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
