Ch. 19 Micro

___ are most often affected by scarlet fever

children

The influenza virus binds to __ cells of the respiratory ___

ciliated; mucosa

___ acquired pneumonias are acquired by individuals in the general public

community

Which of the following describes the M. tuberculosis cell wall?

contains cord factor; contains waxes; contains mycolic acid; difficult to stain

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

convalescent

Which of the following are first line defenses for the respiratory system?

coughing, sneezing, nasal hair, ciliated epithelium, mucus production

the typical incubation period for influenza is 1 to 4

days

Influenza A viruses are named according to

differing H and N spikes

To prevent noncompliance in TB therapy, it is recommended that all TB patients are treated with ___ ___ therapy

directly observed

The best prevention for group A streptococci infection is good ___ ____

hand washing

the best way to prevent the common cold is through frequent ___ ___ along with covering sneezes or coughs to prevent airborne transmission

hand washing

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

healthcare-associated

The spike found on the lipid envelope of influenza that contributes to red blood cell clumping is

hemagglutinin

The best way to prevent pneumococcal pneumonia in elderly adults is

immunization with polysaccharide vaccine

Over-the-counter medications are effective for which of the following in cases of the common cold?

minimizing the symptoms & lessening the inflammation

MDR-TB stands for ___ - ___ tuberculosis

multidrug-resistant

The ___ of patients if one of the biggest problems in successful tuberculosis therapy

noncompliance

Those at greatest risk for exposure to TB work or live in

nursing homes & jails

In the Ziehl-Neelsen acid-fast staining procedure, acid-fast organisms will appear what color?

red

The role of the normal biota in the upper respiratory tract is to

reduce the growth of harmful pathogens in the system

The most common portal of entry for pathogens is the ___ tract

respiratory

Tuberculosis is transmitted primarily through

respiratory mucus

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

respiratory syncytial

The most common group of viruses that cause the common cold are

rhinoviruses

Hantavirus is transmitted in airborne dust that has been contaminated with the urine, feces, or saliva of

rodents

Diptheria is easily prevented by

routine vaccination

Which of the following is the most noticeable symptom seen in the catarrhal stage of pertussis

runny nose

The most common signs/symptoms of the common cold include

runny nose, sneezing, scratchy throat

Antibiotics are always used to treat pharyngitis caused by Streptococcus pyogenes because

serious complications can occur if it is not treated

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

shift

The upper respiratory tract includes which of the following structures?

sinuses, larynx, oral cavity, nasal cavity, epiglottis, pharynx

inflammation of any of the four pairs of air cavities in the cranial bones is also known as

sinusitis

S. pyogenes produces ___ whose action is to lyse red blood cells to release hemoglobin

streptolysin

___ are bacterial toxins that are potent stimuli for T cells causing an excessively strong reaction

superantigens

Which diseases are prevented by the DTaP vaccine

tetanus, pertussis, diphtheria

Why is annual flu vaccination recommended?

the virus is altered by antigenic drift

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

viruses ; bacteria

T or F: People with untreated TB often have a normal life span, with alternate periods of disease

T

T or F: The cough seen in pertussis is uncontrollable and presents with a distinct sound as the patient gasps for air between bouts. It can even lead to small hemorrhages in the eyes and brain

T

T or F: The majority of TB patients recover from the primary infection

T

TB strains with resistance to four drugs are called ___ TB

XDR-TB

Newer cultivation schemes have reduced the incubation period of M. tuberculosis from 6 weeks to

a few days

Pharyngitis can be caused by

bacterial infection; viral infection; mechanical irritation; sinus drainage

Pneumonia caused by ___ organisms is often more serious than pneumonia caused by ___

bacterial; viruses

Streptococcal pharyngitis will show ___-hemolytic activity on blood agar

beta

Viral pharyngitis will not show ___-hemolytic activity on blood agar

beta

The treatment for suspected bacterial sinusitis is

broad-spectrum antibiotics

For the most effective action against the virus, antiviral drugs should be given to a patient within how many days after infection?

2

Only ___% of people who become infected with tuberculosis develop a clinical case

5-10%

Streptococcus pyogenes is a member of Group ___ streptococci

A

Pertussis is caused by the bacterium ___ ___

Bordetella pertussis

T or F: Currently, the recommended treatment for uncomplicated otitis media involves the use of a broad-spectrum antibiotic

F

T or F: Most cases of scarlet fever are untreatable and result in serious sequelae

F

T or F: Nausea and diarrhea are typical signs and symptoms of influenza

F

T or F: OTC meds are effective in curing the common cold

F

The main causative agent for tuberculosis is ___ tuberculosis

M.

The skin screening test for tuberculin hypersensitivity is known as the___ test

Mantoux

Atypical pneumonias are often caused by which agents

Mycoplasma, Chlamydophila

___ is a glycoprotein that is part of the influenza virion spikes and breaks down the protective mucous of the respiratory tract

Neuraminidase

___ ___ is the most common cause of community acquired pneumonia

Streptococcus pneumoniae

Which of the following are fungal agents that are known to cause cases of pneumonia?

Pneumocystis jiroveci; Histoplasma capsulatum

The presence of superantigens and the surface antigens mimicry of host proteins are factors contributing to the virulence of

S. pyogenes

Which viral agents are known to cause serious viral pneumonias as their primary disease

SARS coronavirus; hantavirus

Vaccination against ___ ___ has been recommended since 2000 as part of the childhood vaccination schedule to prevent the most common cause of acute otitis media

Streptococcus pneumoniae

___ ___ causes the greatest number of lethal cases of pneumonia compared to any other microorganism

Streptococcus pneumoniae

The cell wall of M. tuberculosis is

acid fast

What type of staining may be used to identify Mycobacterium in a sputum sample?

acid-fast

The 4 techniques used in the clinical diagnosis of TB are

acid-fast stains; chest x-rays; tuberculin tests; antimicrobial sensitivity tests

Pharyngitis caused by Fusobacterium necrophorum is found at the highest rate in which age groups?

adolescents & young adults

Most commonly, sinusitis is caused by which of the following?

allergies

Sinusitis can be caused by ___, ___, or structural problems

allergy; infections

Which of the following are second and third line defenses for the respiratory system?

alveolar macrophages & secretory IgA

Failure of the patient to adhere to the antibiotic treatment regimen against tuberculosis can lead to ___ resistance

antibiotic

___ is/are the usual treatment for pneumococcal pneumonia

antibiotics

Who is able to receive the influenza vaccine?

anyone over 6 months of age

Pneumonias caused by Mycoplasma usually have symptoms that differ from pneumococcal pneumonia and therefore are often called ___ pneumonias

atypical

Sinusitis is caused by which general types of microorganisms

bacteria, viruses and fungi

Which main categories of microorganisms are known to cause pneumonia?

bacteria; viruses; fungi

The influenza virus has a high level of variation in its genome due to antigenic ___ and antigenic ____

drift & shift

Bordetella pertussis is transmitted primarily via ___ transmission

droplet

What preventative measures can help discourage the development of healthcare-associated pneumonia?

education of patients on breathing; proper use of ventilation equipment; elevation of patient needs

Which types of patients are most susceptible to complications of influenza?

elderly & infants and young children

A condition in which tuberculosis bacteria have spread to organs other than the lungs is referred to as ___ TB

extrapulmonary

During which season is transmission of the influenza virus greatly increased?

fall & winter

True or False: Diphtheria is an emerging disease worldwide

false

Signs and symptoms of scarlet fever include a high ___ and a ___ that feels like sandpaper

fever & rash

Why is tuberculin testing restricted to at-risk populations?

focused screening of those populations; prevent unnecessary expense

The second most common route for transmission of influenza is

fomite contact

Primary TB may present with which of the following signs

formation of tubercles; mild fever

Rapid influenza tests provide results

in less than 24 hours

Which factors affect the susceptibility of a person to TB?

inadequate medical care, poor diet, immunosuppression, inherited genes, lung damage

The treatment for uncomplicated acute otitis media has changed in the last decade due to

increase in antibiotic-resistant biota

The current rates of TB worldwide are

increasing

A ___ will form in the skin with a positive tuberculin test

induration

___ are most susceptible to RSV infection

infants

The causative agents for the flu are the ___ viruses

influenza

Which of the following are infectious diseases of both the upper and lower respiratory tract?

influenza, pertussis, RSV

The major route for transmission of influenza is

inhalation of droplets

Multidrug-resistant tuberculosis is defined as being resistant to

isoniazid & rifampin

Viral infection of the upper respiratory system can lead to acute otitis media because

it leads to inflammation of the eustachian tubes; fluid builds up in the middle ear

In the US, prevention of TB is accomplished by

limiting exposure to airborne particles

To prevent reactivation in patients with latent TB, patients may be subjected to

long-course antibiotic therapy

85% of all cases of tuberculosis are contained in the

lungs

Streptococcus pyogenes cause scarlet fever when it has become infected with a ___ bacteriophage

lysogenic

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

lysogenic

The first white blood cells that respond to Mycobacterium tuberculosis are alveolar

macrophages

Chest X rays are used in the diagnosis of TB when

other tests give unclear results; further verification of a positive test is required

The main signs and symptoms of pharyngitis include

pain and swelling of throat; reddened mucosa in throat; swollen tonsils

The ___ stage is the second stage of pertussis characterized by uncontrollable coughing with a distinct sound

paroxysmal

Even though they are considered "normal" biota, many ___ bacteria are frequently present in the upper respiratory system

pathogenic

What must an organism be able to do in order to cause pneumonia?

penetrate the lower respiratory tract & survive the immune defenses

___ is another name for whooping cough

pertussis

Inflammation of the throat is called

pharyngitis

Pharyngitis caused by Fusobacterium necrophorum is increasing in incidence because

physicians screen only for Streptococcus and may miss this organism

___ is an inflammatory condition of the lung in which fluid fills the alveoli

pneumonia

Complications of influenza infection include which of the following?

pneumonia & secondary bacterial infections

Streptococcus pyogenes is a gram-___ coccus that grows in chains and forms capsules and ___ layers

positive; slime

The three types of tuberculosis are

primary, secondary, extrapulmonary

The respiratory syncytia virus gets its name from its ability to

produce giant cells; infect the respiratory tract

A diagnosis of tuberculosis is usually confirmed if a follow-up chest X-ray shows abnormal ___ ___

radiopaque patches

Why do physicians distinguish between nosocomial and community-acquired pneumonia

they are transmitted by different types of bacteria

The lower respiratory tract includes

trachea, bronchi, bronchioles, alveoli

The granulomatous lung lesion seen in TB that can serve as a focus for latent infection is called a

tubercle

Skin testing to determine tuberculosis exposure uses ___ injected under the skin

tuberculin

Tuberculosis is diagnosed through the ___ test

tuberculin; Mantoux

Which of the following are infectious diseases of only the lower respiratory tract?

tuberculosis & pneumonia

Children who have high rates of recurrence of ear infection have ___ surgically placed in the eardrum to aid drainage of fluid

tubes

The __ respiratory tract normally contains a large population of commensal microorganisms

upper

The ___ respiratory tract contains a large normal biota population

upper

Pneumonia due to Haemophilus influenzae has been greatly reduced due to an effective

vaccine

Pharyngitis is most commonly caused by a

virus

The common cold is caused by which general type of microorganism?

viruses

What occurs in secondary TB?

wasting of the body due to severe symptoms; live dormant TB bacteria are reactivated; tubercles expand and drain into the upper respiratory tract

The drier air of which season most effectively facilitates the spread of influenza virus, leading to the highest rates of infection

winter

Which 2 seasons have the peak incidence of RSV infection?

winter & spring

Which age group is the most susceptible to RSV disease?

young infants