1. What is a prokaryote?
Simple, single-celled organism that lacks a nucleus and membrane bound organelles
2. What substance forms many bacterial walls and consists of glycosaminoglycan chains interlinked with short peptides?
Peptidoglycan
3. What structure does penicillin target to disrupt the integrity of the bacterial cell wall? Attach the diagram from slide #10.
Peptide cross-links
4. What is a bacterial chromosome?
Single, large, circular, double-stranded DNA molecule that contains all the genetic information required by a cell
-located in the nucleoid
5. What is a plasmid?
Small, circular, double-stranded DNA; not essential to growth or metabolism; duplicated and passed down to offspring
-located in the nucleoid
6. Briefly describe transcription and translation synthesis and explain why they can occur simultaneously in the prokaryotic cell.
Transcription: synthesis of mRNA from DNA
Translation: synthesis of proteins from mRNA
-the two process are couple allowing the cell to quickly make protein
-this happens because the cell lacks a membrane bound nucleus; all components needed in the cytoplasm
7. Which bacterial genres produce endospores? Which bacteria is known to cause outbreaks of diarrhea in hospitals and nursing homes? Will bleach-free disinfectants kill this bacterium?
-Bacillus and Clostridium
-C. diff
-resistant to bleach-free disinfectants
8. Which type of bacteria has a thick layer of peptidoglycan that forms a single layer around the cell? During a gram stain, what color will this type of bacteria appear under a microscope? Why?
Gram +; purple bc it retains the crystal violet stain
9. Describe the steps involved in performing a gram stain. Which step is the most critical and why?
Flood slide with crystal violet x10 sec then rinse flood with Gram’s iodine x 10 sec then rinse decolorize with 95% ethanol until thinnest parts are colorless then rinse flood with safranin (pink) x10 sec then rinse air dry or blot with absorbent paper. The third step is the most important because it is the most affected by technical variations in timing and reagents
10. When viewed under a microscope, which gram-positive bacteria appear as cocci in clusters “bunches of grapes”?
Staphylococcaceae
11. When viewed under a microscope, which gram-positive bacteria appear as cocci in pairs or chains?
Streptococcus
12. There has been a recent outbreak of listeria that has been linked to contaminated deli meat. Describe how this bacterium would look after a gram stain when viewed through a microscope. (Color and shape) Does this bacterium produce spores?
Gram +, purple, linked rods, non-sporeforming
13. Define pleomorphism. Why is pleomorphism extreme in the Mycoplasma genus of bacteria?
Present in different sizes and shapes due to variations in cell wall
14. List the 6 I’s of culturing microbes and the purpose of each.
Inoculation: introduction of sample into a container of sterile media
Incubation: provides conditions for optimal growth
Isolation: getting a pure culture of the microbe
Inspection: looking at colonies and microscopic characteristics
Information gathering: biochemical, immunologic, and genetic testing
Identification: assigning a specific name to the microbe
15. What factors affect microbial growth?
Nutrients, temperature, pH and presence of water, atmospheric gases (O2, CO2, N2)
16. Describe synthetic, non-synthetic, general purpose, enriched, selective, and differential media.
Synthetic: contains pure organic and inorganic compounds in an exact chemical formula
Non-synthetic: contains at least one ingredient that is not chemically definable: organic extracts
General purpose: grows on a broad range of microbes, usually non-synthetic, nutrient agar and broth, peptone water, etc
Enriched: contains complex organic substances such as blood, serum, hemoglobin, or special growth factors required by fastidious microbes
Selective: contains one or more agents that inhibit growth of some microbes and encourage growth of the desired microbes
Differential: allows growth of several types of microbes and displays visible difference among desired and undesired microbes
17. Which specific medium would be best to isolate pathogenic Staphylococci?
Selective
18. Why is the growth curve in a bacterial culture closed? What is the average period it takes to complete this curve?
Nutrients and space are finite: no mechanism for the removal of waste products
Entire curve is exhibited over a period of 4 days
19. List and describe the four phases in the microbial growth curve.
Lag: “flat” period of adjustment, enlargement, and synthesis of DNA, enzymes, ribosomes; little growth
Exponential Growth (Log): period of maximum growth will continue if cells have adequate nutrients and a favorable environment
Stationary: rate of cell growth = rate of cell death; caused by depleted nutrients and O2, excretion of organic acids and pollutants
Death: as limiting factors intensify, cells die exponentially in their own wastes
20. Which gram-positive bacteria stain like gram-negative bacteria? Why?
Actinomyces, corynebacterium, mycobacterium, Propionibacterium due to their walls being sensitive to breakage during cell division
21. Which bacteria respond best to acid-fast staining?
Mycobacteria
22. Which groups of bacteria are considered obligate intracellular parasites? How are they different from non-obligate intracellular bacteria?
Rickettsia and Chlamydia: cannot survive or multiply outside of a host cell; cannot carry out metabolism on their own
23. List the 4 main fungal divisions. Give examples of each division except for the one that does not cause human disease.
Zygomycota -bread mold
Ascomycota -penicillium, yeast, ringworm, candida albicans, black mold
Basidiomycota -Crypto Neoformans
Chytridiomycota -does not harm humans
24. What are the two morphologies in which microscopic fungi exist?
Yeast and Hyphae (molds)
25. What is the difference between primary and opportunistic fungal pathogens? List examples of both.
Primary: exist in yeast and mold forms (dimorphic) -histoplasma, Blastomyces
Opportunistic: happen secondary to a weakened immune system -cryptococcus, candida
26. Marine algae toxins can cause food poisoning. List the two examples given in the lecture and the marine life each condition is associated with.
Red tide: algae animals toxic
Paralytic shellfish: exposed clams neurological symptoms
Ciguatera fish poisoning: serious intoxication -barracuda and moray eel, mahi
27. What are the two protozoan stages?
Trophozoite – motile feeding stage Cyst – dormant resistant stage
28. What are the protozoan groups based on? List the protozoan pathogens associated with the Mastigophora group.
Locomotion and reproduction
- Trypanosoma cruzi (Chagas), Leishmania, Giardia lamblia, and Trich Vaginalis
29. List and describe the two groups of parasitic helminths.
Flatworms: flat, thin, segmentated body -tapeworms: long, ribbon like; flukes: flat, ovoid
Roundworms: round, elongate, cylindrical, unsegmented, spines, hooks -pinworms
30. What is the difference between an enveloped and naked virus?
Enveloped has an envelope/covering around the capsid, naked do not
31. List and describe the six stages of virus replication.
Adsorption: attachment to cell surface receptors
Penetration: fusion or endocytosis release nucleic acid
Uncoating: release of the viral capsid and RNA into the cytoplasm
Duplication/Synthesis: takes control of cell cell synthesizes the basic components of a new virus
Assembly: nucleocapsid and envelope are formed
Release: viruses bud off the membrane; virion is ready to infect other cells
32. List examples of cytopathic effects caused by viruses.
Damage to host cells that alters their appearance
- Cell lysis, alter DNA cancerous cells, change shape, fuse (RSV), damage
33. What type of infections do prions cause? How are they spread? What is the name of the rapidly progressive neurodegenerative human prion disease?
Transmissible spongiform encephalopathies (TSEs)
- spread by direct contact, contaminated foods form hoes in nervous tissue
- Creutzfeldt-Jakob disease
34. Which microbes have the highest resistance to control?
Bacterial endospores
35. What is the goal of sterilization?
Destroying endospores (kills all microbial life)
36. Define microbiostatic and microbicide. Which microbicidal agent is considered a sterilizing agent?
Microbiostatic: process that temporarily prevent microbes from multiplytng
Microbicide: any chemical agent that kills pathogenic organisms
-sporicide
37. Define and give examples of sanitization, degermation, antisepsis, and disinfection.
Sanitization: any cleansing technique that mechanically removes microbes -dishwashing
Degermation: process to reduce the number of microbes on the human skin -surgical hand scrub
Antisepsis: process of using chemical agents on the skin to destroy or inhibit vegetative pathogens -antibacterial soap, preoperative iodine
Disinfection: any process to destroy vegetative pathogens, not endospores on inanimate objects -5% bleach, boiling water
38. Define microbial death. List the factors that can affect an antimicrobial agent's mechanism of action.
Permanent loss of reproductive capability, even under optimum growth conditions
- Number of microbes, nature of microbes in the population, temperature and pH of the environment, concentration of agent, mode of action of the agent, presences of solvents, organic matter, or inhibitors
39. What are the four cellular targets that antimicrobial agents aim to destroy? Which antimicrobial agents are most effective for each cell target and why?
Cell wall (antibiotics, detergent, and alcohol), cell membrane (surfactants), cellular synthetic process of proteins and nucleic acids: DNA, RNA (antibiotics, chemicals, radiation), proteins structure and function (heat and chemicals)
40. Is moist or dry heat more effective for microbial control? What is a common form of moist heat used in hospitals and medical offices to sterilize equipment?
Moist heat; autoclave
41. What is desiccation and is it an effective method of sterilization?
Gradual removal of water from cells metabolic inhibition; NO not effect method of microbial control, disinfection, or sterilization
42. Differentiate ionizing and nonionizing radiation.
Ionizing: “cold”, deep penetrating, breaks DNA, gamma rays, xrays
Nonionizing: little penetrating, used to disinfect/sterilize air, water, and solid surfaces
43. What is filtration? Give examples of substances that are best sterilized by filtration.
Mechanical removal of microbes by passing a gas or liquid through a filter
44. Which heavy metals are used for antimicrobial control? What is silver sulfadiazine ointment commonly used for?
Silver and mercury; burn patients
45. Differentiate narrow and broad-spectrum antimicrobial drugs and list the advantages and disadvantages of each.
Narrow: effective on a small range of microbes, target specific cell component
- Advantages: cause less resistance of the bacteria
- Disadvantages: causative organism must be identified
Broad: greatest range of activity, tart components common to most pathogens
- Advantages: less need to identify the infecting agent before starting treatment
- Disadvantages: increase rise to drug resistance
46. What is the mechanism of action of beta-lactam antimicrobials? What are the most used beta-lactams?
Interfere with cell way synthesis; penicillins and cephalosporins
47. Differentiate natural and semisynthetic penicillins and provide examples of each.
Natural: do not penetrate the outer membrane and are less effective against G- bacteria; considered narrow spectrum (Pen G, Pen V)
Semisynthetic: cross the cell walls of G- bacteria and are broad spectrum (ampicillin, amoxicillin, carbenicillin)
48. Carbapenems and monobactams are also beta-lactam drugs. List examples of each and state if they have broad or narrow spectrum coverage.
Carbapenems: broad (imipenem, meropenem)
Monobactams: narrow (aztreonam, only work on G-)
49. Cephalosporins are a family of bacterial antibiotics structurally related to PCN and have a synthetically altered beta-lactam structure. What root names are associated with all generic cephalosporin medications? What type of bacteria are these medications most effective against and how has each successive generation of medication expanded its coverage?
-cef, ceph, or kef; G+; each group is more effective against G- than before
50. List the antimicrobials discussed in class that disrupt cell membrane function.
Polymxins, daptomycins, amphotericin B, nystatin
51. Which antimicrobials affect nucleic acid synthesis?
Fluoroquinolones, antiviral drugs that are analogs of pruines and pyrimidines
52. How do fluroquinolones stop DNA replication and repair? What should you warn your patient about if you prescribe fluoroquinolone?
Bind and inhibit DNA gyrase and topoisomerases, stopping DNA replication and repair
- Warnings of tendinosis and cardiac conduction issues
53. Which ribosomal subunit do aminoglycosides target to disrupt protein synthesis? Are they broad or narrow spectrum? List the three aminoglycoside medications discussed in class. What other class of antibiotics target this ribosomal subunit?
30S: broad (Streptomycin, gentamicin, tobramycin); tetracyclines
54. Which antimicrobials interfere with protein synthesis by targeting the 50s ribosomal unit? Which antimicrobials interfere with protein synthesis by targeting both the 30s and 50s ribosomal units?
- Chloramphenicol, erythromycin, azithromycin, clarithromycin
- Oxazolidinones
55. Which medications have a mechanism of action that affects a microbe’s metabolic pathway?
Sulfamethoxazole, trimethoprim
56. Define synergistic effect.
The effects of a combination of antibiotics are greater than the sum of the effects of the individual antibiotic
57. What is the mechanism of action of antifungal medications?
Macrolide polyenes: nystatin, amphotericin B; crypto meningitis
Griseofulvin: treatment for ringworm and athletes foot
Synthetic azoles: ketoconazole, etc; vaginal suppositories; candidiasis, dermatophyte
Flucytosine: cutaneous mycoses
Echinocandins: damage cell wall of fungi w/o harming human cells; capsofungin, micafungin
58. Create a table for antimalarial, antiprotozoal, and antihelminthic drugs.
Antimalarial: quinine, chloroquine, mefloquine, primaquine
Antiprotozoal: metronidazole
Anthelminthic: mebendazole, pyrantel, piperazine, ivermectin
59. The goal of antiviral medications is to block a step in the completion of the virus cycle. List the modes of action of antiviral medications.
Blocking penetration of the virus not the host cell; blocking replication, transcription, or translation of viral genetic material; preventing the normal maturation of viral particles
60. Which antiviral medications are also called anti-herpetics?
Acyclovir, valacyclovir, famiciclovir
61. What is a superinfection?
An infection occurring during antibiotic therapy that is caused by an overgrowth of drug-resistant microorganisms
62. What percentage of patients will experience a serious adverse reaction to antimicrobials? What is considered a major side effect?
5%; direct damage to tissue, allergic reactions, disruption in the balance of normal flora
63. Define minimum inhibitory concentration.
Smallest concentration of drug that visibly inhibits growth
64. Define therapeutic index. Is a high or low therapeutic index more desirable? Why?
Ratio of the dose of the drug that is toxic to humans as compared to its minimum effective dose; high, the lower it is the more toxic the drug
65. Define normal flora, infection, pathogen, and disease. Define transient and resident microbes.
Normal flora: microbes that engage in mutual or commensal association w/ humans
Infection: condition in which pathogenic microbes penetrate host defenses, enter tissues, and multiply
Pathogen: infectious agent
Disease: infection that causes damage or disruption to tissues and organs
66. Define microbial antagonism. What are endogenous and exogenous infections?
Microbial Antagonism: bacterial flora benefit host by preventing overgrowth of harmful microbes
Endogenous infection: occur when normal flora is introduced to a previously sterile site
Exogenous infection: caused by organisms not normally present in the body
67. What is the largest and most accessible organ?
skin
68. Which part of the body has the most diverse and unique flora, with more than 600 species?
Mouth
69. Do human bites that break the skin typically require antibiotic coverage? Why?
Yes, increased risk of infection due to the high bacterial count
70. How is the GI tract exposed to the environment? What type of bacteria does the intestinal environment favor? What is the name of the chemical that gives feces a characteristic odor?
Via oral cavity and anus; anaerobic bacteria; skatole
71. List the three bacterial groups we discussed that are normal respiratory tract flora.
Streptococci, S. Aureus, Neisseria
72. If a patient was being screened for MRSA, what is the most common location to swab for culture?
nose
73. Changes in physiology influence the composition of the normal vaginal flora examples.
Estrogen, glycogen, pH
74. List factors that can weaken host defenses and increase susceptibility to infection.
Old age, extreme youth, defects in immunity, surgery, organ transplants, organic disease, chemotherapy, physical and mental stress, other infections
75. What are true and opportunistic pathogens?
True: capable of causing disease in a healthy person with normal immune defenses
Opportunistic: cause disease when the host’s defenses are compromised or when they grow in part of the body that is not natural to them
76. Define virulence factor.
Any characteristic or structure of the microbe that contributes to the infection or disease
77. What is the STORCH acronym?
Common infections of the fetus and neonate
S: syphilis, T: toxoplasmosis, O: other (Hep B, HIV, Chlamydia), R: rubella, C: cytomegalovirus, H: herpes simplex virus
78. What is an infectious dose? Where does the initial response of host defenses come from?
Minimum number of microbes required for an infection to proceed; phagocytes
79. How do pathogen exoenzymes affect the host? What can toxigenic pathogens produce?
Disrupt the structure of tissues; toxins
80. Differentiate bacterial endotoxins and exotoxins. When are they secreted?
Endo: not secreted, released form cell after damage
Exo: secreted by a living bacterial cell into the infected issue, strong specificity
81. List the targets of neurotoxins, enterotoxins, hemotoxins, and nephrotoxins.
Neuro: brain, entero: GI, hemo: blood, nephron: kidneys
82. List and describe the 4 distinct stages of clinical infections.
Incubation: time from initial contact with the infectious agent to the appearance of first symptoms; agent is multiplying but no symptoms present
Prodromal: vague feelings of discomfort; nonspecific complaints
Invasion: multiplies at high levels, become well-establish, specific signs and symptoms
Convalescent: person begins to respond to the infection, symptoms decline
83. Define local, systemic, focal, mixed, and primary-secondary infections and give examples of each.
Local: confined to a specific site (boils, warts, fungal skin infections)
Systemic: spreads to several sites and tissue fluids like the bloodstream (measles, typhoid, syphilis, rubella, chickenpox, histoplasmosis, cryptococcosis)
Focal: local spreads to systemic (TB, streptococcal pharyngitis)
Mixed: several microbes grow simultaneously at the same site (human bits, dental carries, gas gangrene, wound infections)
Primary-secondary: an initial infection is complicated by a second one in the same or different location and caused by a different microbe
84. Differentiate asymptomatic and latent infections.
Asymptomatic: host doesn’t show any signs of disease despite being infected
Latent: periodically becomes active and produce recurrent disease
85. Who is a living reservoir carrier?
Humans, animals, soil, water, plants
86. Differentiate incubation, convalescent, and chronic carriers?
Incubation: spread the infectious agent during the incubation period
Convalescent: recuperating w/o symptoms, but still shed viable microbes
Chronic: shelters the infectious agent for a long period after recovery
87. What is a vector? Give examples of biological and mechanical vectors.
Live animal (non-human) that transmits an infectious agent from one host to another
- Biological: mosquitos, fleas
- Mechanical: houseflies, cockroaches
88. What is a zoonotic disease?
Disease indigenous to animals but spreads to humans
89. What is the difference between a communicable and non-communicable disease? What is a nosocomial infection?
Communicable: infection can spread from one host to another; contagious
Non-communicable: does not transfer from one person to another
Nosocomial: acquired or developed during a hospital stay
90. Describe the patterns of infectious disease occurrence. Include endemic, sporadic, epidemic, and pandemic
Endemic: relatively steady frequency over long period of time in a particular area
Sporadic: occasional cases are reported at irregular intervals
Epidemic: prevalence of a disease is increasing beyond expected
Pandemic: epidemic across continents