HLTH 245 Final Exam-- Burnett
Explain selective toxicity and give three examples of drugs that exhibit selective toxicity.
Selective toxicity is that antibiotics are harmful or toxic to a specific microbe and not the human body. Some examples include penicillin, cephalosporin, and vancomycin antibiotics.
Compare and contrast the 1975 Asilomar conference and the 2015 Napa conference
The 1975 Asilmar Conference allowed researchers to push genetic engineering to its limits without endangering public health. The 2015 Napa Conference strongly discouraged researchers from create germline modifications using the new genome editing CRISPR/Cas system.
Microbes may play a greater role in which of these types of diseases than previously suspected?
chronic
R plasmids (resistance plasmids)
confer resistance to antibiotics and other growth inhibitors
a pathogen selected as a bioterrorist agent would be one that is not routinely seen in the population. this would mean that the population would be particularly susceptible due to a lack of
herd immunity
acyclovir is used in the treatment of __________
herpes simplex virus infection
a relatively long __________ for many infectious agents plays a factor in their tactical usefulness, as ppl may spread a pathogen for a long time before becoming symptomatic w/ it
incubation period
CIDRAP
infectious disease preparedness
the practices of personal and public health can be brought to bear on the prevention and control of ______
infectious diseases
which form of anthrax poses the greatest threat?
inhalation anthrax
Bacteriostatic
inhibits growth of bacteria
Progress in ________ has resulted in a dramatic increase in the number of living immune compromised patients
medical advances such as organ transplants OR and immune suppressive treatment
In a sense, our partners in life are
microbes
_____ are essential for the maintenance of life on the planet, and others have been harnessed for a better quality of life
microbes
OIE (world org for animal health)
mission to improving animal health international
biological agents and the diseases the cause have been categorized into three groups based on their risk to the ________
nation's security
The cruise ship industry has been subject to waves of criticism because of outbreaks caused by
norovirus
smallpox as a bioweapon
not enough vaccines 30% fatality
the antibiotic tetracycline interferes w/ the synthesis of _______
proteins
Interferons
proteins (cytokines) secreted by T cells and other cells to aid and regulate the immune response
one health concept
recognizes that the health of people is connected to the health of animals and the environment; worldwide transdisciplinary approach
Continued advancement in society's understanding of its environment and establishes direction for future investigation is accomplished by
research
Criteria for assessing eradicability of diseases & conditions: scientific feasibility vs political will/popular support
scientific feasibility: - no nonhuman reservoir - effective vaccine or treatment - feasibility of elimination Political/pop support: - perceived burden of disease (death) - need for eradication vs control
streptomycin acts on bacterial ________
small unit of the ribosome and 16sRNA (protein synthesis)
_____ was the first infectious disease eradicated from the world in 1980
smallpox
which disease has been eliminated from the human population, but still exists as frozen samples and may be used as a bioweapon?
smallpox
biological weapons
so-called germ warfare; the use of bacteria, viruses, and parasites on a large scale to incapacitate or destroy a population
what makes anthrax an ideal weapon
stability of endopores which are also relatively cheap to manufacture.
interfere with metabolic reactions
sulfa drugs isoniazid trimethoprim
Glyphosate (Roundup)
systemic herbicide used to control perennial grasses; - very water soluble - doesn't bioaccumulate - metabolized by soil microorganisms - half-life 60 days in the environment
oligodynamic effect
takes very few molecules of a heavy metal to kill or be toxic to microbes
chlorine bleach
Recommended disinfectant that is used by mixing with water at a ratio of 1:10
hand washing
The most important part of personal hygiene. - with soap
Inhalation anthrax
(1) Exposed person may develop dry cough, mild chest pain, fever, fatigue (2) Not transmitted from person to person (3) Tx = COMBO of ATB's (4) Fatality rate = 95 - 100%
List and briefly discuss at least three advantages and three disadvantages of biological weapons.
- Advantages include the sparing of physical surroundings, its low cost, and the fact that it is so incapacitating. - Disadvantages include public aversion, the fact that they may backfire, and that environmental factors may limit its power.
List and briefly explain three different mechanisms by which bacteria become resistant to antibiotics.
- Alteration of the target of the drug by preventing binding - Inactivation of the drug by an enzyme produced by the bacterium - Keeping the drug away from the target by decreasing membrane permeability or quickly expelling it from the bacteria (tetracycline)
How is the US government preparing for acts of bioterrorism?
- The CDC is protecting and monitoring dangerous and infectious pathogens - We have developed methods to thoroughly detect and track infections - We are stockpiling pharmaceuticals that treat illnesses we believe to be potentially used as acts of bioterrorism - We are expanding on research of biological weapons
List three innovations in medicine since the 1900s that may have played a role in the increase in life expectancy.
- The development of man made insulin helped people whose bodies produce none or an insufficient amount. - The discovery of pasteurization helped kill microbes in milk and other foods. - With penicillin, we can now treat and minimize the damage of bacterial infections that were previously harmful or deadly.
criticisms of anthrax vaccine
- difficult immunization schedule (5-6 shots over 18 months) - annual booster required - not proven effective against inhalation anthrax
characteristics that led to eradication of smallpox
- disease only of humans; no natural/biological reservoirs - infection is easily diagnosed (characteristic rash) - limited duration/intensity - recovery= permanent immunity - one-dose vaccine - vaccine leave scar as sign of being immune
local level disease control (community, city, health department)
- reflect pop size - health departments focus on prevention of disease and promotion of health within jurisdiction - food and water sanitation - restaurants
Clinical Challenges to antibiotic therapy
- slow growing bac (TB) - biofilm (resistant to antibiotics)
US Public Health Service (PHS)
-Headed by the U.S. Surgeon General -6000 Commissioned Corps members and staff -In 1912, became PHS, previously the Marine Hospital Service -Promotes public health through immunization programs, education of the public, and research into infectious disease and its treatment
interfere with nucleic acid synthesis
-Rifamycin (RNA transcription) -Nalidixic acid (DNA replication) - quinolones
CDC (national)
-detect and investigate health problems -conduct research to enhance prevention -develop/advocate sound public health policies -implement prevention strategies -promote health behavior -foster safe/heathful environments -leadership/training -nation's main line of defense against epidemics and plagues -hold deadly microbes
List 3-4 microbes or infectious agents that are difficult to inactivate with disinfectants.
1. Bacterial spores, such as anthrax, are difficult to inactivate. They cannot be killed via boiling because they typically have a hard barrier that is difficult to penetrate. 2. Prions are the most difficult to inactivate because they must be autoclaved at about 266 degrees fahrenheit for 4.5 hours while other infectious agents usually only have to be sterilized for a minimum of 15 minutes. 3. Helminth eggs are difficult to disinfect because they require being soaked in very strong, specific disinfectants for a longer period of time (at least an hour).
Mechanisms of antibiotic resistance
1. Enzymatic destruction of drug 2. Prevention of penetration of drug 3. Alteration of drug's target site 4. Rapid ejection of the drug
Transposons (jumping genes)
DNA segments that can move to new location on same/different chromosome; 2 types: insertion sequences consist of only one gene that codes for enzyme that just transports it (transposase); complex transposons code for extra: replication, antibiotic resistance, etc. Insertion of transposons into another region could cause mutation (little to no effect).
Cite three landmark treaties associated with biological warfare. Describe each treaty and give an approximate date for each.
1. The 1925 Geneva Protocol prohibited the use of asphyxiating, poisonous, or other gases or bacteriological methods in war. It didn't prohibit basic research of biological weapons. 2. The 1972 Biological Weapons Convention treaty prohibited the development, production, and stockpiling of biological and toxic weapons within nine months of signing. 3. The 1977 ENMOD Convention prohibited military or any other hostile use of environmental modification
4 ways a public health emergency threatens national security
1. puts pressure on a country's economy at both micro and macro levels 2. causes social disruption 3. leads to political destabilization 4. affects nantional defense
FAO (Food and Agriculture Organization)
A United Nations agency that works on international efforts to defeat hunger by helping developing countries modernize and improve agriculture, forestry and fisheries practices.
an antibiotic that halts growth, but doesn't outright kill a bacterium is referred to as being _________
bacteriostatic
American Red Cross
A disaster relief organization founded in Washington, D.C. on May 21, 1881 by Clara Barton to aid US military and conduct peace time relief work. - humanitarian nonprofit volunteer organization - 40% blood supply 1. ppl affected by disasters in US 2. support for military and families 3. blood collection, processing, distribution 4. health/safety education and training 5. international relief and development
Federal Emergency Management Agency (FEMA)
A federal agency responsible for disaster preparedness, response and recovery. Now under Department of Homeland Security.
Bt toxin
A natural insecticide made by the bacterium Bacillus thuringiensis that kills some kinds of caterpillar.
World Bank
A specialized agency of the United Nations that makes loans to countries for economic development, trade promotion, and debt consolidation. Its formal name is the International Bank for Reconstruction and Development.
Which of the following is NOT an antibiotic?
A. chloramphenicol B. erthromycin C. INTERFERON D. Penicillin
Why is anthrax on the list of biological weapons?
Anthrax is on the list of biological weapons because it is easy to grow, infect people with, disperse and it's not easy to treat or detect.
List at least five ways in which microbes have challenged their hosts throughout history and have influenced the course of civilization.
Antibiotic drug resistance has caused us to seek new means to fight bacteria, vector borne diseases (like malaria), the flu mutations make us have to prepare for and anticipate each strain, polio devised and handicapped many, infected food made us find ways to better prepare and store food products, and pandemic-causing diseases led us to create worldwide surveillance systems.
Which of the following can be used on skin?
Antiseptic wipe
___ is the city that is the headquarters of the CDC
Atlanta, GA
Which of the following should be used to sterilize a solution of saline for use in hospital?
Autoclave
Which of the following is a bacterial enzyme that can inactivate penicillin?
B-lactamase
Describe a clinical situation when it might be best to use a bacteriostatic antibiotic.
Bacteriostatic antibiotics would best be used in a situation where a patient is suffering from meningitis which inhibits the growth of new bacterial cells so that the body's defense mechanisms can fight it off itself. This is necessary because it is difficult for antibiotics to reach the infected areas and kill the bacterial themselves.
Which might provide an advantage for bacteria growing on an intravenous catheter?
Biofilm formation
a bacterial toxin, called _______, which kills insects that ingest it has been added to crop plans to protect them from insect predation
Bt
which agency is not part of the coordinated framework for the regulation of biotech?
CDC
which protein cuts DNA at a specific region, based on an RNA guide?
CRISPR
interferes with cell wall synthesis
Carbapenems penicillin vancomycin
_____ is a category A bacterium that produces a toxin that causes double vision, blurred vision, slurred speech, difficulty swallowing, dry mouth, muscle weakness, and paralysis of breathing muscles, leading to death.
Clostridium botulinum
Which mechanism is most likely to be involved in the spread of antibiotic resistance from one bacterium to another?
Conjunction
Briefly describe the three types of anthrax and how they are acquired
Cutaneous (skin) anthrax is acquired via animals, gastrointestinal anthrax is acquired by eating poorly cooked infected meat, and inhalation anthrax is acquired by inhalation of spores.
Which of the following is generally the most resistant to disinfection?
Mycobacteria
Narrow spectrum antibiotics
Effective against specific bacteria
Cutaneous anthrax
Endospores enter through minor cut 20% mortality
Which agency focuses on the safety of foods, vaccines, antibiotics, and other medicinal and medical products?
FDA
Which agency has oversight for approval of new drugs in the US?
FDA
Which army facility has been involved in biological warfare defense?
Fort Dentrick
WHO (international)
Geneva, Switzerland - uses surveillance and communication systems to track microbial diseases on global level -
which virus was recently altered to make it more dangerous
H5N1 influenza A
the scientific and medical community once found it difficult to accept that stomach and intestinal ulcers are caused by ______, a bacterium present in the acidic environment of the stomach
Helicobacter pylori
State your opinion on the use of genetically modified crops, in general.
I am all for innovation but I worry about some of the adverse effects of genetically modified plants because it is changing nature itself. There is a balance to nature that this may negatively affect. However, over time, I'm sure nature will adapt. But, will it adapt in a way that we like?
Explain the importance of real-time infectious disease surveillance on a worldwide basis.
Infectious diseases are worldwide and with all of the technological advances we have to easily and quickly move around the world, we need a system that closely monitors any outbreaks because they can easily turn into pandemics. In today's age, we are very much so all connected.
gastrointestinal anthrax
Ingestion of undercooked, contaminated food 50% mortality
which agency is the primary support of medical research in the US
NIH
Discuss why infectious disease outbreaks occur after natural catastrophic events.
Natural catastrophic events may cause disrupted sanitation systems, physical trauma, or disrupt the environment that leave room for infectious agents to flourish and take advantage. Changes in the environment after a catastrophic event can set conditions up for disease e.g. flooding creates more breeding grounds for mosquitoes which harbor viruses, deforestation via fires may result in the loss of habitat of an animal/mammal that is a carrier of a pathogen that can infect humans. The animal/mammal may encroach into areas where humans reside.
From a Darwinian point of view, describe the emergence of antibiotic-resistant strains
Natural selection favors the survival of bacteria that are resistant to antibiotics that would kill it.
Which interferes with influenza virus release from host cells?
Oseltamivir
Explain why partnerships are needed to make enormous health strides in many countries.
Partnerships are needed because without sharing of funds, talents, and resources between levels and sectors, tackling infectious disease would be incredibly difficult. - Partnerships are needed in order to pool resources, talents, skills, and technologies in order to meet microbial challenges on a worldwide scale.
Penicillin acts on the synthesis of which of the following bacterial components?
Peptidoglycan
autoclave
Piece of equipment used to sterilize articles by way of steam under pressure and/or dry heat
isopropyl alcohol
Rubbing alcohol; 70% alcohol solution used as a cleaner
List at least five examples of advancements in technology that have dramatically improved the lifespan and health of humans.
Some examples include vaccines, water filtration, the creation of international health organizations, waste treatment, and patient testing.
Create a list of items that should be included in an emergency supply kit if a pandemic were to occur.
Some things that should be included in a pandemic preparation kit are first aid kit, water, non perishable foods (staples), disinfectants, masks, gloves, over-the-counter & prescription meds, batteries, matches, money, etc
interferes with protein synthesis
Tetracycline aminoglycosides chloramphenicol erthromcin
how does the Coordinated Framework for the Regulation of Biotech regulate genetic engineering in the US?
The Coordinated Framework for the Regulation of Biotechnology includes three different agencies that create safety regulations for specific applications of genetic engineering.
Penicillin is not toxic for humans because it interrupts bacterial
cell wall synthesis
list features of mycobacteria TB that make it difficult to treat
The long generation time and mycolic acids of the cell wall which reduce antibiotic permeability make it difficult to treat TB patients. They need a long course of antibiotic therapy.
horizontal gene transfer
The transfer of genes from one genome to another through mechanisms such as transposable elements, plasmid exchange, viral activity, and perhaps fusions of different organisms.
Explain the following statement in your own words: "The ongoing saga of infectious diseases is a reflection of the ongoing evolutionary dance."
This quote means that infectious diseases are not a simple battle because they parallel evolution. They shift and change in a fight to survive and reproduce just like any other living creature, This means that over time we will have to adjust our methods while infectious diseases do the same. Microbes adapt and evolve rapidly.
Department of Homeland Security
US federal agency created in 2002 to coordinate national efforts against terrorism
antiviral drugs
Used to treat infections caused by viruses other than HIV - interfere w/ viral replication sparing host cells - amp up immune response
antibiotic misuse
Using outdated or weakened antibiotics Using antibiotics for the common cold and other inappropriate conditions Using antibiotics in animal feed Failing to complete the prescribed regimen Using someone else's leftover prescription
______ are circular extrachromosomal DNA elements that carry antibiotic resistance genes
plasmids
What is the controversy surrounding genetically modified crop plants, such as Bt corn?
While GMOs help protect plants from insects, the controversy rallies around the idea that this may have adverse effects such as harming butterflies, declining the bee populations, and causing allergies.
interferes with cell membrane function
polymyxins
a new form of bioweaponry, called _________, is associated w/ small groups of ppl, not governments, intentionally releasing pathogens with the intent of making ppl sick and causing civil unrest
biological terrorism
Failures in _________ will often result in the accidental exposure of ppl to pathogens
biosafety
failures in ______ may result in a pop being targeted by pathogens spread by terrorists or foreign govs
biosecurity
the fundamental cause of disadvantaged populations suffering more than their fair share of infectious diseases is ____
poverty
which of the following is a category A biological agent
a. brucella spp. b. variola virus**** c. mycobacterium tb d. yellow fever virus
broad spectrum antibiotics
affect a broad range of gram-positive or gram-negative bacteria; used when patient is very ill and they don't know what they're infected with con: normal microbiota are killed too causing oral thrush or yeast infection
Bacteriocidal
agents that kill bacterial cells
FDA (Food and Drug Administration)
an agency in charge of ensuring the safety of all foods sold except meat, poultry, and seafood
biological terrorism
an intentional release of viruses, bacteria, or their toxins for the purpose of harming or killing.
Pan American Health Organization (PAHO)
an international public health agency with 100 years of experience in working to improve health and living standards of the countries of the Americas. PAHO serves as the specialized organization for health of the Inter-American System. It also serves as the Regional Office for the Americas of the World Health Organization and enjoys international recognition as part of the United Nations system.
UNICEF (United Nations Children's Fund)
an international watchdog and relief organization for children (providing healthcare, immunizations, safe water, sanitation, nutrition, education, emergency relief
Despite major advances in sanitation and the availability of clean water, antibiotics, and immunization, microbial diseases remain
an ongoing battle
An epidemic of __________ occurred in Sverdlovsk, Soviet Union in 1979.
anthrax
sanitation, vaccines and ____ have made enormous strides against pathogenic microbes
antibiotics
Microbes may act as causative agents, as cofactors, or as _____ that cause damage through autoimmune reactions
antigens or triggers
________ can be used on skin before drawing blood
antiseptics
Superbugs
bacteria that are resistant to large numbers of antibiotics
why are antibiotics no longer added to hand soap
dual resistance. Studies have found no advantage in using soaps supplemented with antibacterial chemicals vs. plain soap and water.
Travelers may get more than they bargained for including a belly full of worms and malaria by
ecotourism
International task force for disease eradication
formed at The Carter Center in 1988 to evaluate disease control and prevention and the potential for eradicating other infectious diseases
researchers and regulatory agencies are concerned w/ ___________ mutation work being done on deadly pathogens bc they are concerned they will fall ino the wrong hands
gain of function
CRISPR
gene editing tool Cas9 proteins - make precise changes to the dna - can be used to target and destroy antibiotic resistance genes in MRSA, edit out embedded HIV, & add wildtype (functional) gene info in place of dysfunctional gene info - too easy
The expression of a gene from one species in another specie is called _____
germline modifications
the 2015 Napa conference recommended a ban on _____, or changes to a organism's genome that can be passed on to offspring
germline mutation
United Nations Foundation
global health issues, partner with UN
________ are the hardest infectious agents to destroy or inactivate
prions
NIH
one of the largest medical research centers
______ are the most susceptible to opportunist infections
organ recipients
heating milk to reduce the number of pathogenic microbes
pasteurization
______ is/are an example of a drug that has bactericidal activity
penicillin
MSF (Médecins Sans Frontières / Doctors Without Borders)
physicians travel around the world to help ppl (Ebola)
private sector
the part of the economy that involves the transactions of individuals and businesses - Rotary: professionals network, exchange ideas, and give back to communities; promote peace, fight disease, clean water, education; helped eradicate polio - Rockefeller Trust: promote the well-being of humanity worldwide; eradicate hookworm, yellow fever vaccine - Bill & Melinda Gates Foundation: pledges over $100 million for vaccine to prevent HIV infection
biological warfare
the use of toxins of biological origin or microorganisms as weapons of war.
when is it best to use bacteriostatic antibiotics
to treat severely ill patients and immunocompromised patients
vertical gene transfer
transfer of genes from an organism to its offspring
Antiseptic
used to kill bacteria in skin cuts and wounds or at a surgical site - can cause antibiotic resistance - takes 9 hrs to be more effective than soup
______ are used as effective, safe, preparations that induce long-lasting immunity and prevents infections caused by specific microbes or viruses
vaccines
the ________ of a pathogenic organism is its ability to cause harm in the form of disease symptoms, not necessarily death
virulence
____ are used in the cdc blog to educate the public about emergency preparedness
zombies
