UTA MICROBIOLOGY EXAM 4

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230 Terms

1

disease

a condition where normal structure and/or function are damaged or impaired

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2

infection

invasion of pathogen or parasite that lead to disease

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signs

things that can be directly measured by clinician (ex: blood cell counts)

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symptoms

things felt by patient that cannot be clinically measured (ex: nausea)

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syndrome

groups of signs and symptoms that help indicate a particular disease

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asymptomatic/subclinical

only signs can be observed through correct testing (ex: patient with herpes and no symptoms)

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International Classification of Diseases (ICD)

World Health Organization codes that are used globally to classify and monitor diseases

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infectious

disease caused by direct effect of a pathogen

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communicable

capable of spreading person-to-person

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contagious

easily spread

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iatrogenic

acquired as result of medical procedure

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nosocomial

acquired from hospital setting

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13

zoonotic

acquired from animal

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14

non-communicable

obtained from non-living thing such as soil or contaminated object

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15

non-infectious

not caused by pathogen

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16

malaria

  • communicable

  • infectious

  • zoonotic

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sickle cell anemia

  • non-communicable

  • non-infectious (genetic)

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18

5 stages of infectious disease

  1. incubation

  2. prodromal

  3. illness

  4. decline

  5. convalescence

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19

incubation

initial entry of pathogen; replication begins

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prodromal

replication continues; host shows signs and symptoms

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illness

signs and symptoms are most severe in host

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decline

pathogen number starts to decrease; host's immune system is weak and vulnerable to secondary infection

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convalescence

host starts to recover

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acute disease

relatively short (hours, days, week)

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chronic disease

longer time (months, years, lifetime)

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latent disease

comes in episodes; pathogen replicates when disease is active

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Koch's postulates

set of standards that must be met to demonstrate that X pathogen causes X disease

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Koch's postulates

  1. The suspected pathogen must be found in every case of disease and not be found in healthy individuals.

  2. The suspected pathogen can be isolated and grown in pure culture.

  3. A healthy test subject infected with the suspected pathogen must develop the same signs and symptoms of disease as seen in postulate 1.

  4. The pathogen must be re-isolated from the new host and must be identical to the pathogen from postulate 2.

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Koch's assumptions (WRONG)

  1. Pathogens are found only in diseased individuals.

  2. All subjects are equally susceptible to infection.

  3. All pathogens can be grown in culture.

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Molecular Koch's postulates

identifies gene instead of pathogen; improved postulates that overcame some of Koch's limitations

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Limitations of Molecular Koch's postulates

  1. genetic manipulation of some organisms isn't possible with current techniques

  2. some diseases do not have suitable animal models

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32

pathogenicity

ability of a pathogen to cause disease

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virulence

degree of pathogenicity ex: highly virulent - Bacillus anthracis induces severe signs and symptoms ex: low virulent - Rhinovirus induces low signs and symptoms

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virulence curve

how virulence can be modeled in controlled experiments

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median infectious dose (ID50)

number of pathogens required to infect 50% of those inoculated

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median lethal dose (LD50)

number of pathogens required to kill 50% of those infected

  • LD50 is 10^4 pathogen cells or virions

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37

primary pathogen

can cause disease in a host regardless of the host's resident microbiota or immune system ex: enterohemorrhagic E. coli (mainly due to Shiga toxin)

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opportunistic pathogen

can only cause disease in situations that compromise the host's defenses (protective barriers, immune system, or normal microbiota) ex: Candida albicans with disrupted microbiota ex: UTI caused by E. coli

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influencers of susceptibility

drugs, resident microbiota, genetics, & age

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40

5 stages of pathogenicity/infection

  1. Exposure to host

  2. Adhesion

  3. Invasion

  4. Infection

  5. Transmission

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41

exposure (contact)

can occur in many ways: pathogens must be exposed to portals of entry to begin adhesion

  • some portals are worse than others (ex: mucosa)

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TORCH infections

pathogens that can cross placental barrier as portal of entry

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Torch

toxoplasmosis --> Toxoplasma gondii (protozoan)

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tOrch

syphilis --> Treponema pallidum (bacterium) chickenpox --> Varicella-zoster virus (human herpesvirus 3) hepatitis B --> Hepatitis B virus (hepadnavirus) HIV --> Retrovirus fifth disease (erythema infectiosum) --> Parvovirus B19

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toRch

rubella (german measles) --> Togavirus

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torCh

cytomegalovirus --> Human herpesvirus 5

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47

torcH

herpes --> herpes simplex virus (HSV) 1 & 2

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48

adhesion

pathogens' varying capability of colonization

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adhesins

molecules/structures that bind to certain host receptors

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50

biofilm

production of community glycocalyx

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51

invasion

occurs when colonization is established; pathogens generally produce toxins to allow further colonization into body/tissue and protection from immune system

  • virulence plays a role in degree of invasion ex: Helicobacter pylori urease production

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intracellular pathogens

invade via endocytosis and evasion of host immune defenses

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invasion mechanisms

  1. Effector proteins are secreted to trigger entry - membrane ruffling (ex: Salmonella and Shigella spp.)

  2. Surface proteins allow for binding to host cell (trojan horse approach)

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Phagolysosome survivors

  • Listeria monocytogenes

  • Mycobacterium tuberculosis

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55

local infection

small area of body

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focal infection

pathogen or toxin spreads to secondary location

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systemic infection

occurs throughout body (ex: septicemia)

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primary infection

can lead to secondary infections of different pathogen ex: HIV lowers immune system and opens door for yeast and others; rhinoviruses can lead to bacterial pneumonia

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transmission

persistence passes on pathogen onto a new host through a portal of exit

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virulence factors

pathogen product that assists in ability to cause infection and disease

  • dictate how severe and extensive a disease is; some have more than one ex: adhesion factors, exoenzymes, toxins, immune evasion

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adhesins

proteins that aid in attachment to host cell receptors

  • found in ALL microbial types (viral, fungal, bacterial, etc.)

  • commonly found on fimbriae or pili

  • can initiate biofilm formation in some species

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-emia

presence of pathogen in blood

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bacteremia

bacteria in blood

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viremia

viruses in blood

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toxemia

toxins in blood

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septicemia

bacteria present and multiplying in blood

  • patients with septicemia (septic) can lead to shock (life threatening disease in BP)

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exoenzymes

extracellular enzymes used to invade host tissues

  • glycohydrolases, nucleases, phospholipases, proteases ex: collagenase produced by C. perfringens causing necrosis and gas gangrene

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toxins

biological poisons that assist in ability to invade and cause tissue damage (toxigenicity)

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endotoxins

lipopolysaccharides that triggers host inflammatory responses; can cause severe fever and shock

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exotoxins

proteins mostly produced by Gram (+)

  • targets receptors in specific cells

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detectors of endotoxins

  1. Limulus amebocyte lysate (LAL) test

  2. Enzyme-linked immunosorbent assay (ELISA)

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LAL test

blood cells of the horseshoe crab mixed with patient's serum; observed chromogenically or by coagulation

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ELISA

uses antibodies to detect endotoxins

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intracellular targeting

a division of exotoxins with A & B regions for activity and binding ex: diptheria and botulinum toxin

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membrane disrupting

division of exotoxins aka phospholipases that degrade bilayer membrane ex: Bacillus anthracis and Rickettsia spp.

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hemolysins and leukocidins

membrane disruptors that can target RBC, WBC, and other cells

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superantigen

division of exotoxins that trigger excessive production of cytokines by immune cells ex: Staphylococcus aureus and Toxic Shock Syndrome

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host evasion

mechanisms to evade phagocytosis ex: capsules that enlarge bacterial cell so phagocytes cannot engulf pathogens ex: proteases digest host antibody molecules

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antigenic variation

alteration of cell surface proteins to hide from immune cell recognition (example of host evasion mechanism)

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antigenic drift

result of point mutations causing slight changes in spike proteins (H & N)

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antigenic shift

major change in spike proteins due to gen reassortment

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virulence in fungi

Many properties similar to bacteria; adhesins, proteases, and toxins ex: Capsule (+) Cryptococcus spp. can cause pneumoniae and meningitis

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mycotoxins

fungal toxins produced by Claviceps purpurea and Aspergillus spp. that contaminate grains and other staple crops

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84

virulence in protozoans

have unique features for attachment ex: Giargia lamblia uses adhesive disk of microtubules to attach to intestines ex: Plasmodium falciparum quickly changes adhesive protein for RBCs to avoid immune recognition; causes chronicity in malaria patients

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85

virulence in helminths

tissue penetration commonly achieved with proteases (worms that burrow into skin) ex: roundworms produce cuticle to last longer against host defense assaults ex: Schistosoma mansoni degrades host antibodies to halt immune defense

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"Glycan gimmickry"

mimic host cells to evade immune system

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87

epidemiology

field that studies distribution and timing of diseases (infectious and non-infectious) Determines:

  1. Etiology

  2. Transmission

  3. Susceptible populations

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morbidity

number of individuals with disease rate calculation: #/population

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mortality

number of deaths from disease rate calculation: #/population

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prevalence

number of individuals at certain time

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incidence

number of new cases

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92

4 patterns of incidence

  1. Sporadic

  2. Endemic

  3. Epidemic

  4. Pandemic

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sporadic

occurs occasionally without regional concentration ex: tetanus, rabies, plague

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endemic

constantly present in certain region ex: malaria, ebola, chickenpox

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epidemic

larger than normal amount of cases ex: influenza, west nile

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pandemic

epidemic that is cross continental ex: virulent influenza, ebola, etc.

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etiology

determining the causative (etiological) agent of infectious disease; epidemiology helps provide clues and the standard procedure is Koch's postulates

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CDC (Center for Disease Control)

protects public from disease/injury by providing physicians and health-care workers with updates on public health issues & latest data on notifiable diseases ex: publication of the MMWR (Morbidity and Mortality Weekly Report)

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NNDSS (National Notifiable Disease Surveillance System)

system where all cases must be reported by physicians; these studies track notifiable diseases to determine risks ex: west nile, HIV, measles, etc.

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John Snow

British physician and father of epidemiology; his study led to the discovery of the contaminated water pump that was responsible for the 1854 cholera London epidemic

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