticosteroids
Monoclonal antibodies
Antihistamines
Aspirin
Acetaminophen
Epinephrine
Term
Pernicious anemia
Definition
is a decrease in RBCs that occurs because the stomach cannot absorb enough B12
Term
ethnic background
Definition
Please note that likelihood of the bone marrow registry having a match is widely different based on the
Term
MHC (HLA) markers
Definition
The closer the match between the donor and recipient, the less likely the donor tissue (graft) will be rejected
Term
(autograph),(allograph),(isograph)
Definition
from self, another human, or from an identical twin
Term
Streptococcal infection
Definition
Rheumatic heart disease is triggered by
Term
Ankylosing spondylitis
Definition
a form of ongoing joint inflammation (chronic inflammatory arthritis) that primarily affects the spine.
Term
Graves’ diseases
Definition
is caused by antibodies against thyroid-stimulation hormone receptor
Term
Myasthenia gravis
Definition
caused by autoantibiodies binding to the receptors for acetylcholine effectively blocking muscle contraction.
Term
Multiple sclerosis
Definition
paralyzing neuromuscular disease characterized by lesions in the myelin sheath that surround neurons in the central nervous system.
T cells and antibodies sensitized to myelin sheath destroy neurons.
Term
titer
Definition
the concentration of antibodies present in serum is called the
Term
Genetic deficiency in B cells (PRIMARY)
Definition
usually results in abnormal immunoglobulin expression:
Agammaglobulinemia
Hypogammaglobulinemia

recurrent bacterial infections
Term
Defects in T cell immunity
Definition
can result in severe opportunistic infections and cancer.(PRIMARY)
DiGeorge Syndrome
Absence of the thymus
prone to infection
Term
Severe combined immunodeficiencies (SCIDs)
Definition
are the most serious and potentially lethal forms of immunodeficiency disease.
Term
Second immune deficiencies are acquired and the can be caused by the following:
Definition
Infections (AIDS)
Cancer
Nutritional deficiencies
Stress
Pregnancy
Aging
Irradiation
Severe burns
Steroids
Immunosuppressive drugs
Removal of spleen
Term
The goal of antimicrobials
Definition
is to destroy an infectious agent without harming the host
Term
origin of antimicrobials
Definition
bacteria and fungi
Term
There are three important factors to consider before starting antimicrobial therapy:
Definition
The nature of the microorganism causing the disease
The degree of the microorganism’s susceptibility to various drugs
The overall medical condition of the patient.
Term
Drug Susceptibility Tests
Definition
Kirby-Bauer shown at top right, the E-test at bottom right, and the automated system which uses microboth dilution.
Term
how antimicrobials work:
Definition
Inhibit cell wall synthesis
Inhibit nucleic acid structure and function
Inhibit protein synthesis
Interference with cytoplasmic membrane structure or function
Inhibition of folic acid synthesis
Term
antifungals
Definition
like eukaryotes, hard to be selective
macrolide polyenes
azoles
echinocandins
nucleotide cytosine analog
Term
protozoal treatment
Definition
Malaria
quinine derivatives
Metronidazole (flagyl)
Term
Helminth infections treatment
Definition
mebendazole, albendazole, praziquantel, and ivermectin
Term
Antiviral actions
Definition
Barring penetration of the virus into the host cell.
Blocking the transcription and translation of viral molecules.
Preventing the maturation of viral particles.
Term
minimum inhibitory concentration or MIC.
Definition
The smallest concentration of drug that visibly inhibits growth is called the
Term
Microbes become resistant to drugs in two ways
Definition
Spontaneous mutations in critical chromosomal genes.
Acquisition of entire new genes or sets of genes via horizontal transfer from another species.
Term
Drug resistance methods
Definition
Inactivation of drug by new enzymes
Decreasing uptake of the drug
Efflux pumps immediately pump drug out of cell.
Drug binding sites are decreased
Metabolic pathways are altered
Term
___ people in the US become infected with bacteria that are resistant to antibiotics and ___ of them die annually.
Definition
2 million, 23,000
Term
Toxicity Reactions to antimicrobials typically fall into the following categories:
Definition
Directly damage tissues
Allergic reactions
Disruption in the balance of normal microbiota.
Term
E. coli O157:H7 with antibiotics increases the likelihood of
Definition
HUS (hemolytic uremic syndrome) by 17 fold!
Term
superinfection
Definition
Broad-spectrum antibiotics can kill normal biota, allowing other microbes that were present in low numbers to begin to overgrow and cause disease. This process is known as

Can also be used to describe secondary infections
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