EXAM III REVIEW

Interactions
1. What are Kochs postulates? How do they differ from the molecular postulates? Kochs Postulates The microorganism must be present in every case of the disease The microorganism must be grown in pure culture from the diseased host The same disease must be reproduced when a pure microorganism is inoculated into a healthy, susceptible host The microorganism must then be recovered from the experimentally infected host The Molecular Postulates The gene or its disease causing product (virulence factor) should be found in pathogenic strains but not in nonpathogenic strains of the suspected organism

2.

Name three functions of the normal flora. Prevents the growth of pathogens by covering surfaces, secreting toxic substances, and competing for nutrients Stimulate the immune system Provide important nutrients and help degradation of food

3.

What are the three ways microbes can interact with humans? Give an example of an organism for each.(SYMBIOTIC) Mutualism An association where both organisms benefit E. coli provides us with Vit. K and certain B vitamins, while we provide it with nutrients and shelter Commensalism An association where one organism benefits and the other is neither helped nor harmed Proprionibacterium live off of skin secretions, but generally dont harm or help Parasitism The microbe benefits at the expense of the host ANY INFECTIOUS DISEASE CAUSING MICROBE

4.

What are the six things that a successful pathogen must be able to do in order to cause disease? Transmission Adherence Colonization and/or invasion Damage to the host Exit host Survive outside host long enough to repeat

5.

What are the four main sources of infectious agents? Soil Water Animals Other humans

6.

What are exotoxins? What is endotoxin? Name two specific exotoxins and the microorganism that produces each. (note: the answer here is not A-B type and superantigen. Give very specific examples) Many bacteria secrete exotoxins that are responsible for many disease signs and symptoms Exotoxins have a variety of functions, and many are powerful poisons Tetanus toxin- Colostridium tetani Cholera toxin- Vibrio cholerae TSST-1 Staph aureus

If you come up with one not on this list you might get an extra point.
Endotoxin-Lipid A

7.

How does diarrhea help bacteria in the infection process? Provides an opportunity to exit from the host The characters on "Desperate Housewives" seem to share quite a few bodily fluids (and probably associated infections) on a weekly basis. What mode of transmission is this? What are some infectious diseases they may have "shared" (name 3)? There are many possible answers! For each example you cite, explain how the microorganism is transmitted (saliva, blood, etc.), and name two symptoms of the disease. Indicate if each disease can be treated, and how. Strep throat- Sore throat, coughing, fever- treatment AbX- spread by direct and indirect contact. Herpes- clusters of small red bumps, which become blisters that break open and ulcerate- There is no treatment and is spread by direct contact. Chlamydia- Inflammation of the urethra, pain during urination, discharge- Treatment includes AbX- Spread by direct contact. Basically anything you can give to the person through direct contact, know what it causes and how/if you can treat it(vaguely)

8.

9.

What are three ways humans use to prevent microbial adherence? What are two ways bacteria use to adhere to our tissues? Humans have mucous, tightly packed cells, and shedding cells that prevent microbial adherence Bacteria use pilli and capsules

10. Name the three ways a microorganism can associate with the host, and briefly explain each Extracellular pathogens Reproduce in the spaces and fluids outside cells These bacteria often cause disease with toxins Facultative intracellular pathogens These can multiply either inside or outside of a cell Obligate intracellular pathogens Can only replicate inside a cell

Epidemiology
An eight-month old infant present at the emergency department with a fever of 38.5 C. Her parents report that she seems very irritable, as seems to be in a lot of discomfort. She is covered in large blisters, some of which have burst and have resulted in large patches of peeling skin. The infant has not been in contact with any hot liquids or surfaces. There arent any other cases like this in the hospital. 1. What are the signs of this illness? The fever of 38.5c,Peeling skin, blisters

2. What are the symptoms of this illness? Irritability and discomfort

3. Would you consider this disease to be sporadic, endemic, epidemic, or pandemic? Why? Sporadic, because there arent any other cases like this in the hospital.

4. Is this disease likely spread by direct or indirect contact? Explain your answer. Direct, although her parents arent showing any of the signs or symptoms the infant has a weaker immune system.

5. From what disease is this girl likely suffering? Is it communicable? Explain your answer. Staphylococcal scalded skin syndrome (SSSS

Causative agent - Staphylococcus aureus strains that produce epidermolytic toxin. It is communicable, Transmitted Person-to-person, usually seen in newborns Questions 6 10 relate to the following scenario:

An older gentleman, who resides at an assisted-living facility, has been admitted to the hospital. He is dehydrated, and he and his carerreport that he has repeated bloody diarrhea and terrible abdominal cramping. You note that he has a fever of 39.0 C. He is feeling very weak. This is the seventh case that your hospital has admitted in the past 48 hours with similar issues. Normally, there are few/no cases of bloody diarrhea. 6. What are the signs of this illness? A fever of 39.0C, Repaeted bloody diarrhea

7. What are the symptoms of this disease? Abdominal cramping, weakness, dehydrated.

8. Would you consider this disease to be sporadic, endemic, epidemic, or pandemic? Why? Localized epidemic the number of cases increased all at once.

9. Is this disease communicable? Explain your answer. Yes, because it seems to be spreading through the senior home.

10. From what disease is this man suffering? Why is this disease more common in facilities like the one where the man resides? Dysentery, its more common in these facilities because you have a lot of elderly persons with weaker immune systems

Gastrointestinal
1. Why is it advantageous for Shigella to spread cell to cell? It avoids the humoral immune response. 2. In at least two paragraphs, discuss the importance of Mary Mallon in public health (DO NOT simply retell her story) 3. How does cholera toxin cause diarrhea? How does cholera differ from shigellosis? Cholera toxin is an A-B type toxin that causes cells of the small intestine to secrete chloride ions, and therefore water

4. List the four types of E. coli infection, and give a description for each (abbreviations not accepted) Enterotoxigenic Travellers diarrhea Enteroinvasive Attaching and effacing, removes microvilli in intestine Enteropathogenic- shiga-like toxin Enterohemorrhagiccauses Hemolytic uremic syndrome (HUS) 5. What is Guillian-Barre syndrome and how is it linked to a common type of gastroenteritis? Campylobacter jejuni has a lipid molecule on it surface similar to those found on nerve cells which is why it is linked to Gullian- Barre syndrome. 6. What are the two major types of infection by Salmonella, and how do they differ? Salmonella enterica S. enterica . Signs and symptoms include severe abdominal cramping, nausea, diarrhea, and a moderate fever (Cells invade intestinal epithelia NOT USUALLY FATAL. Localized. S. typhi, a human specific pathogen causes typhoid fever. MOST LIKELY FATAL Systemic infection, not localized.

Staph/Strep/STDs
1. What bacterial species is most likely to cause UTIs? From where does it usually come? E. coli usually originates from your normal fecal flora 2. What is the most common bacterial STD in the US? What are the signs/symptoms in men and women? CHALMYDIA Men- Inflammation of the urethra, pain during urination, and a thick, pus-containing discharge Women-inflammation of the urethra, epididymis, and fallopian tubes being common 3. In three paragraphs or more, discuss the Tuskegee Syphilis Study, and its implications for ethical medical research. Your opinions are welcome. (To be typed and turned in on test day) Six points

4. Briefly discuss the significance of the vaccine for certain strains of HPV. HPV associates with several types of cancer, and it can be vaccinated against, why wouldnt you want to get vaccinated for something that can prevent CANCER! 5. A man presents in his doctors office complaining of painful urination and purulent discharge. What would you test for, and why? What factors would you consider, and what would be your recommended treatment? We would test for Gonorrhea and Chlamydia considering the pus-like discharge by taking an inoculated culture recommended treatment would be Penicillin, but many resistant; cephalosporin would be the next option.

6. What are the three stages of syphilis? Give a brief description of each.

Primary- The lesions at this stage are called chancres, and are often painless Secondary-(2-10 weeks after primary) Flu-like symptoms Rash that involves the soles and palms Tertiary characterized by a hypersensitivity reaction to a small number of organisms still in the tissues. Can cause aneurysms, especially of the aorta and can cause gumma

7. What are the three major causes of UTIs? SEX, Catheterization, and Surgery/anesthesia 8. Why are women more likely than men to acquire a UTI? Shorter urethra 9. You are called in to treat a newborn with a rash. The baby looks as if she were doused in boiling water. Her skin is peeling off, she is irritable, and you discover a small cut that appears to be infected. What infection is afflicting this child? What toxin is responsible? Staphylococcal scalded skin syndrome (SSSS), epidermolytic toxin 10. Compare and contrast Streptococcus pyogenes and Staphylococcus aureus. Staphylococcus aureus Gram + Cocci In clusters Catalase + Protein A Streptococcus pyogenes Gram + cocci In chains Catalase (no H2O) M- Protein

11. What are the signs/symptoms of impetigo? What organisms can cause impetigo? How is it treated? Blisters that crack and weep plasma and pus; formation of golden colored crusts; lymph nodes enlarge Oral penicillin if known to be S. pyogenes, otherwise it is Staphylococcus aureus and an anti-staph antibiotic orally or topically 12. What toxin does S. aureus possess to cause Toxic Shock Syndrome? What can be done to treat and prevent this disease? Toxic Shock Syndrome Toxin-1 it is a super antigen. Prevention - Prompt treatment of serious S. aureus infections; frequent changing of tampons Treatment - Anti-staph medications 13. Why are scientists so worried about drug-resistant Streptococcus pneumoniae? Before AbX it caused huge epidemics, with high death rates. If it becomes drug resistant it could come back.