Term
1. What are the characteristics of the Influenza virus? |
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Definition
1. Enveloped, with segmented, single-stranded, negative-sense RNA genomes |
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Term
2. What part of the influenza virus must fuse with the host cell membrane to transfer the virus? |
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Definition
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Term
3. What is the basis for emergence of new pandemic strains? |
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Definition
3. segmented genome allows reassortment |
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Term
4. What 3 proteins are located on the influenza envelope? |
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Definition
4. Hemagglutinin, Neuraminidase, M2 |
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Term
5. Which proteins on the flu virus are targets for neutralizing antibodies? |
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Definition
5. Hemagglutinin, Neuraminidase |
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Term
6. Which protein is essential for the infectivity of the flu virus? |
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Definition
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Term
7. What is the replication scheme for the flu virus? |
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Definition
7. 1. Entry through receptor mediated endocytosis 2. Low pH of endosome required for infectivity 3. Replication in nucleus |
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Term
8. Does the flu virus need a symport to release the virus into the host cell? |
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Definition
8. No, low pH of endosome opens M2 channel and releases virus |
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Term
9. Why does the flu virus have to replicate in the nucleus? |
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Definition
9. mRNA spliced, requires capped mRNAs from host (cap-stealing) |
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Term
10. How can Influenza A, B, and C be distinguished ? |
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Definition
10. Antigenic Differences between their nucleocapsid (NP) and Matrix (M) proteins |
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Term
11. What influenza infects Humans only? |
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Definition
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Term
12. What species can the Influenza A virus infect? |
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Definition
12. humans, pigs, horses, avian species, aquatic mammals |
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Term
13. Which flu virus can infect humans and pigs? |
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Definition
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Term
14. How many distinct RNA segments does Flu A and B have? |
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Definition
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Term
15. Why does Flu C on contain 7 RNA segments? |
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Definition
15. 2 segments are found on the same protein |
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Term
16. Influenza A is subdivided into subtypes and designated by 5 things, whats the only part you need to know about? |
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Definition
16. The antigenic description of the HA and NA molecules (EX. H3N2, H1N1) |
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Term
17. What part of the body is Influenza isolated to? |
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Definition
17. Respiratory Tract, Upper and Lower |
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Term
18. How is Flu mainly spread? |
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Definition
18. Aerosol droplets (coughing, sneezing) |
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Term
19. After infection of Flu virus when do virus titer peak? |
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Definition
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Term
20. How long does it take for a person to stop shedding the Flu virus after infection? |
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Definition
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Term
21. What does influenza induce in the body that contributes to recovery? |
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Definition
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Term
22. Where is the antibody response found in the body? |
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Definition
22. Both Serum and Secretory |
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Term
23. What is the incubation period for the Flu virus? |
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Definition
23. Short 24hrs, can be up to 4-5 days |
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Term
24. What are the initial symptoms of the Flu? |
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Definition
24. Headache, chills, and dry cough |
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Term
25. What follows the initial symptoms of the Flu? |
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Definition
25. high fever, myalgias, malaise, anorexia |
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Term
26. After the fever resolves from the flu how long can cough and weakness persist? |
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Definition
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Term
27. How do the symptoms of the flu differ in children and adults? |
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Definition
27. Children have higher fever – can result in convulsions, higer incidence of vomiting and abdominal pain |
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Term
28. What are some complications of Influenza if the virus is not cleared? |
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Definition
28. Primary viral Pneumonia, Combined viral-bacterial pneumonia, Bacterial pneumonia, Reye’s syndrome |
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Term
29. What population is at high risk of developing Primary Viral pneumonia after the flu? |
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Definition
29. Elderly, Patients with cardiopulmonary disease |
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Term
30. How soon after onset of illness can influenza progress to Primary viral pneumonia? |
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Definition
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Term
31. If an elderly patient presents with Flu and shortly after develops tachypnea, tachycardia, cyanosis, high fever and hypotension, What are you worried about and how can you treat him? |
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Definition
31. Primary viral pneumonia, Supportive treatment and Antivirals, monitor for bacterial superinfection |
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Term
32. What is a more likely complication of flu then primary viral pneumonia? |
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Definition
32. Combined viral-bacterial pneumonia |
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Term
33. How is viral-bacterial pneumonia distinguished from primary viral pneumonia? |
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Definition
33. onset is usually delayed in viral-bacterial pneumonia |
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Term
34. A patient develops shaking chills, pleuritic chest pain, and productive cough, 4 days after improving from the flu, what’s wrong? |
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Definition
34. Influenza followed by bacterial pneumonia |
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Term
35. What are the most common culprits of bacterial pneumonia after the Flu? |
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Definition
35. S. pneumonia, S. Aureus, H. influenza |
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Term
36. What are some atypical causes of bacterial pneumonia? |
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Definition
36. M. pneumonia, Chlamydia pneumonia |
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Term
37. What syndrome is characteristic of noninflammatory cerebral edema and fatty infiltration of the liver? |
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Definition
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Term
38. What does Reye’s syndrome result in, how is this tested? |
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Definition
38. severe hepatic dysfunction, elevated serum transaminase and ammonia levels |
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Term
39. What type of Antigenic variation results from minor point mutations in a single HA gene? |
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Definition
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Term
40. How does antigenic shift change the Influenza virus? |
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Definition
40. major antigenic changes that result from replacement of either the HA or NA gene segment (Ex. H1 àH3) |
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Term
41. What type of antigenic variation is responsible for most of the major influenza pandemics? |
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Definition
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Term
42. What is the definition of a pandemic strain? |
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Definition
42. New subtype with no existing human immunity, highly pathogenic, transmitted easily between humans |
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Term
43. What type of tests are available to detect influenza A and B? |
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Definition
43. immunoassay-based nasopharyngeal swabs |
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Term
44. How are inactivated vaccines made and how are they administered? |
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Definition
44. purified virus grown in eggs, whole virus or subvirion, inactivated with formalin or β-propiolactone, Administered IM |
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Term
45. T/F The inactivated vaccine protects against influenza infection. |
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Definition
45. F – Does not protect against infection but induces resistance to illness |
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Term
46. Who is approved for the Live vaccine FluMist? |
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Definition
46. Healthy kids 2-17, Health Adults 18-49 |
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Term
47. This year who does the CDC recommend get the Flu vaccine? |
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Definition
47. EVERYONE – Universal Influenza Vaccination |
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Term
48. Who is the influenza vaccine recommended for? |
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Definition
48. Pregnant women in 2nd-3rd trimester during flu season, Healthy kids 6mo-5yrs, People 50+yrs, Any age with Chronic medical conditions, Nursing home residents and providers, People who care for those at high risk, Children/Teens with long-term aspirin therapy |
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Term
49. How do Amantadine and Rimantadine work as antiviral agents? |
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Definition
49. Inhibits the M2 ion channel of influenza A |
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Term
50. Who are amantadine and Rimantadine used for? |
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Definition
50. individuals at high risk, people with egg allergies that can’t receive flu vaccine |
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Term
51. T/F Resistance to Aniviral Agents can develop. |
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Definition
51. T – results from single amino acid substitutions in the transmembrane domain of the M2 channel; H3N2 and H1N1 are resistant |
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Term
52. How do Neuraminidase inhibitors work as antiviral agents? |
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Definition
52. inhibit virus release, limiting spread |
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Term
53. What are 2 types of Neuraminidase inhibitors? |
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Definition
53. Relenza (zanamivir), Tamiflu (oseltamivir phosphate) |
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Term
54. When do Neuraminidase inhibitors need to be administered to be most effective? |
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Definition
54. within 48 hrs of symptoms developing |
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Term
55. What is different about the Paramyxoviruses compared to the Influenza viruses? |
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Definition
55. Paramyxoviruses are nonsegmented |
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Term
56. What are the characteristics of a paramyovirus? |
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Definition
56. Consist of 2 Subfamilies, containing 5 genera, Enveloped, Nonsegmented, negative stranded RNAviruses |
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Term
57. Where do paramyxoviruses replicate? |
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Definition
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Term
58. What is an important characteristic of paramyxoviruses that can cause syncytia formation? |
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Definition
58. They fuse at the cell surface |
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Term
59. What respiratory pathogen is important in infants and children? |
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Definition
59. Human parainfluenza viruses (hPIV) |
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Term
60. What are the major causes of croup? |
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Definition
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Term
61. What are the major causes of pneumonia and bronchiolitis? |
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Definition
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Term
62. What is hPIV4 linked to? |
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Definition
62. mild upper respiratory illnesses |
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Term
63. Where do PIVs initially infect? |
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Definition
63. mucous membranes of nose and throat |
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Term
64. What can severe hPIV3 infections result in? |
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Definition
64. bronchopneumonia, bronchiolitis, bronchitis |
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Term
65. What are the typical symptoms of hPIV infection in children? |
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Definition
65. cough, hoarseness and fever |
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Term
66. If a childs cough becomes brassy, “seal-like” or barking and stridor ensues, what has developed? |
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Definition
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Term
67. What other viral infection can cause the same hPIV Croup symptoms? |
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Definition
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Term
68. Chlamydia trachomatis can cause similar symptoms to what virus? |
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Definition
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Term
69. What pathogens can cause bronchitis similar to hPIVs? |
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Definition
69. Streptococcus pneumonia, Mycoplasma pneumonia |
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Term
70. Can symptoms of adenovirus, rhinovirus, or coronavirus be distinguished from mild cases of hPIV infection? |
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Definition
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Term
71. When are hPIV 1 and 2 infections most common? |
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Definition
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Term
72. If croup develops in the winter months what is usually the culprit? |
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Definition
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Term
73. How are hPIVs transmitted? |
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Definition
73. direct contact, large droplet spread |
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Term
74. T/F Reinfection with the same serotype of PIV is uncommon. |
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Definition
74. F – common and can occur relatively quickly |
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Term
75. T/F There are no vaccines or antivirals used for hPIVs. |
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Definition
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Term
76. What is responsible for many lower respiratory tract infections in children? |
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Definition
76. Human metapneumovirus (hMPV) |
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Term
77. What is the MOST important cause of viral lower respiratory tract disease in infants and children worldwide? |
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Definition
77. Respiratory Syncytial Virus (RSV) |
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Term
78. Where does RSV initially infect? |
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Definition
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Term
79. If RSV spreads to the lower respiratory tract, how long does it take and what are the symptoms? |
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Definition
79. 1-3 days, cough and low-grade fever develop |
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Term
80. T/F RSV can cause permanent lung damage and the development of asthma. |
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Definition
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Term
81. Where can RSV antigens be found? |
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Definition
81. both epithelium and in exfoliated epithelia cells plugging the airways |
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Term
82. T/F RSV is uncommon in adults. |
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Definition
82. F – common in normal adults; symptoms – rhinorrhea, cough, headache, fatigue, fever |
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Term
83. What patients are at high risk for RSV |
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Definition
83. premature infants, children with chronic lung disease, Premature infants <1yr at start of RSV season |
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Term
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Definition
84. Large droplet or Fomite contamination |
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Term
85. What the heck is a Fomite? |
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Definition
85. any inanimate object or substance capable of carrying infectious organisms (ex. bedding, cloth, stethoscope) |
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Term
86. What is the treatment for RSV infection? |
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Definition
86. mostly supportive, ensure adequate oxygenation, hydration, and nutrition |
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Term
87. What is Synagis (palivizumab) and who is it use for? |
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Definition
87. recombinant monoclonal antibody that neutralizes RSV, used for high risk infants |
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Term
88. What family is Rhinovirus part of? |
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Definition
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Term
89. How many serotypes do Rhinoviruses have? |
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Definition
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Term
90. What characteristics does the Rhinoviruses have? |
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Definition
90. Small, non-enveloped, positive-strand RNA virus |
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Term
91. What is the distinguishing feature of the mRNA of Rhinovirus? |
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Definition
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Term
92. What differentiates Rhinoviruses from other picornaviruses? |
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Definition
92. Inactivated by pH 6.0 or lower |
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Term
93. Why is Rhinovirus difficult to grow in culture? |
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Definition
93. requires reduced temperature (33C) for optimal growth |
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Term
94. What does Rhinovirus bind to get into the host cell? |
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Definition
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Term
95. How does Rhinovirus exploit the host cell? |
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Definition
95. IFN and TNF-α upregulate iCAMs, Rhinovirus binds iCAMs |
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Term
96. Once the Rhinovirus enters the cell what is the first event that takes place? |
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Definition
96. Translation of a polyprotein |
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Term
97. How are Rhinovirus viral proteins released from the polyprotein? |
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Definition
97. following specific cleavage events by the virally encoded proteases |
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Term
98. How is translation of picornavirus genomes initiated? |
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Definition
98. cap-independent mechanism |
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Term
99. What is the IRES (internal ribosome entry site)? |
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Definition
99. Sequence near the 5’ end of picornavirus genome that initiates translation |
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Term
100. How is translation of picornavirus genomes linked to host cell translation? |
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Definition
100. Linked to mechanism by which host cell translation is inhibited. |
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Term
101. What are the characteristics of a Coronavirus? |
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Definition
101. Large, Enveloped, positive-stranded RNA virus, Genome capped at 5’ end, has 3’poly A+ tail |
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Term
102. What RNA virus has the largest Genome? |
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Definition
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Term
103. How is the polymerase polyprotein of the coronavirus translated? |
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Definition
103. 1. cis-cleavage of viral polymerase which synthesizes a (-)sense antigenome, 2. antigenome is template for synthesis of sub-genomic mRNA |
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Term
104. What is unique about the coronavirus mRNA synthesis mechanism? |
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Definition
104. “leader-primed” – results in nested set of overlapping mRNAs with common 3’ end |
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Term
105. What allows for a high frequency of recombination in the coronavirus? |
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Definition
105. “Leader-primed” – polymerase “hopping” |
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Term
106. What percentage of Upper respiratory infections does coronavirus cause in humans? |
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Definition
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Term
107. What “severe atypical pneumonia” was caused by a coronavirus in 2003? |
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Definition
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Term
108. T/F coronaviruses cause a significant amount of GI problems? |
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Definition
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Term
109. What do Rhinovirus and coronavirus infections do to the nasal mucosa? |
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Definition
109. Cause shedding of the ciliated epithelium |
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Term
110. Why are conventional vaccinations not feasible for coronaviruses and rhinoviruses? |
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Definition
110. Large # of serotypes for rhinoviruses, high frequency of recombination for coronaviruses |
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Term
111. What is Structure of Adenovirus? |
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Definition
111. Linear, double-stranded DNA genome, 36 kilobase pairs, No envelope |
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Term
112. What does Adenovirus cause infection in? |
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Definition
112. Respiratory, Eye, GI |
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Term
113. What is Adenovirus stable against? |
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Definition
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Term
114. How many serotypes of Adenoviruse are known to infect humans? |
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Definition
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Term
115. Where does replication and assembly of Adenovirus occur? |
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Definition
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Term
116. How is adenovirus spread? |
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Definition
116. Respiratory or fecal-oral route |
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Term
117. What Bug is associated with pharyngoconjunctival fever in children? |
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Definition
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Term
118. Conjunctivitis that feels like “sand in the eye” is caused by what bug? |
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Definition
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Term
119. What is the main pathogenic species of Pseudomonads? |
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Definition
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Term
120. What bug is widely distributed in nature and is highly resistant to antibiotics and can rapidly evolveresistance? |
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Definition
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Term
121. What characteristics do Pseudomonas have? |
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Definition
121. Gram Negative, motile, aerobic rods, Produce Soluble Pigments |
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Term
122. What allows pseudomonas to grow just about anywhere? |
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Definition
122. Obligate aerobes – can us CO2, atmospheric ammonia, nitrogen sources |
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Term
123. An organism that grows at 42C is diagnostic for what bug? |
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Definition
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Term
124. What do cultures of Pseudomonas smell like? |
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Definition
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Term
125. What type of pigmented siderophores do pseudomonas produce and what color are they? |
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Definition
125. Pyocyanin – Blue, Pyoverdin – fluorescent yellow pigment |
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Term
126. What do some strains of pseudomonads produce that is induced in the CF lung? |
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Definition
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Term
127. What does an overproduction of alginate result in? |
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Definition
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Term
128. Who do pseudomonads cause a problem for? |
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Definition
128. immune suppressed people |
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Term
129. What type of toxin do pseudomonads produce? |
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Definition
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Term
130. How does Exotoxin A effect the cell? |
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Definition
130. causes necrosis by blocking protein synthesis |
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Term
131. What 2 toxins have an identical mechanism of blocking protein synthesis, but are produced by different bugs? |
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Definition
131. Exotoxin A and diphtheria |
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Term
132. What bug is associated with Swimmers ear frequently? |
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Definition
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Term
133. What type of rash can you get if you are on a medical conference and you shave your legs before going into a hot tub that doesn’t have enough chemicals? what bug caused it? |
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Definition
133. Hot Tub Folliculitis, Pseudomonas |
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Term
134. How are pseudomonas infections treated? |
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Definition
134. Combined therapy to limit resistance |
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Term
135. What are the characteristics of Acinetobacter? |
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Definition
135. Ubiquitous aerobic gram negative coccobacillus |
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Term
136. How does Acinetobacter infect? |
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Definition
136. compromised patients – low pathogenic potential |
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Term
137. What strain of Acinetobacter is most common? |
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Definition
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Term
138. What bug has recently been a major problem in the Burn Wards of Memphis? |
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Definition
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Term
139. What pathogen is A. baumanii easily mistaken for? |
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Definition
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Term
140. How is A. baumanii differentiated from Neisseria? |
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Definition
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Term
141. Why is antimicrobial testing necessary to guide therapy of Actinobyces? |
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Definition
141. Extremely resistant to antibiotics |
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Term
142. What bug shows biopolar metachromic granules? |
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Definition
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Term
143. What bug is a small gram negative coccobacillus that looks like H. influenza? |
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Definition
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Term
144. Why do you have to let the lab know before you culture someone you suspect as having whooping cough? |
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Definition
144. requires an enriched and selective medium for primary isolation – Bordet-Gengou medium |
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Term
145. How is B. pertussis transmitted? |
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Definition
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Term
146. What does B. pertussis produce a lot of that causes irritation, inflammation, and cough? |
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Definition
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Term
147. Does B. pertussis invade the ciliated epithelium? |
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Definition
147. No, multiples on epithelia without invasion |
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Term
148. What controls the virulence gene expression of B. pertussis? |
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Definition
148. bvgA/bvgS two component regulatory system |
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Term
149. What is the enzymatic action that is specific for the Pertussis toxin? |
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Definition
149. Interfere with PMN, monocyt, and macrophage function, Lymphocytosis, Sensitization to histamine, Hypoglycemia |
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Term
150. How does the BvgS/A system regulate virulence factors? |
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Definition
150. BvgS senses a stimulus, phosphate from a donor transferred to BvgS eventually goes to BvgA which Activates transcription of several genes. |
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Term
151. How Does Pertussis A toxin interfere with normal function? |
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Definition
151. Conversion of ATP to cAMP cannot be stopped because the Gi protein that normally inhibits adenylate cyclase is inhibited by A toxin. |
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Term
152. How long is the incubation period for B. Pertussis? |
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Definition
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Term
153. When are patients most infections with B. Pertussis? |
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Definition
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Term
154. How is the paroxysmal stage of B. pertussis characterized? |
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Definition
154. coughing fits – with whoop inhalation, lasts about 2 weeks, high white blood cell count |
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Term
155. How is B. pertussis diagnosed? |
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Definition
155. primary by clinical features, Nasopharyngeal swap |
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Term
156. Whats the drug of choice for B. pertussis? |
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Definition
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Term
157. How is B. pertussis prevented? |
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Definition
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Term
158. What bug is a Gram positive Rod that appear in clumps resembling Chinese letters? |
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Definition
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Term
159. Where is C. diphtheriae found? |
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Definition
159. Human reservoir – not found anywhere else in nature |
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Term
160. T/F Production of diphtheria toxin only occurs in cells that have been transduced with a phage that carries the toxin genes. |
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Definition
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Term
161. What is the expression of the Diphtheria toxin dependent on? |
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Definition
161. iron – Low concentrations increase toxin production, High concentrations repress production |
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Term
162. What type of toxin is the Diphtheria toxin? |
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Definition
162. AB toxin (like pseudomonas) |
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Term
163. What tissues are most affected by Diphtheria toxin? |
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Definition
163. myocardium and peripheral nerves |
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Term
164. What does the A subunit of Diphtheria toxin inhibit? |
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Definition
164. polypeptide elongation in the presence of NAd by inactivation of EF-2 |
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Term
165. What is the characteristic pathology of Diptheria toxin? |
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Definition
165. pseudomembrane over tonsils, pharynx, and larynx |
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Term
166. What bug can cause the characteristic “bull neck”? |
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Definition
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Term
167. What is the mainstay of therapy for Diphtheria? |
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Definition
167. Antitoxin – immediately |
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Term
168. What is the characteristic stain of Mycobacteria? |
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Definition
168. Acid fast stain positive |
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Term
169. What is unique about the M. Tuberculosis envelope? |
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Definition
169. Mycolic Acid, Cord Factor, Wax-D |
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Term
170. What properties are associated with the high concentrations of lipids in the cell wall of M. tuberculosis? |
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Definition
170. Impermeability to stains and dyes, Resistance to antibiotics, acidic and alkaline compounds, osmotic lysis, lethal oxidations, desiccation |
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Term
171. When do Tubercles form with tuberculosis infection? |
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Definition
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Term
172. What are calcified tubercles seen called? |
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Definition
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Term
173. In the absence of CMI, how can TB progress? |
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Definition
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Term
174. What test for TB indicates infection but does not indicate disease? |
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Definition
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Term
175. How long do cultures of TB need to be kept to rule out disease? |
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Definition
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Term
176. What is the treatment plan for TB? |
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Definition
176. Combined therapy - Isoniazid, Rigampin, pyrazinamide, and ethambutol or streptomycin, 6-9 months, patients are non-infectious within 2 weeks but not cured |
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Term
177. What is Cord Factor for? |
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Definition
177. virulence factor that functions to inhibit PMN migration |
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Term
178. What are the characteristics of Actinomyces? |
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Definition
178. Club-shaped, gram + rods that form Branched filaments. |
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Term
179. What do the microcolonies of actinomyces in pus look like? |
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Definition
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Term
180. What is the reservoir of Actinomyces? |
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Definition
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Term
181. What is Actinomyces israelii nearly always associated with? |
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Definition
181. Trauma and compromised immunity (surgery, tooth extraction, IUDs) |
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Term
182. What Disease is characterized by “lumpy jaw”? |
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Definition
182. Cervicofacial actinomycosis |
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Term
183. What is the treatment for Actinomyces? |
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Definition
183. Prolonged Penicillin |
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Term
184. Where is Nocardia found? |
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Definition
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|
Term
185. What does Nocardia resemble? |
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Definition
185. Aerobic weakly gram positive branching rods that look like fungi |
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Term
186. What kind of acid stain do Nocardia have? |
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Definition
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Term
187. T/F Nocardiosis are Penicillian resistant. |
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Definition
187. T – use Trimethylprim-sulfamethoxazole |
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Term
188. Does Atypical Pneumonia always include fever? |
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Definition
188. No – may or may not, radiological evidence may distinguish |
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Term
189. How does growth of Chylamydia occur? |
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Definition
189. biphasic developmental cycle |
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Term
190. What is a significant cause of community acquired pneumonia? |
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Definition
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Term
191. What are the characteristics of Chlamydia? |
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Definition
191. Gram-negative spherical bacteria that are obligate intracellular parasites |
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Term
192. What is the developmental cycle of Chlamydiae? |
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Definition
192. Elementary Bodies attach and enter cell, Primary Differentiation, Cell division, Rapid multiplication, Effector secretions, Secondary differentiation, EB released and Reinfect |
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Term
193. What bug is associated with chronic atherosclerotic disease? |
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Definition
193. Chlamydia Pneumoniae |
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Term
194. What are the 3 predominant bacterial causes of Atypical Pneumonia? |
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Definition
194. Chlamydia, Mycoplasma, Legionella |
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Term
195. What is the smallest free-living organism? |
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Definition
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Term
196. T/F Mycoplasma lack a cell wall. |
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Definition
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Term
197. What are the symptoms of Mycoplasma pneumoniae, and who do they typically occur in? |
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Definition
197. Mild respiratory infection, sore throat and pharyngitis, occur in 1-5 YO |
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Term
198. How does mycoplasma activate inflammatory cytokines? |
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Definition
198. lipoproteins interact with alveolar macrophage Toll-like receptors |
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Term
199. T/F Mycoplasma will not show up in a blood test. |
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Definition
199. F – Positive blood test after 10 days of infection |
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Term
200. What is used to Treat M. pneumonia? |
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Definition
200. 2nd Generation – Macrolides, Tetracyclines, Fluoroquinolones |
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Term
201. What are the characteristics of Legionella? |
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Definition
201. Aerobic Gram Negative Rod, facultative intracellular bacteria |
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Term
202. What is Legionnaires Disease? |
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Definition
202. more severe pneumonia form of L. pneumophila infection |
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Term
203. What temperatures are Legionella dormant, have ideal growth, and survive but don’t multiple? |
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Definition
203. Dormant <20C, Ideal Growth Rate 20-50C, Survive but don’t multiple >50C |
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Term
204. Where does L. pneumophila replicate? |
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Definition
204. alveolar macrophages after inhalation |
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Term
205. How does L. pneumophila avoid phagosome-lysosome fusion? |
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Definition
205. creating a specialized vacuole that resembles the endoplasmic reticulum of the host |
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Term
206. Who does L. pneumophila most often infect? |
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Definition
206. middle age to older patients, smokers, chronic lung disease patients and immunocompromised |
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Term
207. How is L. pneumophila treated? |
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Definition
207. Macrolides, fluoroquinolones |
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