Chapter 19: Infectious Diseases Affecting the Respiratory System

The H-spike on the Influenza A virus can have a total of ____ subtypes.

16

On average, about ________ Americans, mostly elderly and very young children, die from Influenza each year.

30,000

How effective are antiviral medications?

70% to 90%

The single-stranded RNA genome of the Influenza A virus is divided into ____ segments.

8

Vaccines for the Influenza A virus are ___ to ___ effective.

80% to 90%

Neuraminidase has a total of ___ subtypes and is located on the ___ spike of the Influenza A virus.

9; N

Which Influenza A virus transmission cycle is more dangerous to humans? A) Circulates with limited pathology in the avian population, transmission to domestic fowl, transmission to humans. B) Circulates with limited pathology in the avian population, transmission to domestic fowl, adaptation/reassortment with swine influenza viruses, transmission to humans.

A) Circulates with limited pathology in the avian population, transmission to domestic fowl, transmission to humans.

Which of the following microorganisms are gram-negative bacteria? (Check all that apply) A) Haemophilus influenzae B) Streptococcus pyogenes C) Neisseria menigitidis D) Staphyolococcus aureus E) Streptococcus pneumoniae

A) Haemophilus influenzae C) Neisseria meningitidis

Rates of diphtheria worldwide have steadily ______. A) declined B) increased C) maintained

A) declined

Antigenic ____ consists of amino acid changes in spikes also known as point mutations. A) drift B) shift

A) drift

Pertussis is caused by the bacterium ______ ______.

Bordetella pertussis

The _________ phase is the recovery period from a disease when the numbers of the causative agent are decreasing and the symptoms have disappeared.

Convalescent

______-______ RNA is the genome that infects a person with the Common cold.

Single-stranded

What is the causative agent of Streptococcal Pharyngitis?

Streptococcus pyogenes

What type of bacteria is associated with beta-hemolysis?

Streptococcus pyogenes

What virulence factor is used to cause beta hemolysis in Streptococcal Pharyngitis?

Streptolysin O and S

Pathogen-specific secretory IgA is part of which line of defense?

Third line of defense

The lower respiratory tract includes what?

Trachea, bronchi, bronchioles, alveoli

True or false: Influenza B and C viruses only circulate in humans.

True

This enzyme is required for the N-spike of the Influenza A virus to facilitate infection.

Trypsin

The condition that is the most common cause of sinusitis is ______.

allergy

High rates of _____ ______ in normal microbiota have caused earlier treatments for treatment of acute otitis media to be reexamined.

antibiotic resistance

Streptococcal pharyngitis will show ____- hemolytic activity on blood agar.

beta

The complete hemolysis of red blood cells is also known as _____-________.

beta-hemolysis

The ________ stage is the first stage of pertussis characterized by cold symptoms, such as a runny nose.

catarrhal

Profuse and watery nasal secretions indicate that a person is in the ____ stage of the infection.

early

Penicillin is used in the treatment for Streptococcal pharyngitis instead of ________ because many group A streptococci are resistant to it.

erythromycin

Streptococcus pyogenes is what kind of bacteria?

gram-positive

Streptococcus pyogenes is commonly referred to as group A streptococcus because of what?

group A carbohydrate in the cell wall

Pneumonia infections that are acquired by patients in the hospital or other clinical setting are called ______-______ pneumonias.

healthcare-associated

Protein G in Streptococcus Pharyngitis is used to ______ antibody.

inactivate

The second line of defense in the respiratory system involve alveolar _____.

macrophages

The upper respiratory tract is composed of (in proper anatomical order): the nasal cavity, the ____ cavity, the ____, the epiglottis, and the ____.

oral; pharynx; larynx

Influenza can leave patients susceptible to _______ and other secondary bacterial infections.

pneumonia

The inflammatory condition of the lung in which fluid fills the alveoli is generally referred to as _______ and can be caused by several different types of microbes.

pneumonia

Hand washing is a good way to ______ Streptococcal pharyngitis.

prevent

What part of the respiratory system includes the mouth, nose, nasal cavity, sinuses, pharynx, epiglottis, and larynx?

Upper respiratory tract

Which of the following are infectious diseases of both the upper and lower respiratory tract? (Check all that apply) A) influenza B) pharyngitis C) sinusitis D) pertussis E) rhinitis F) RSV G) Diphtheria H) Otitis media I) Tuberculosis J) Pneumonia

A) influenza D) pertussis F) RSV

Because of its constant contact with the external environment, the upper respiratory tract harbors a _____ population of commensal biota A) large B) small C) uniform D) sparse

A) large

Due to _______ _____ a new vaccine for the Influenza A virus in required every year.

Antigenic drift

You have identified a new strain of Influenza A virus which has novel HA spikes due to point mutation in viral genome. This tells you that the virus has undergone: A) Antigenic shift B) Antigenic drift

B) Antigenic drift

Which two gram-positive bacterial groups are very common members of the upper respiratory tract biota? (Check all that apply) A) Micrococcus B) Streptococcus C) Candida D) Staphylococcus E) Pseudomonas

B) Streptococcus D) Staphylococcus

A patient presents with a red sore throat and white pus patches. You take a sample and plate it out on blood agar. It is bacterial in nature and turns out to be beta-hemolytic. Your diagnosis would be: A) common cold B) Streptococcus pyogenes C) Seasonal cold

B) Streptococcus pyogenes

Beta hemolysis is due to: A) Protein G B) Streptolysin O or S C) exfolatin D) A-B toxin

B) Streptolysin O or S

Put the steps of pathogenesis of the Influenza A virus in the correct order. I. Infected cells die and slough off. II. Virus attaches to host cells via hemagglutinin spikes. III. Host immunity quickly controls viral spread. IV. Envelope fuses with host membrane, leading to viral replication within the cell. V. Mature viruses bud from host cell. VI. Acquired through inhalation of infected respiratory secretions. VII. Budding allows mature virus to pick up envelope. A) I, II, III, IV, V, VI, VII B) VI, II, IV, V, VII, I, III C) II, IV, V, VII, VI, I, III D) VI, I, V, VII, IV, III, II

B) VI, II, IV, V, VII, I, III

Which of the following are first line defenses for the respiratory system? (Check all that apply) A) alveolar macrophages B) coughing C) sneezing D) nasal hair E) specific antibodies in mucus F) ciliated epithelium G) mucus production

B) coughing C) sneezing D) nasal hair F) ciliated epithelium G) mucus production

Which age group(s) is effected MOST severely by the Influenza A virus each year in the United States? (Check all that apply) A) middle age persons B) elderly C) pregnant women D) very young children

B) elderly D) very young children

The mortality rate of Influenza A virus is: A) high B) low

B) low

Put the steps of pathogenesis of the Common cold into the correct order: I. Infection is halted by inflammatory response, interferon release, and immune response. II. Large number of viruses released from infected cells. III. Injured cells cause inflammation which stimulates profuse nasal secretion, sneezing and tissue swelling. IV. Virus attach to specific receptors on respiratory epithelial cells and multiply in cells. V. Infection can extend to ears, sinuses and lower respiratory tract before stopping. A) III, I, V, II, IV B) V, II, III, IV, I C) IV, II, III, I, V D) IV, III, II, I, V

C) IV, II, III, I, V

Amantadine, rimantadine, and Tamiflu are all examples of what kind of medication? A) antibiotic B) over the counter C) antiviral

C) antiviral

An initial viral infection can predispose a patient to a secondary _____ infection in the upper respiratory tract. A) fungal B) protozoal C) bacterial D) helminthic

C) bacterial

Influenza viruses are named according to: A) the species of animal the virus infects B) differing makeup of matrix protein C) differing H and N spikes D) differing genetic material

C) differing H and N spikes

_________ on the H-spike of the Influenza A virus aids in attachment to host cells. A) neuraminidase B) trypsin C) Hemagglutinin D) IgA

C) hemagglutinin

The upper respiratory tract includes which of the following structures? (Check all that apply) A) alveoli B) trachea C) oral cavity D) epiglottis E) larynx F) pharynx G) bronchi H) Sinuses I) Nasal Cavity J) Bronchioles

C) oral cavity D) epiglottis E) larynx F) pharynx H) sinuses I) nasal cavity

What must an organism be able to do in order to cause pneumonia? (Check all that apply) A) release leukocidins to the blood B) penetrate the upper respiratory tract C) penetrate the lower respiratory tract D) secrete an antiphagocytic capsule E) survive the immune defenses

C) penetrate the lower respiratory tract E) survive the immune defenses

Symptoms of the Type A Influenza include all of the following EXCEPT: A) headache B) muscle pain C) red throat with pus patches D) dry, non-productive cough E) fever

C) red throat with pus patches

Which of the following is the most common portal of entry for pathogens? A) digestive tract B) skin C) respiratory tract D) urogenital tract

C) respiratory tract

A yeast infection is caused by which bacteria?

Candida albicans

The most common cause of pharyngitis is: A) Aspergillus B) S. aureus C) S. pneumoniae D) Common cold viruses E) H. influenzae F) Herpesvirus

D) Common cold viruses

Which of the following are fungal agents that are known to cause cases of pneumonia? (Check all that apply) A) Streptococcus pneumoniae B) Haemophilus influenzae C) Mycoplasma pneumoniae D) Histoplasma capsulatum E) Pneumocystis jiroveci F) Legionella pneumophila G) Streptococcus pyogenes

D) Histoplasma capsulatum E) Pneumocystis jiroveci

You become ill and have severe malaise, sore throat and fever. It is an enveloped virus. What is your diagnosis? A) Pertussis B) Strep. pyogenes C) Rhino virus D) Influenza A virus

D) Influenza A virus

The most lethal cases of pneumonia are due to infection with which of the following causative agents? A) Streptococcus pyogenes B) Legionella pneumophila C) Haemophilus influenzae D) Streptococcus pneumoniae E) Histoplasma capsulatum F) Mycoplasma pneumoniae

D) Streptococcus pneumoniae

Which of the following are second and third line defenses for the respiratory system? (Check all that apply) A) mucus production B) nasal hair C) ciliated epithelium D) alveolar macrophages E) secretory IgA F) coughing G) sneezing

D) alveolar macrophages E) secretory IgA

The role of the normal biota in the upper respiratory tract is to: A) produce important vitamins for the health of the system B) increase the involuntary coughing response that protects the system C) participate in communication with other body systems for overall homeostasis D) reduce growth of harmful pathogens in the system

D) reduce the growth of harmful pathogens in the system

Bacterial toxins that are potent stimuli for T cells causing an excessively strong reaction are called: A) A-B toxins B) cell-mediated antigens C) endotoxins D) superantigens

D) superantigens

The current vaccine for pertussis is most commonly part of a mixed vaccine called the _____ vaccine.

DTaP

Scarlet fever most often affects: A) neonates B) fetuses C) middle-aged adults D) immunocompromised E) school-age children F) elderly

E) school-age children

How many people are infected with Influenza A virus each year in the United States?

Hundreds of thousands or millions or people

The best way to prevent rhinitis is through frequent ______ ______ along with covering sneezes or coughs to prevent airborne transmission.

Hygiene practices

The causative agents for the flu are the ______ viruses.

Influenza

Streptococcus pyogenes causes scarlet fever when it has become infected with a _____ bacteriophage.

Lysogenic

Even though scarlet fever had a 95% fatality rate in the early 20th century, cases today are often ____.

Mild

The Spanish flu of 1918 spanned the globe in 9 _____.

Months

________ acts as an enzyme to cleave H protein to allow function of viral and cellular membranes.

Neuraminidase

_____ medications are used for the treatment of the Common cold.

OTC (over the counter)

The use of antibodies to detect group A streptococci describes ______ __________ tests on pharyngeal swab specimens that have a high rate of false-negative results.

Rapid diagnostic

The _____ _____ virus causes colds in most people, but can cause a potentially devastating infection in children and neonates.

Respiratory syncytial

______ _____ are the cause 30% to 50% of Common cold infections.

Rhino viruses

The lower respiratory tract includes the _____, the _____, the _______ in the lungs and the _____.

trachea; bronchi; bronchioles; alveoli

Primary infections of the upper respiratory tract are often caused by _____, which can predispose a patient to a secondary infection caused by ______.

viruses; bacteria

Most patients diagnosed with Streptococcal Pharyngitis recover within a ______.

week

The potentially pathogenic bacteria found in the normal biota of the upper respiratory tract include which of the following? (Check all that apply) A) Haemophilus influenzae B) Histoplasma capsulatum C) Streptococcus pyogenes D) Neisseria menigitidis E) E. coli F) Staphylococcus aureus G) Bordetella pertussis H)Streptococcus pneumoniae

A) Haemophilus influenzae C) Streptococcus pygoenes D) Neisseria meningitidis F) Staphylococcus aureus H) Streptococcus pneumoniae

Complications of infection that occur during acute illness of Streptococcal Pharyngitis include which of the following? (Check all that apply) A) Scarlet fever B) Rubella C) Varicella D) Acute glomerulonephritis E) Acute rheumatic fever

A) Scarlet Fever D) Acute glomerulonephritis E) Acute rheumatic fever

Influenza viruses bind to which cell type to initiate infection? A) ciliated cells of respiratory tract B) respiratory phagocytes C) connective tissue cells connected to basement membrane D) epithelium of lung alveoli

A) ciliated cell of respiratory tract

The symptoms associated with Streptococcal Pharyngitis include which of the following? (Check all that apply) A) Difficulty swallowing B) fever C) runny nose D) malaise E) red throat with pus patches F) enlarged tender lymph nodes localized to the neck G) scratchy mild sore throat

A) difficult swallowing B) fever E) red throat with pus patches F) enlarged tender lymph nodes localized to the neck

The signs and symptoms of scarlet fever include: (Check all that apply) A) high fever B) generalized weakness C) arthritis D) sandpaper-like rash E) muscle paralysis F) skin nodules over bony areas

A) high fever D) sandpaper-like rash

Inflammation of the throat is also known as: A) pharyngitis B) rhinitis C) laryngitis D) sinusitis

A) pharyngitis

Which types of patients are most susceptible to complications of influenza infection? (Check all that apply) A) pregnant women B) adolescents C) heart/lung patients D) elderly persons E) middle-aged adults F) infants and young children

A) pregnant women C) heart/lung patients D) elderly persons F) infants and young children

Pharyngitis can be caused by: (Check all that apply) A) sinus drainage B) nasal trauma C) viral infection D) bacterial infection E) mechanical irritation F) protozoan infection

A) sinus drainage C) viral infection D) bacterial infection E) mechanical irritation

Sinusitis is caused by which general types of microorganisms? (Check all that apply) A) viruses B) bacteria C) protozoans D) fungi E) helminths

A) viruses B) bacteria D) fungi

The current treatment for uncomplicated acute otitis media is: A) wait for resolution B) broad-spectrum antibiotics C) mechanical removal from ear D) Narrow-spectrum antibiotics

A) wait for resolution

Which season exhibits the largest incidence of influenza infections? A) winter B) fall C) spring D) summer

A) winter

Genetic mixing that occurs when two different viruses infect a cell at the same time resulting in a new virus that is often more virulent.

Antigenic shift

Viral infection of the upper respiratory system can lead to acute otitis media because: (Check all that apply) A) increased antibody production favors the growth of bacteria B) it leads to inflammation of the Eustachian tubes C) fluid builds up in the middle ear D) it decreases mucus production in the tract

B) it leads to inflammation of the Eustachian tubes C) fluid builds up in the middle ear

Pneumonias caused by _____ usually have symptoms that differ from pneumococcal pneumonia and therefore are often called atypical pneumonias. A) streptococci B) mycoplasmas C) mycobacterium

B) mycoplasmas

The first line of defense in the respiratory system include: (Check all that apply) A) macrophages B) nasal hairs C) pathogen-specific secretory IgA D) cilia E) mucus

B) nasal hairs D) cilia E) mucus

__________ is the causative agent for the Influenza A virus. A) rhinovirus B) orthomyxovirus C) Streptococcus pyogenes D) Rubeola virus

B) orthomyxovirus

Treatment for Streptococcal pharyngitis includes: (Check all that apply) A) hand washing B) penicillin C) first-generation cephalosporin (if patient has penicillin allergies) D) Over the counter medications

B) penicillin C) first-generation cephalosporin (if patient has penicillin allergies)

The incidence of pneumonia caused by Haemophilus influenzae has been greatly reduced due to which of the following? A) mutation of the bacterial genome B) routine childhood vaccination C) natural immunity D) decline of the bacterial population E) prophylactic antibiotics

B) routine childhood vaccination

The common name for pertussis comes from: A) the animal in which the organism that causes pertussis was first discovered B) the sound a patient makes during uncontrollable bouts of coughing C) the action of the exotoxin produced by Bordetella pertussis D) the researcher who first described the organism that causes pertussis

B) the sound a patient makes during uncontrollable bouts of coughing

The most common signs/symptoms of rhinitis include: (Check all that apply) A) diarrhea B) nausea/vomiting C) runny nose D) sneezing E) muscle aches F) scratchy throat G) high fever

C) runny nose D) sneezing F) scratchy throat

Sinusitis can be caused by which of the following? (Check all that apply) A) facial trauma B) autoimmunity C) structural problems with nose D) microbial infection E) allergies

C) structural problems with nose D) microbial infection E) allergies

Why do physicians distinguish between nosocomial and community-acquired pneumonia? A) nosocomial infections are usually more deadly B) it allows the CDC to study the epidemiology of pneumonia C) they are caused by different types of bacteria D) it demonstrates the shortcoming of specific health care settings

C) they are caused by different types of bacteria

_________ ________ colonizes the oral mucosa.

Candida albicans

Malaise, scratchy mild sore throat, runny nose, cough and hoarseness, nasal secretions all describe symptoms of what viral infection?

Common cold

The Bacitracin disc test plated on blood sheep agar used for pharyngeal swab specimen.

Culture of pharyngeal swab specimen

True or false: Antiviral medications can be taken after the appearance of symptoms.

False

True or false: Antiviral medications can be used as substitutes for the vaccine for Influenza A virus.

False

True or false: Rhino viruses are enveloped bacteria.

False: Rhino viruses are non-enveloped bacteria.

The only subtypes of the H-spike in the Influenza A virus that circulate in humans are ____, ____, ____.

H1, H2, H3

Major changes in the influenza A virus due to recombination of viral strains from 2 different host species are referred to as antigenic ____.

Shift

______ is the inflammation of any of the 4 pairs of sinuses in the skull that is usually caused by allergies, infections, or structural issues in the nasal area.

Sinusitis

The most famous pandemic of 1918 was called the _____ flu.

Spanish

The common name for Streptococcal Pharyngitis is _____ _____.

Strep throat

The gram-positive bacteria most common in the normal biota of the upper respiratory tract are___________ and ___________.

Streptococci; staphylococci