1. What normal microbiota of the upper respiratory system may become opportunistic pathogens?
    • Nose: Haemophilus influenza, Staphylococcus aureus(1/3 healthy americans)
    • Upper pharynx: Streptococcus pneumonia
  2. Signs and symptoms of Strep throat? Streptococcal respiratory disease
    • back of pharynx is red, swollen lymph nodes
    • pus- containing abscesses on tonsils
  3. What causes Scarlet Fever? Streptococcal respiratory diseases
    strains of Streptococci carry a lysogenic virus that produce toxins.
  4. What disease complications can occur if strep throat is not treated?
    • acute glomerulonephritis= kidney disease
    • rheumatic fever= damage heart valves & muscle
  5. Whats pathogen is the major cause of sore throat and scarlet fever, rheumatic fever, and glomerulonephritis?
    Streptococcus pyogenes= Group A
  6. How are the many species of streptococci differentiated?
    • serology and type of hemolysis on blood agar
    • B= clear
    • a= green
    • Streptococcus pyogenes is Lancefield's serological "Group A" and B hemolytic
  7. How is strep throat spread?
    respiratory droplets
  8. How is strep throat diagnosed and treated?
    immunological test- penicillin
  9. can a person have strep throat more than once?
  10. Are all cases of pharyngitis (sore throat) actually strep throat?
  11. What are the signs and symptoms of diptheria?
    sore throat
  12. What is the pseudomembrane? diptheria
    • blood clothing factors
    • leukocytes
    • bacteria and dead cells
  13. What is the pathogen that causes diptheria?
    Corynebacterium diphtheriae
  14. Why do bacteria look like Chinese letters? diptheria
    • Snapping division
    • help identify the organisms
  15. How is the pathogen transmitted?diptheria
    direct contact or respiratory droplets
  16. What are the pathogens that usually cause sinusitis and otitis media, and where do they come from (what part of body)?
    • Streptococcus pneumoniae, S. aureus, Haemophilus influenza, moraxella catarrhalis
    • =pharynx
  17. Which disease (sinusitis or otitis media) is more common in adults, and which is more common in children?
    • adults= sinusitis
    • children= otitis
  18. What are the signs and symptoms of the common cold?
    Sneezing, runny nose, congestion, sore throat, malaise, cough
  19. What are the pathogens of the common cold?
    • 200 different viruses
    • rhinoviruses
    • cornaviruses
  20. Can cold viruses infect the lower respiratory tract?
    • No, because of the higher temp.
    • effective at 33C
  21. Why is it difficult to produce antibodies to the attachment sites on cold viruses?
    attachment sites are hidden deep and its difficult for them to attach
  22. Once the virus attaches to cells lining the nasal cavity, what happens? cold
    • signals reproduction of many more viruses and infect neighboring cells.
    • amplification
  23. How are the cold viruses spread? and most common?
    • single particle: coughing, sneezing, fomites
    • Most common: hand-to-hand contact
  24. What is the most important preventative measure for colds?
    hand washing
  25. Pneumonia?
    inflammation of the lungs
  26. lobar pneumonia?
    • means a lobe is involved
    • inflammation of the lungs
  27. Nosocomial pneumonia
    • means it was acquired in a hospital setting
    • inflammation of the lungs
  28. What are the signs and symptoms of pneumococcal pneumonia?
    • usually lobar fever, chills, congestion, cough, chest pain, short rapid breathing, nausea, vomit
    • sputum
  29. what is the pathogen that causes most cases of pneumonia?
    Streptococcus pneumoniae= pneumococcus
  30. How is the pathogen acquired, and who is most likely to become infected? pneumonia
    • Normal microbiota 75% people 
    • Inhaled into lungs damaged by a previous viral disease(flu)
    • elderly are more likely
  31. What is the means of treatment or prevention for pneumococcal pneumonia?
    • penicillin drug choice
    • CDC recommends a vaccine at 2,4,6 and 12-15 months of age and adults over 65
  32. What are the signs and symptoms of primary atypical pneumonia?
    • fever, malaise, headache, sore throat, excessive sweating
    • unreproductive cough
    • walking pneumonia
  33. Describe the pathogen that causes primary atypical pneumonia?
    Mycoplasma pneumonia
  34. How does the organism of primary atypical pneumonia cause disease? Mycoplasma pneumonia
    attach to base of cilia and stops them from beating, which parents removal of mucus by ciliary escalator, causes buildup of mucus that irritate respiratory tract
  35. How is the pathogen of primary atypical pneumonia spread? Mycoplasma pneumonia
    nasal secretions
  36. Is a vaccine available for Mycoplasma pneumonia?
    no vaccine
  37. what are the signs and symptoms of TB?
    • minor cough and fever
    • breathing difficulty, fatigue, malaise, weight loss, chest pain
    • wheezing, cough blood
  38. What is causative agent of TB?
    • Mycobacterium tuberculosis:
    • acid fast stain
    • mycolic acid, cell wall, waxy
  39. How long can the pathogen Mycobacterium tuberculosis live outside the body?
    8 months - dried aerosol droplets
  40. M. tuberculosis is not very virulent, but if the disease does occur, what percent of untreated patients die?
    55% of people
  41. Describe the 3 types of TB?
    • Primary TB – small, hard nodules are formed (tubercles) in the lungs – bacteria may remain dormant inside these tubercles for decades; replicate inside phagocytes
    • Secondary or reactivated TB - Tubercle is ruptured  and the bacteria spread through the lungs
    • Disseminated TB –macrophages carry the bacterium to other places (bone marrow, spleen, kidneys, spinal cord, and brain
  42. Describe the tuberculin skin test including:
    what is injected into the skin?
    what is a positive result?
    what type of hypersensitivity response and what does a positive response mean?
    • screens for exposure to TB
    • cells walls of m.tuberculosis
    • red, swollen, painful bump
    • Type IV hypersensitivity
    • positive mean it has the antigens
  43. What other tests are used to diagnose TB?
    • chest X-ray
    • acid fast sputum
  44. what are the two primary drugs used to treat TB, and how long does treatment last?
    • isoniazid (INH), rifampin
    • 6 months
  45. What are MDR and XDR strains? Tuberculosis
    • Multi-drug-resistant (MDR) strains:
    • Resistant to INH and rifampin
    • Have arisen in several countries
    • Extensively drug-resistant (XDR) TB is even worse:
    • Resistantto INH, rifampin and 3 or more anti-TB drugs
    • In S. Africa, 52 of 53 patients died
  46. Is there a vaccine for TB? what is DOTS?
    • Yes, BCG vaccine
    • Directly Observed Treatment Shortcourse: has reduced incidence in US
  47. What are the signs and symptoms of the Flu?
    • Incubation period of 1 day
    • Fever of 102-106°F, pharyngitis, congestion, dry cough, malaise, headache, and muscle soreness
    • Lasts for 1-2 weeks
  48. What are the pathogens that cause the flu?
    • orthomyxoviruses –Types A and B
    • Virus has spikes composed of hemagglutin (HA) or neuraminidase (NA) – provide attachment
  49. What are HA and NA, and what is their function?
    • Influenza virus budding from a cell.
    • Glycoprotein spikes are neuraminadase (NA) 
    • hemagglutinin (HA)
    • Variations In these determine the type of virus.
  50. what is antigenic drift?
    is the result of mutations in the HA and NA genes – results in a slow, gradual change in viral antigens
  51. what is antigenic shift?
    • is a major antigenic change that results from reassortment of genes from different influenza
    • A viruses infecting the same host cell (either human or animal  [e.g., birds, bats o
  52. how are influenza viruses named?
    • Type  (A or B)
    • Location and date of original identification
    • Type of antigens (HA and NA)
    • For example, A Singapore/1/80 (H1N2)
    • Ifisolated from an animal, it may also get a common name, like Hong Kong flu or swine flu
  53. why is there concern about H5N1 flu virus?
    • Has spread over Asia, Africa, North America, and Europe
    • Fatal 50% of the time in humans, but rarely spreads from human to human (humans get it from birds)
    • Deadly nature of the virus and the speed with which it has spread around the world cause epidemiologists to predict the arrival of a major pandemic like that of 1918
    • If it mutates to allow easy passage between humans, this could be a huge health challenge
  54. what are the signs and symptoms of valley fever?
    • Initially resembles pneumonia or TB
    • 60% get mild, respiratory symptoms that resolve on their own
    • Others develop severe infections – fever, cough, chest pain, difficulty breathing, coughing up blood, headache, night sweats, weight loss and pneumonia; some get a rash
  55. what is the causative agent of valley fever?
    Coccidioides immitis – a soil fungus that grows like a mold, and like a yeast at body temperatures
  56. how is the pathogen of valley fever acquired?
    Inhalation of asexual spores from dust
  57. what percent of population in endemic areas develop the disease valley fever?
    • 3% of people living in endemic areas develop the disease each year
    • Anything that disrupts the soil can spread the spores
  58. what is the treatment for valley fever?
    • Identification in specimens
    • Usually resolves on its own, but when spreads to brain and spinal cord is fatal if untreated
    • Amphotericin B is the drug of choice: very toxic
  59. what is the most common fungal systemic disease affecting humans?
  60. what are the signs and symptoms of histoplamosis?
    • Asymptomatic in 95% of people and resolves without damage
    • 5% develop severe coughing with blood-tinged sputum or skin lesions
  61. how is histoplasmosis acquired?
    • Histoplasma capsulatum- a soil fungus  that becomes a yeast at body temperatures
    • Found in bat and bird droppings
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