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Exam Review with Complete Solutions 2024 Chain of Infection Virulence IgM IgG Physical barriers Complement system Skin defects; examples and associated pathogens Mucous membrane barrier defects; examples and associated pathogens Body passage obstruction; examples and associated pathogens ...

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  • 13 de marzo de 2024
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Exam Review with Complete Solutions 2024

1). Chain of infection

 Ans: 1)Infectious agent= organism with ability to cause disease; greater virulence,
invasiveness, and pathogenicity => increased odds of infection
2) Reservoir: place where microbes can persist and reproduce
3) Portal of Exit: way for microbe to leave the reservoir
4) Mode of transmission: method of microbe transfer from one place to another
5) Portal of entry: opening that allows microbe to enter host
6) Susceptible host: Lacks immunity or physical resistance to prevent invasion by
microbe
Is a circle; each link must be present in sequential order for infection to occur


2). Virulence

 Ans: Measure of microbe's ability to invade and create disease
Depends on ability to:
Survive in environment between hosts
Transmit between hosts (moving; adherence)
Proliferate


3). Igm

 Ans: Pentamer; primary response, short-lived (<6 months); best at fixing complement


4). Igg

 Ans: Monomer; main blood antibody, secondary response; longer lived. opsonization
and toxin neutralization. 4 subclasses


5). Physical barriers

 Ans: Skin; fever; secreted antimicrobials; innate immunity




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, 6). Complement system

 Ans: 11=protein cascade; classically activate by ab:ag complexes; alternate by
pathogen surfaces


7). Skin defects; examples and associated pathogens

 Ans: Wounds, burns, trauma, serious derm problems, indwelling devices, injections.
Skin flora- S. aureus, CNS, strep pyo, corynebacteria, malassezia furfur


8). Mucous membrane barrier defects; examples and associated pathogens

 Ans: chemo-induced mucositosis, head/neck trauma, smoking, inhalational injury,
antacids/PPIs. Resident flora- anaerobes, aerobic GNR, candida, enteroccus, bovis


9). Body passage obstruction; examples and associated pathogens

 Ans: Tumors, foreign bodies, stones, cystic fibrosis. Resident flora overgrow or invade;
site-specific.


10). Abnormal number or function of granulocytes

 Ans: Leukemia, chemo, congenital disorders, diabetes. If short term (< 2 wks) then
aerobic GNR, Sa, CoNS. IF long term, add fungi (candida, t. glabrata, aspergillus)


11). Abnormalities of cell-mediated immunity

 Ans: BMT, HIV, steroids, malnutrition, 3rd tri pregnancy. Bacteria: Intracellular
pathogens (listeria, salmonella, mycobacteria, nocardia, legionella).
Fungi: candida, Cryptococcus, coccidioides, histoplasma. Virus: Herpes group
Also toxoplasma and strongyloides.


12). Abnormalities of humoral immunity

 Ans: BMT, HIV, some cancers, aging. Strep pneumo, encapsulated H. flu, Neisseria
meningitidis


13). Preventing infection for immunocompromised patients

 Ans: Take thorough patient history. Prepare before starting with all vaccines,
procedures, line placement, screening. Support gastric acidity. Prevent exposures with



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, awesome hygiene, approp food and water precautions, visitor education, no flowers or
plants, and possible abx prophy (for infections that might reactivate or high-risk for
pneumocystis)


14). Mycoplasma spp.

 Ans: No cell wall --> limited abx choices. Cause atypical pneumonia. Usually
diagnosed by serology


15). Chlamydiae

 Ans: obligate intracellular parasites. Elementary body=infectious, reticulated=
intracellular. DFA or ELISA for detection of antigen is most common. Can also detect
antibodies.


16). Rickettsiae

 Ans: obligate intracellular parasites. arthropod vectors. Rarely culturing; detected by
serology using ELISA for antibodies.


17). Textbook viral replication cycle

 Ans: 1. Attachment 2. penetration/entry 3. replication 4. maturation/assembly 5.
release


18). Sensitivity

 Ans: % of true + who test +; inherent to test


19). Specificity

 Ans: % of true neg who test neg; inherent to test


20). Ppv

 Ans: Likelihood that a + test represents a true case (% T+/all+); depends on the test
and on prevalence of disease in population


21). Npv




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,  Ans: Likelihood that a negative test result is a true non-case (%TN/allN); depends on
test and population prevalence


22). Csf analysis- bacterial mening

 Ans: 1000-5000 WBCs, mostly PMNs. Increased pressure. Increased protein .
Decreased glucose. Bacteria seen on smears.


23). Csf analysis- viral mening

 Ans: Pressure, glucose normal. Lymphocytes seen, but few WBC in general. Protein
normal-elevated. Nothing on smears.


24). Csf analysis- fungus mening

 Ans: Pressure variable. Glucose low, protein high. WBCs vary, but lymphocytes
predominate. India ink smear +.


25). Csf analysis- tb mening

 Ans: Pressure variable. Glucose low to megalow. WBCs vary, mostly lymphocytes.
Protein elevated. AFB stain +


26). Cold agglutinins test

 Ans: Used to detect antibodies for Mycoplasma pneumoniae or mononucleosis.
Positive test is high titer, with resp Sx indicates M. pneumo infection, viral pneumo, or
primary atypical pneumo


27). Crp test

 Ans: Serum sample looking for the CR protein; normal value is none or low CRP.
Indicates current acute inflammation


28). Liver function tests

 Ans: chemistry assays on blood; looking for various things including enzymes,
bilirubin, ammonia, and albumin. Generally higher is worse. Helps detect liver problems,
differentiate among liver problems, measure liver damage, and follow response to Tx.




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