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Microbiology
Final Exam
Medical Bacteriology
12-2007
Taxonomy/Morphology
Major Divisions of Microorganisms (Cell Types):
1.) Describe the major features of Prokaryotes:
2.) Describe the major features of Eukaryotes:
3.) Describe the major features of Viruses:
1.) Within the Whittaker & Woesian classification
system, there are 3 _____. Name them:
2.) Which of the domains are prokaryotic?
3.) Which are eukaryotic?
4.) Within each domain, there are 7 sublevels of
classification, name them in order:
5.) Which of those should ALWAYS be underlined
OR italicized?
6.) Properly write the following genus and species:
ESCHERICHIA COLI
7.) Which shape are the following: cocci, bacilli,
curved?
1.) What are tetrads?
2.) What are Sarcina?
3.) What are Palisades?
I tried to underline whatever she had underlined, but
probly missed lots… 
Good Luck, as always!!!  ☻ 
↑ = increasing/hi
↓ = decreasing/lo
1.) ~name = “pro” (before) + “karyos” (nucleus) = no nucleus
~NO nuclear membrane
~Haploid (single) circular chromosome IN cytoplasm
~Cell walls of peptidoglycan
~Replicate by binary fission
~Includes bacteria & archea
~70S ribosome
~No mitochondria
2.) > name = “eu” (true) + “karyos” (nucleus) = true nucleus
>Contain membrane bound organelles
>Chromosomes physically separate from cytoplasm (nucleus)
>Diploid chromosome (2 chromosomes)
>Replicate by mitotic division
>80S ribosome
>Includes fungi, parasites, & protozoans
3.) ~NOT prokaryotes (but are microorganisms)
~Acellular, often referred to as particles (can’t live w/o host)
~Genetic material either DNA or RNA (not both)
~DO NOT replicate (disassemble, make copies, reassemble)
Domains – Archea, Bacteria, Eukarya
Prokaryotic = Archea & Bacteria
Eukaryotic = Eukarya (Duh!)
Domain – Kingdom – Phylum – Class – Order –
Family – Genus – species (Dumb Kings Play
Chess On Funny Green Squares) 
5.) Genus and species
6.) Escherichia coli or Escherichia coli
*Notice 1st letter of genus capital, species all lower case
7.) Cocci = round
Baccili = rods
Curved = comma-shaped
1.)
2.)
3.)
4.)
1.) Arrangements of bacterial cells – cocci in groups
of 4
2.) Cocci in groups of 8, 16, 32, etc... (I would like to
know who sits n counts em?!?! )
3.) Irregular rods that remain hinged @ one end
(typical of corynebacteria)
Appendages:
1.) There are 4 types of flagella, describe each:
Monotrichous, Amphitrichous, Lophotrichous,
Peritrichous
2.) What is the difference between flagella and
endoflagella?
3.) Which type can go in “reverse”
4.) What are Fimbirae?
5.) What are Pili?
6.) T or F? The Pili are longer and less numerous than
the fimbirae.
7.) Pili are found almost exlusively in _____ bacteria.
1.) Monotrichous = single, polar flagellum
Amphitrichous = flagella @ BOTH ends
Lophotrichous = multiple, polar flagella (@ one end)
Peritrichous = multiple flagella over entire surface of
bacterial cell
2.) Endoflagella are on INSIDE of the cell and they provide
movement in spirochetes. (Flagella are on outer surface of
cell and provide locomotion)
3.) Endoflagella
4.) Used for Attachment – often compared to bristles (short &
numerous)
5.) Sex pilus – used for exchange of genetic information via
process called conjugation (rigid and tubular/hollow)
6.) True!
7.) Gram-NEGATIVE bacteria
Cell Envelope (outer, protective “wrapping”):
1.)
2.)
3.)
4.)
5.)
6.)
7.)
There are 2 types of cell envelopes, name them:
Which maintains cell shape?
Which is mainly for adherence?
Which protects from osmotic pressure?
T or F? ALL bacteria contain a Capsule/Glycolax?
T or F? ALL bacteria contain a Cell Wall?
Which has 2 types, Gram-positive & Gramnegative?
Gram (+) vs. Gram (-): tell whether each cell type have
the below feature… *KNOW*
1.)
2.)
3.)
4.)
5.)
6.)
Capsule
Outer Membrane
LPS - lipopolysaccaride (endotoxin)
Teichoic Acid
Periplasmic Space
Peptidoglycan – they both have it, but which type
has a “thick” (20-80nm) peptidoglycan layer and
which type has a “thin” (10nm) one?
7.) T or F? LPS is exotoxic b/c it is a potent
stimulator of the immune system.
Definitions of above features:
1.)
2.)
3.)
4.)
5.)
6.)
What is an Outer Membrane?
Describe the LPS (lipopolysaccaride):
Describe Teichoic Acid & Lipoteichoic Acid:
Where is the periplasmic space?
What is the peptidoglycan?
What is the Cytoplasmic/Cell membrane? Which
bacteria type(s) have it?
7.) Which of the above is known as the inner
membrane in gram negative bacteria?
1.) Capsule/Glycolax (outer layer of lg. polymers,
usually polysaccarides) & Cell Wall
2.) Cell Wall
3.) Capsule/Glycolax
4.) Cell Wall
5.) False! Some DO NOT have one.
6.) True!!
7.) Cell Walls
1.)
2.)
3.)
4.)
5.)
6.)
Some (+) & (-) have a capsule
Gram (-) only
Gram (-) only
Gram (+) only
Gram (-) only
“Thick” = gram (+)
“Thin” = gram (-)
7.) False! It is endotoxic b/c it is a potent stimulator
of the immune system (she might try to trick us w/
this on the exam…)
1.) Bi-layer membrane external to peptidoglycan. Major proteins
are porins, which allow passage of hydrophilic molecules in
& out of cell [gm(-) only]
2.) On external side of outer membrane of gm(-). Composed of
Lipid A (toxic), Core polysaccharide, O antigen (antigenic)
3.) Teichoic = Embedded in peptidoglycan & is toxic
Lipoteichoic = is anchored in the cytoplasmic membrane
Both ONLY in gm(+)
4.) Area between cytoplasmic membrane & outer membrane of
gm(-) bacteria. Thin layer of peptidoglycan in this space.
5.) Meshwork of polysaccarides, rigid. Present in BOTH
gm(-)&(+), but much thicker in gm(+)
6.) Lipid bilayer (phospholipids), selectively permeable
functions in: electron transport, nutrient uptake, energy
production, nutrient & waste transport.
7.) Cytoplasmic/Cell Membrane (b/c they have additional membrane)
Cytoplasmic Structures:
1.) What is a Nucleoid?
2.) What are Plasmids?
3.) What are 3 things that Plasmids can ‘do’ that
makes them so special? (why so advantageous)
4.) What is the main function of ribosomes?
5.) How do bacterial (prokaryotic) ribosomes differ
from ours (eukaryotic)?
6.) ____ are a target for antibiotics b/c of their unique
structure compared to ours.
7.) What are Endospores?
8.) Give 2 examples of medically important
endospores:
1.) Contains chromosome for a bacteria [remember, bacteria
(prokaryotes) have NO nuclear membrane]
2.) Small pieces of double-stranded DNA (usually
xtrachromosomal, but can insert into chromosome)
3.) ~Can replicate independently of the chromosome
~Can be transferred from one bacteria to another
~Can be passed to offspring
4.) Provide platform for protein synthesis
5.) Bacterial are smaller (70S) that ours (80S).
6.) Ribosomes
7.) Dormant, non-vegetative form of certain gm(+) bacteria.
Have complete genetic info. Extremely resistance to harsh
extremes (heat, cold, desiccation, pH, chemicals). Germinate
to become vegetative when conditions favorable.
8.) Bacillus (Anthrax) & Clostridium
Prokaryote, Eukaryote, Virus Summary: *KNOW*
1.) Which contain organelles?
2.) Which contain no nuclear membrane?
3.) Which have a haploid chromosome?
4.) Which have a diploid chromosome?
5.) Which are often referred to as “particles”? Why?
6.) Which have 70S ribosomes?
7.) Which have 80S ribosomes?
8.) Which can contain either DNA or RNA as their
genetic material? Can they contain both?
9.) Fungi are in which category?
10.) Bacteria are in which category?
11.) Which cannot multiply without a host?
1.) Eukaryotes
2.) Prokaryotes (b/c they have no nucleus)
3.) Prokaryotes
4.) Eukaryotes
5.) Viruses (b/c acellular & cannot live w/o host)
6.) Prokaryotes
7.) Eukaryotes
8.) Viruses, No! can’t have both!!
9.) Eukaryotes (also includes parasites & protozoans)
10.) Prokaryotes (also includes archea)
11.) Viruses
Bacterial Descriptions Summary: *KNOW*
1.) Lipid A and O antigen are part of what? Which
one is toxic and which is antigenic?
2.) What is also known as endotoxin? Why?
3.) Name 3 features seen in BOTH gm(-)&(+):
4.) Name the features unique to gm(-) bacteria:
5.) Name those unique to gm(+) bacteria:
6.) The Peptidoglycan layer is found within what?
7.) The ______ is also called the inner membrane in
gram __ bacteria.
8.) Endospores can only be gram ___ bacteria.
9.) ____ contains the chromosomes in a bacterium.
10.) ____ contains the chromosomes in a eukaryote.
1.) Part of LPS on outer membrane of gm(-) bacteria
Lipid A = toxic ; O antigen = antigenic
2.) LPS (b/c potent stimulator of immune system)
3.) Capsule, Peptidoglycan, and Cytoplasmic/Cell
Membrane
4.) Outer Membrane, LPS, and Periplasmic Space
5.) Teichoic Acid & Lipoteichoic Acid
6.) Periplasmic space
7.) Cytoplasmic/Cell Membrane ; negative
8.) Gram Positive!!!
9.) Nucleoid
10.) Nucleus *Do not mix them up!!!
Cultivation
1.) Each species has a temperature range in which it grows
best, which type include human & animal pathogens b/c
they like temps around 20º-40ºC?
2.) Which type causes food to spoil in your fridge b/c they
like temps around 10º-20ºC?
3.) Response to O2 greatly depends on the presence or
absence of which enzymes? *KNOW*
4.) Name the species which require O2 for growth:
5.) Name the species which O2 is toxic:
6.) Which species can switch between aerobic & anaerobic
types of metabolism? (best w/ aerobic, however)
7.) Which type uses strictly Anaerobic metabolism, &
doesn’t care if O2 present or not (insensitive to O2)?
1.)
2.)
3.)
4.)
Mesophiles *KNOW*
Psychrophiles *should probly know me too*
Superoxide dismutase & Catalase
Obligate Aerobes (need O2 as final e- acceptor)
(has both enzymes)
5.) Obligate Anaerobes (live by anaerobic respiration
or fermentation) note: some can tolerate O2, but never use it for growth
6.) Facultative Anaerobes (has both enzymes)
7.) Aerotolerant Anerobobes
Define the following:
1.) Acidophiles
2.) Give an example of an Acidophile:
3.) Neutrophiles
4.) Alkaliphiles
5.) Human pathogens fall in which category above?
6.) Halophiles
7.) Generation time
8.) List 4 things that can affect generation time:
1.) Prokaryotes grow by _______.
2.) Describe Binary Fission:
3.) The growth of bacteria is broken up into four
phases, name and describe each:
4.) T or F? After period of time in the death phase, the
population eventually reaches zero and is extinct.
Welcome to the “Media” Center:  (focus on their
unique characteristics!)
1.)
2.)
3.)
4.)
5.)
Describe Nutrient (general purpose) media:
Describe Selective media:
Describe Differential media
Describe Selective and Differential media:
Give an example of a Selective & Differential
media.
6.) Describe Enrichment:
Measuring Growth:
1.) Describe Optical Density:
2.) Describe Colony Forming Units (CFU’s):
3.) Which equates to the number of living cells in the
culture?
4.) Which utilizes light refraction?
5.) Which one counts both live and dead cells?
6.) Which involves liquid media?
7.) Which involves solid media?
8.) ___ is the most important step in I.D of a pathogen.
9.) List 3 things to consider when collecting specimen:
“Acid-loving” – prefer pH around 2-3.5
Thiobacillus (requires low pH for growth)
“Neutral-loving” – prefer pH around 6-8
“Basic-loving” – prefer pH around 8.5-10.5
Neutrophiles (b/c the human body pH is around 7
or neutral)
6.) “Salt-loving” – require some NaCl for growth
7.) The time it takes for a population to double in
number. (vary from 20 minutes to weeks)
8.) ~Availability of nutrients
~Physical environment (overcrowding)
~Build up of waste products
~Environmental factors (O2, temp, pH, salt, etc…)
1.)
2.)
3.)
4.)
5.)
1.) Binary Fission (1  2  4  8  16  32…)
2.) The circular DNA molecule is replicated; then the cell splits
into 2 identical daughter cells (each containing complete
copy of original DNA).
3.) Lag Phase: the adjustment period (occurs while they
acclimate to their new environment). Cells are Metabolically
active, but growth is slow.
Log Phase: Exponential growth. Nutrients are plentiful &
wastes are minimal.
Stationary Phase: Growth slows & levels off (# of new cells
= # of dying cells)
Death Phase: More cells dying than dividing. Dividing cells
mostly recycling & using products from dead cells.
4.) False! Doesn’t go to zero b/c constant recycling keeping the
population alive
1.) Provides enough nutrients for most bacteria to grow. Does
NOT enhance or suppress growth.
2.) Inhibits growth of certain bacteria. Done by addition of
certain compounds.
3.) Distinguishes between species of bacteria (does NOT inhibit
growth). Components added that cause changes in medium or
appearance of colonies that have grown.
4.) Selective in that it inhibits growth of certain types of bacteria
& Differential b/c it includes components that allow bacterial
colonies to be distinguished.
5.) MacConkey Agar – inhibits growth of gm(+) while
distinguishing between lactose-fermenting & non-lactosefermenting gm(-) colonies that have grown.
6.) Contains additives that enhance growth of certain types of
bacteria. Useful when bacteria present in relatively small #’s
1.) Measures the turbidity (liquid becomes cloudy)
2.) Count the number of individual colonies present on solid
agar
3.) CFU’s
4.) Optical Density
5.) Optical Density (cannot distinguish between live & dead
cells in the liquid turbidity)
6.) Optical Density
7.) CFU’s
8.) Specimen Collection (if you screw up here, everything else
is gonna be messed up!)
9.) ~must be from actual site of infection
~contamination by human cells/normal flora @ minimum
~collect any specimen before admin. of therapy
Cultivation Summary: *KNOW*
1.) Which temperature class includes human & animal
pathogens? (prefer 20º- 40ºC)
2.) Tell what “relationship” each has with O2: (a)Obligate
Aerobes
(b)Obligate Anaerobes (c)Facultative
Aerobes (d)Aerotolerant Aerobes
3.) In this growth phase, there is exponential growth:
4.) In this growth phase, growth is slow b/c the cells are
getting used to a new environment:
5.) In this phase, more cells are dying than dividing:
6.) In this phase, # of dividing cells = # of dying cells:
7.) Which media type can enhance growth?
8.) Which media type can inhibit growth?
9.) T or F? Bacterial growth measured by population.
1.) Mesophiles (“they love ME”)
2.) (a) Requires O2 b/c uses O2 as final e- acceptor
(b) O2 is toxic for them
(c) Can switch between both aerobic and anaerobic
(d) Strictly Anaerobic metabolism, but doesn’t
matter if O2 is present.
3.) Log Phase
4.) Lag Phase
5.) Death Phase
6.) Stationary Phase
7.) Enrichment (can enhance certain bacteria types)
8.) Selective (can inhibit certain bacteria types)
9.) True! (NOT individual cells)
Define Metabolism.
Which metabolism types generate energy?
Which type requires energy?
Which metabolism type(s) uses free O2 as the final
electron acceptor? *KNOW*
5.) Which type(s) uses oxygen-containing salts as the
final electron acceptor? *KNOW*
6.) Which is catabolism is the absence of O2?
1.) Regulation of catabolism & anabolism to maintain
stability of cell
2.) Catabolism, Aerobic Respiration (24 ATP),
Anaerobic Respiration (22 ATP), Fermentation (0
ATP, but uses partial oxidation of metabolites to
produce energy), and Respiratory Chain/Electron
Transport Chain.
3.) Anabolism (“building up”)
4.) Aerobic Respiration (produces much more ATP)
5.) Anaerobic Respiration
6.) Fermentation
Carbohydrate Metabolism:
1.) Bacteria oxidize ____ as their main energy source.
2.) What is glycolysis?
3.) T or F? Glycolysis requires oxygen.
4.) How do we make energy after glycolysis produces
2 pyruvic acid molecules?
5.) What is the net gain from each pyruvic acid
molecule? This is through what?
6.) What is the major generator of energy?
7.) T or F? Like glycolysis & TCA, the Respiratory
Chain uses substrate-level phosphorylation.
8.) Fermentation occurs under anaerobic conditions
utilizing ___ as the final electron acceptor.
1.) Carbohydrates (glucose most common, but many
other substrates can be used)
2.) Conversion of glucose  2 pyruvic acid molecules
= net gain of 2 ATP through substrate-level
phosphorylation.
3.) False! Does not require it!
4.) They enter the TCA (tricarboxylic acid) cycle!
5.) 1 ATP, 3CO2 through Substrate-level
phosphorylation (just like glycolysis)
6.) The Electron Transport Chain or Respiratory Chain
(“processing mill” for e-‘s and H atoms)
7.) FALSE! It uses oxidative phosphorylation.
8.) Organic molecules (methanol, lactic acid)
Metabolism Summary: *KNOW*
1.) Glycolysis nets 2 ATP’s via ______.
2.) T or F? Oxygen is the final electron acceptor for
anaerobic respiration.
3.) T or F? Oxygen is the final electron acceptor for
aerobic respiration.
4.) T or F? Aerobic respiration produces more ATP
than Anaerobic & Fermentation combined.
5.) ______ process uses oxidative phosphorylation.
6.) T or F? Oxygen in the final electron acceptor
during fermentation.
7.) T or F? Fermentation produces ATP.
LAST EMAILED HERE!!!
1.) substrate-level phosphorylation (when it converts
glucose into 2 molecules of pyruvic acid)
2.) FALSE!! Oxygen-containing salts are the final eacceptor
3.) True!!
4.) True!! (anaerobic produces way less ATP than
aerobic and fermentation produces no ATP)
5.) Respiratory Chain/Electron Transport Chain
6.) False!! – it is an anaerobic process which uses
organic molecules as final e- acceptor.
7.) False!! It regenerates NAD+ for use in glycolysis
so more ATP can be generated
Metabolism - we learned all of this in biochem so I
am gonna keep it short:
1.)
2.)
3.)
4.)
Bacterial Genetics:
Define/Describe the following:
1.)
2.)
3.)
4.)
5.)
6.)
7.)
Chromosome/Genome
Gene
Codon
Cistron
Operon
Wild-type
T or F? A mutation is any change in the genotype
that results in a changed phenotype.
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
When the genome is duplicated, it is called what?
What is transcription, generally?
What is translation, generally?
When making proteins, the mRNA is read how?
Each codon specifies what?
Transcription (DNA  mRNA) takes place where?
Translation (mRNA  protein) takes place where?
There are 2 sites in the translating ribosome, name
each and tell what attaches to each:
9.) The amino acids are added to the chain via a ____
bond. *KNOW*
1.) Double stranded DNA encoding the total content of
organisms genetic information
2.) The fundamental unit of heredity w/in a chromosome
3.) Specific sequence of 3 nucleotides in mRNA that
constitutes the genetic code for particular amino acid
4.) Region of the DNA that encodes a single polypeptide
(protein)
5.) A group of 2 or more genes that are transcribed from a
single promoter. Usually the genes w/in an Operon are
functionally related.
6.) Starting material of a known genotype (full repertoire of
organism’s genes). Any derivation from wild-type is
considered a mutation.
7.) False! It is any change in the genotype [may or may not
change the phenotype (observable characteristics)]
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
9.)
Replication
Synthesizing RNA from the DNA template.
Synthesizing proteins using the mRNA template.
In groups of 3 nucleotides known as codons.
A specific amino acid to be added to the growing
peptide (protein) chain.
In the nucleus
On the ribosomes.
P-site (peptide) & A-site (aminoacyl) – tRNA (w/
its matching amino acid) 1st attaches to P-site, then
the amino acid is transferred to the A-site and the
peptide chain now has 1 more amino acid attached.
Peptide Bond
Mutations:
1.) T or F? Mutations are always spontaneous.
2.) Agents that induce a mutation, such as chemicals
are known as _____.
3.) Define a Substitution/Point Mutation
4.) Define an Inversion
5.) Define an Insertion
6.) Define a deletion
Results of Mutations: Describe the following
1.)
2.)
3.)
4.)
Silent Mutation
Missense Mutation
Nonsense Mutation
Framshift
1.) False! Sometimes mutations can be induced
(example: exposure to chemicals, etc…)
2.) Mutagens
3.) 1 nucleotide replaced by another (1for1)
4.) Adjacent nucleotides change positions (switch)
5.) 1 or more nucleotides are added
6.) 1 or more nucleotides are removed
1.) Nucleotide changes, but the amino acid stays the same.
(remember, in the genetic code, there is more than 1
codon per amino acid) = minor change in genotype, no
change in protein function.
2.) Changes the amino acid (but does NOT create a stop
codon). May or may not affect the function of the
protein, depending on mutation.
3.) Creates a stop codon. May or may not affect the
function of the protein (probably will hinder it)
depending on where stop codon appears.
4.) Nucelotides are inserted/deleted but NOT in groups of 3
(thus alters the reading frame). Nearly always results in
non-functional protein (b/c every triplet is altered
downstream of the mutation). 
Elements of Genetic Transfer: Describe each
1.)
2.)
3.)
4.)
Plasmids
T or F? Bacteria require plasmids for their survival
Transposons
T or F? Both Plasmids & Transposons are capable
of self-replication.
5.) T or F? Both Plasmids & Transposons carry
adaptive genetic elements (example: resistance).
6.) Bacteriophages (a.k.a phages)
Mechanisms of Genetic Transfer:
1.) What is Conjugation?
2.) In order for conjugation to occur, the donor cell
must have what? Describe it:
3.) There are 2 types, name & describe each:
4.) What is Transformation?
5.) When a bacteria ____ it is said to have been
transformed.
6.) What is competence?
*note: Hfr stands for high frequency b/c when F plasmid integrated into donor cell’s
chromosome, there is higher frequency that transfer of chromosomal elements will also
occur.
Mechanisms of Genetic Transfer: cont…
7.) What is Transduction?
8.) In order for transduction to occur, the participating
bacteria (both donor & recipient) must ______.
9.) There are 2 types of transduction, describe the 1st type,
Generalized Transduction:
10.) What’s the difference between a bacteriophage and a
Transducing Particle? (these are the 2 types of particles
that form during Transduction)
11.) T or F? Whether a bacteriophage or Transducing
particle bind to a bacterium, the bacterium is considered
“infected”.
12.) Describe the 2nd type, Specialized Transduction:
Mutation Summary: *KNOW*
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
9.)
Mutations always affect genotype or phenotype?
____ occurs on ribosomes.
In translation, amino acids brought in by the tRNA are joined to the
other amino acids by a ____ bond.
If a bacterium takes up and incorporates free DNA from the
environment easily, it has high _____.
When this bacterium takes up and incorporates a piece of free,
environment DNA it has been _____.
When DNA transfer mediated by bacteriophage, it is called what?
During Conjugation, does the donor or recipient cell have to contain
the F plasmid in order to undergo conjugation?
Which of the above transfer types require that the both the donor
and recipient bacterium be of the same species?
List the main differences between the 2 types of transduction:
1.) Self-replicating dsDNA molecules (can be
extrachromosomal or integrated into chromosome)
2.) False! They are not required, but they sure help! They may
confer specific phenotypic traits (example: antibiotic
resistance, enzymes, etc…)
3.) Segments of dsDNA that can move from 1 place on a
chromosome to another OR can remove itself from
chromosome and integrate into plasmid.
4.) False! Transposons only have genes for self-mobilization,
NOT self-replication. They can move alone, but must enter
chromosome or plasmid for their genes to be expressed
(replicated).
5.) True! (so they are both very advantageous)
6.) Viruses of bacteria (every known bacterium is
parasitized by phages).
1.) Unidirectional transfer of DNA by direct contact between 2
cells through a pilus.
2.) F plasmid (cell termed F+) – F plasmid is extrachromosomal
and only contains genetic info for synthesis & assembly of F
pilus (has no other chromosomal info).
3.) F Factor Transfer – where ONLY the F plasmid is
transferred to recipient cell.
Hfr Transfer – where the F plasmid has been integrated into
the donor chromosome. When the conjugation occurs it
transfers some of the chromosomal DNA as well.
4.) Uptake & incorporation of free/”naked” DNA from the
environment into genome. DNA usually from lysed bacteria.
5.) Takes up the free DNA (transformation)
6.) The ability of a bacterium to take up this free DNA from the
environment (varies, but usually greatest in Log phase)
7.)
8.)
DNA transfer mediated by a bacteriophage
MUST be of the same species (due to specificity of
Bacteriophages/viruses for their bacteria)
9.) Random fragments of disintegrating bacterial DNA from virally
infected bacterial cell are accidentally packaged into some of the
new phage particle. When this new phage particle infects another
bacterium, it can transfer this DNA to the new bacterium’s genome.
10.) Bacteriophage contain its own DNA only (just like a virus), while
Transducing Particle contains bacterial DNA only.
11.) False! NOT considered infected if Transducing Particle binds b/c
this particle contains ONLY bacterial DNA (from the same species
bacterium), therefore, NOT virus-like, NOT “infected”.
12.) Only occurs when bacteriophage DNA has become integrated into
bacterial host cell chromosome. When the bacteriophage removes
its own DNA from the bacteria, it also removes some bacterial
DNA. Therefore, this bacterial DNA becomes packaged in ALL
new phage particles. These transducing particles contain BOTH
phage & bacterial DNA. Particle = Recombinant Phage.
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
Genotype
Translation
Peptide bond
Competence
Transformed (b/c underwent transformation)
Transduction (remember, bacteriophage = virus)
Donor cell (if it has it, donor cell is called F+)
Transduction (due to specificity of bacteriophages)
9.) ~Generalized produces 2 particles (one w/ ONLY phage DNA,
other w/ ONLY bacterial DNA), Specialized only produces 1
particle (mixed phage AND bacterial DNA)
~Generalized only some of phage particles get the bacterial
DNA, Specialized ALL of the new phage particles will contain
the bacterial DNA
~Generalized involves random fragments of disintegrating
bacterial DNA, Specialized involves integration into an
infected/host bacterium’s chromosome
Normal Flora:
1.) What is normal flora?
2.) T or F? Normal flora are never pathogenic.
3.) On a cell-for-cell basis, microbes outnumber
human cell __:__.
4.) T or F? Normal flora is the same for everyone.
5.) T or F? Normal flora is passed to the fetus after 18
weeks gestation.
6.) Name 3 main bacterium that colonize after birth?
7.) Do bottle-fed and breast fed infants acquire the
same flora?
1.) What other factors, other than infant feeding
method, contribute to colonization or alteration in
normal flora?
2.) T or F? Normal flora is involved in both
maintenance of health and causation of disease.
3.) Give 2 examples of how normal flora can cause
disease:
4.) Give 3 examples of how they promote our good
health:
Normal Flora by Region: *KNOW*
1.) Normal flora of the Skin include: (4)
2.) T or F? These skin flora grow ‘best’ in the warm,
moist areas of the axilla, groin, & between the toes.
3.) Normal flora of the Conjunctiva (eye) include: (2)
4.) Why is the eye more difficult to colonize than the
skin?
5.) Normal flora of the Nasal Cavity include: (3)
6.) Normal flora of the Nasopharynx include: (4)
Normal Flora by Region: cont… *KNOW*
1.) Normal flora of the Oropharynx include: (2)
2.) If ____ is found in the oropharynx of a child, it
indicates oral sexual contact & is grounds for child
abuse investigation.
3.) Normal flora of the Mouth include: (7)
4.) Normal flora of the Stomach include: (2)
5.) Normal flora of the Sm. Intestine include: (3)
6.) Normal flora of the Lg. Intestine include: (6)
7.) ____ has the largest microbial population in body.
1.) Collection of bacteria, fungi, protists, viruses, & archea
found routinely in specific site of body.
2.) FALSE! Normally they are not, but under certain
circumstances it can be. Also, in some people, normally
pathogenic microbes are normal flora.
3.) 10:1 Ewwww!!! 
4.) False! Varies by age, sex, stress, diet, genetics (Suum
quique – to each his own)
5.) False! Fetus has no flora! Colonization by flora begins
w/in 12 hours of parturition (birth?).
6.) Staphylococci, Streptococci, & Lactobacilli
7.) Nope, Bottle-fed = a mix of coliforms (E. coli, Klebieslla,
Enterobacter, & Citrobacter species)
Breast-fed = Bifidobacterium (protects from some
intestinal pathogens)
1.) Teething, puberty, Menstruation, Menopause
2.) True!!
3.) ~Can be pathogenic if immunocompromised
~Can become pathogenic when introduced into
new sites within the body.
4.) >Occupy attachment sites to prevent colonization
by pathogenic bacteria (Colonization Resistance)
>Important for stimulating host defenses
>Nutritional functions (synthesize & secrete
vitamins B & K)
1.) Staphyloccus epidermis & aureas,
Corynebacterium, Propionibacterium
2.) True!
3.) Staphylococcus & Viridans Streptococci
4.) B/c tears contain bactericidal enzyme (lysozyme)
5.) Staphylococcus epidermis & aureas,
Cornebacterium *so similar to skin flora
6.) Streptococci (*most common), Neisseria
meningitidis (main carrier site for this organism),
Haemophilus influenae (main carrier site…),
Streptococcus pneumoniae (main carrier site…)
1.) Haemophilus influenzae, Assorted & minor species
of Streptococci
2.) Neisseria gonorrhoeae
3.) Streptococcus salivarus, mutans, & sanguis,
Gingival crevices are perfect for: Bacteroides,
Lactobacillus, Fusobacterium, & Actinomyces
4.) Helicobacter pylori & Lactobacillus
5.) Peptostreptococcus, Prevotella, & Porphyromonas
6.) Bacteroides, Bifidobacterium, Escherichia,
Enterococcus, Fusobacterium, Lactobacillus
7.) Colon!! (flora can be up to 30% fecal volume)
Normal Flora by Region: cont… *KNOW*
1.) ____ & ____ are the most predominant, but rarely
cause disease.
2.) ____ & ____ are relatively minor populations, but
they are 2 of the most common causes of intraabdominal infections.
3.) Normal flora of the Urethra include: (3)
4.) Normal flora of the Vagina (infant) include: (1)
5.) Normal flora of the Vagina (children) include: (3)
6.) Normal flora of the Vagina (adults) include: (3+)
7.) Normal flora of the Vagina (post-menopause)
include:
Normal Flora Summary: *KNOW*
1.) What is Colonization Resistance?
2.) What is the most common normal flora in the
nasopharynx?
3.) Staphylococcus is especially important, why?
4.) Where, in the human body, is Staphylococcus
considered as predominant normal flora?
5.) The main carrier site for N. meningitidis, H.
influenzae, and S. pneumoniae is ______.
6.) Streptococci are normal flora in what parts of the
human body?
7.) Lactobacillus is normal flora in what parts of the
body?
Pathogenesis:
1.) T or F? Colonization is the same thing as
infection.
2.) Define Colonization
3.) Define Incubation Period
4.) Define Infection
5.) Define Pathogenesis
6.) Define Pathogenicity
7.) Define Virulence
8.) Define Virulence Factor
1.) List & briefly describe the 6 steps involved in
pathogenesis: (establishment of infectious disease)
2.) There can be 2 types of Encounters, Endogenous or
Exogenous, describe each:
1.) Eubacterium & Bifidobacterium
2.) E. Coli & Bacteroides fragilis
3.) Lactobacillus, Non-hemolytic Streptococci,
Coagulase-negative Staphylococci
4.) ↓ pH due to maternal estrogen - Lactobacillus
5.) Higher pH b/c ↓ estrogen – Corynebacterium,
Staphylococcus, Streptococcus
6.) pH declines as estrogen ↑ - Lactobacillus,
Gardnerella, Mycoplasma & Ureaplasma,
Childhood flora still persists
7.) pH rises due to ↓ estrogen – Childhood flora
become dominant & adult flora persists.
1.) The protection we get from normal flora via their
ability to block attachment sites and prevent
colonization by pathogenic bacteria.
2.) Streptococci
3.) b/c it is a dangerous human opportunistic pathogen
4.) Skin, Conjunctiva, Nasal Cavity (epidermis only),
Urethra (coagulase-negative), Vagina (children)
5.) Nasopharynx
6.) Nasopharynx, Oropharynx, Mouth, Urethra (nonhemolytic), Vagina (children)
7.) Gingival crevices (mouth), Stomach, Lg. intestine,
Urethra, and is dominant is infant & adult vagina
1.) False! Colonized = No disease yet
Infected = colonization results in disease.
2.) The presence & persistence of microorganisms in/on
particular site of body.
3.) Time interval between infection & appearance of 1st
sign or symptom
4.) Colonization by microorganisms that results in disease.
5.) Process or mechanisms in the dev’pmnt of disease
6.) The capacity to cause disease
7.) The degree to which a pathogen can cause disease or
damage, a qualitative measure of Pathogenicity,
measured by # of organisms req’d to cause disease.
8.) Bacterial constituents that promote infection
1.) ~Encounter: agent & host meet
~Entry: agent enters the host
~Spread: agent spreads from the site of entry
~Multiplication: agent multiplies once on host (almost
always must ↑ in # before they can cause infection)
~Damage: the agent, the host’s response to the agent, or
both cause tissue damage
~Outcome: the infectious agent wins, the host wins, or
they learn to coexist
2.) Endogenous Encounter = disease results from agents
already present in/on body (normal flora).
Exogenous Encounter = agent present within the
environment. Agent acquired through air, water, food,
insect bites, etc…
1.) There can also be 2 kinds of Entry, Ingress or
Penetration, describe each:
2.) There are also 2 types of Spreading, Lateral
Propagation or Dissemination, describe them:
3.) What 2 things affect the spread of bacteria?
Factors that affect outcome:
1.) How does the Portal of Entry affect the outcome?
2.) How does the Virulence of the Organism affect the
outcome of it is a True Pathogen?
3.) What if it is an Opportunistic Pathogen?
4.) How does the Condition of the Host affect the
outcome?
1.) Ingress Entry = No epithelial barriers crossed (disease
can result w/o entry into deeper tissue) Entry gained
through inhalation or ingestion.
Penetration
Entry = entry into deeper tissues by crossing an
epithelial barrier (some carried across by insect bite,
cut, organ transplant, some on their own, especially
single layer mucous membranes)
2.) Lateral Propagation = stays near site of entry, only
spreads to contiguous tissues (ex: Gangrene)
Dissemination = spread to distant sites.
3.) ~Anatomical Factors (ex: kids ears make them more
susceptible to ear infections)
~Active Participation by Microbe (ex: flagella,
enzymes to breakdown clots, etc…)
1.) If microbe enters host through a portal that does not
support it, then disease does not occur. Also, some
agents cause different diseases depending on where
they enter. (ex: Staph. in GI causes food poisoning but
in respiratory. system causes pneumonia.)
2.) Capable of causing disease even in healthy individuals
(proper portal of entry still required)
3.) Only cause disease when host defenses are
compromised, OR the microbe gained access to tissues
in body where doesn’t normally reside.
4.) Many factors such as age (weak immune system in the
very old & young), immunodeficiencies, and overall
health affect hosts ability to defend against infection.
1.) Disease severity depends on both the ____ & the
_____. *KNOW*
2.) Virulence is determined by what 3 things?
3.) Virulence is measured by what 2 things? *KNOW*
4.) What is found within the “Pathogenicity Island”
and what is it?
1.) Virulence of the organism ; susceptibility of host
2.) ~Infectivity (ability to overcome host defenses)
~Invasiveness (ability to multiply & spread)
~Pathogenic potential (ability to damage host)
3.) Infectious Dose (ID50) – the number of organisms
required to cause infection in 50% of
experimentally infected animals or cultured cells.
Lethal Dose (LD50) – the number of organisms
required to kill 50% of experimentally infected
animals of cultured cells.
4.) Chromosomal virulence genes (genes that encode
for features to help them evade host defenses) may
be found there. Is a discrete region of the genome.
1.) T or F? All virulence genes are found within the
“Pathogenicity Island”
2.) Define Tropism.
3.) There are 3 virulence factors that promote
colonization & invasion. Name & describe each:
1.) False! They may be, but they may also be
throughout the genome or on a plasmid or phage.
2.) Preference for a certain tissue over another
3.) ADHERENCE – bacteria use fimbriae & pili to
bind to specific host cell receptor. This determines
Tropism & species specificity (ex: pathogenic to
humans but not dogs) Capsules also used for
adherence but don’t req. specific receptors. May
have other adhesins that are not fimbriae & pili.
INVASION – described later
MOTILITY – can use both flagellar & nonflagellar means to move (ex: E. coli use flagella)
1.) There are 2 ways (Active or Passive) in which a
bacteria can invade a host, describe both:
2.) Which of the Invasion Types are usually
“professional” phagocytic cells?
3.) Which are usually “nonprofessional” phagocytic
cells?
4.) T or F? All bacteria must invade host tissues,
either active or passively, in order to cause disease.
5.) Invasins are in which category?
Virulence Factors to Promote Survival:
1.) Name some virulence factors that bacteria have
against Non-specific host defenses: (4)
Examples of Virulence Factors:
1.) Give an example of a bacterium which prevents the
migration of phagocytes & how it’s done.
2.) Give 2 examples of how bacteria survive within a
phagocyte.
3.) Give 3 examples of how bacteria can evade
complement.
Examples of Virulence Factors cont…:
4.) Give 2 examples of how bacteria can survive in
hostile environments:
1.) Active = bacterial surface proteins that promote
invasion of the host cell
Passive = host cell surface molecules facilitate
invasion into the cell
2.) Passive = Professional (usually)
3.) Active = Unprofessional (usually)
4.) False! Some bacteria cause disease through
secretion of toxins without further invasion.
5.) Active (they are mostly “nonprofessional”)
1.) ~Inhibition of phagocytes [Prevent the migration of
phagocytes to site of infection, Killing phagocytes,
Avoiding phagocytes (capsules provide physical
barrier to prevent phagocytosis)]
~Surviving within Phagocytes (some agents enjoy
the “protection” offered by living in these cells b/c
protected from complement & antibodies, plus
large supply of nutrients)
~Evading Complement
~Survival in Hostile Environments
1.) Streptococcus pyogenes  produces an enzyme (C5a
peptidase) that degrades complement protein 5a. Since 5a
attracts phagocytes, degrading it reduced the # of phagocytes
@ site of infection.
2.) ~Listeria monocytogenes  produces enzyme Listeriolysin
O, allows it to escape phagosome before it fuses w/ lysosome
~Produce enzymes (catalase & superoxide dismutase) that
detoxify reactive oxygen species created by phagocyte.
3.) >M protein of streptococcus pyogenes prevents the binding
of complement proteins.
>LPS of gm(-) bacteria binds sialic acid to the O antigen,
effectively preventing formation of C3 convertase (C4b2b) so
complement cascade cannot proceed.
>Gm(-) bacteria can change length of their O-antigen,
making it longer & obstructing the cell surface, making it
difficult for the MAC to form.
4.) ~Production of enzyme Urease to degrade urea to
ammonia + CO2 + H20, to raise pH & make
environment more hospitable. (ex: stomach)
~Acquire iron from iron-depleted environment
Siderophores are bacterial proteins that have
higher affinity for free iron than hemoglobin does.
Lactoferrin binding proteins & Transferrin binding
proteins are bacterial binding proteins that bind to
host proteins and “steal” their iron.
Virulence Factors that Promote Survival cont…:
1.) Name some Virulence Factors that bacteria have
against Specific Host Defenses: (5)
Examples of Virulence Factors cont…:
1.) Provide 2 examples of how bacteria prevent
antibody binding.
2.) Define the 2 types of Removal or Alteration of an
Antigen by a bacterium: (Antigenic Variation &
Phase Variation)
Virulence Factors that Promote Damage to Host Cell:
1.) What are “Spreading Factors”?
2.) There are 3 specific Spreading Factors which
promote damage to the host cell. Name & describe
each:
3.) Along w/ Spreading factors, bacteria contain
Membrane Disrupting Exotoxins. They do what?
4.) Specifically, what do Hemolysins do?
5.) What do Leukocidins do?
6.) What does Streptolysin do?
Virulence Factors that Promote Damage to Host Cell:
1.) Agents also contain A-B Exotoxins to promote damage
to the host. These A-B Exotoxins contain what?
2.) Describe “Simple” A-B Toxins
3.) Describe “Compound” A-B Toxins
4.) What does the “A Domain” of the molecule contain?
*KNOW*
5.) What does the “B Domain” of the molecule contain?
*KNOW*
6.) What do Neurotoxins target? (always the B domain that
gives them this specificity)
7.) What about Cytotoxins?
8.) What about Enterotoxins?
1.) ~Prevent antibody binding (capsules provide
physical barrier so Abs cannot bind their targets)
~Antigenic disguise (bacteria coat themselves w/
host proteins or host polysaccharides.)
~Removal or Alteration of Antigen (2 types,
defined below)
~Destruction of Ab molecules
~Immunosupression
1.) ~Capsules = physical barrier
~Protein A of staphylococcus aureus binds Fc
portion of antibodies
2.) Antigenic Variation = change of amino acid
composition so the antigen is no longer recognized
or bound by Ab’s made earlier.
Phase Variation = turning off the gene so the
antigen is no longer made & is therefore no longer
a target.
1.) Spreading factors are enzymes which breakdown tissues
allowing the bacteria to enter new areas:
2.) ~Hyaluronidase – produced by streptococci spp. digests
hyaluronic acid (the “glue” that holds certain tissues
together), allowing pathogen to move between cells.
~Coagulase – this enzyme accelerates clotting of blood
providing protective barrier around the pathogen.
~Streptokinase & Staphylokinase – enzymes dissolve
blood clots, allowing pathogen to spread.
3.) Damage cellular membranes, causing cells to lyse
4.) Destroy red blood cells (produced by staphylococci)
5.) Lyse phagocytes (produced by staphylococci)
6.) Lyse phagocytes & destroys red blood cells (produced by
streptococci)
1.) 2 domains
2.) Are a single polypeptide w/ 2 domains
3.) Consist of separate polypeptides that make up the 2
domains.
4.) Contains the enzymatic activity & determines the
mechanism of action.
[Domain A = Activity & mechanism of Action]
5.) Contains the binding properties & therefore determines
cell specificity.
[Domain B = Binding properties]
6.) Target neuronal cells (disrupt neurotransmitter signals).
7.) Kill cells by inhibiting protein synthesis
8.) Affect cells w/in intestinal tract, usually causing
diarrhea. (ex: cholera toxin)
Virulence Factors that Promote Damage to Host Cell:
1.) Define Endotoxin:
2.) What part of the Endotoxin [Gm(-) LPS] contains
the toxic activity?
3.) Other than Exo & Endo Toxins, bacteria can also
contain Superantigens. What are these?
4.) How do they work?
Steps of an Infectious Disease:
1.) Put the following steps in proper order:
Acute Stage, Convalescent Stage, Incubation
Period, Prodormal Period.
2.) Define Each:
1.) This term ONLY refers to Gram-Negative LPS.
All other toxins are referred to as Exotoxins.
2.) Lipid A [Lipid A = toxic Activity]
3.) Bacterial proteins capable of activating large
numbers of T-cells without specificity for the
antigen.
4.) They “trick” the T-cells into thinking they have
been properly activated by its antigen. The antigen
binds both the MHC Class II molecule on the
antigen-presenting cell & the T-cell receptor
forming a bridge, causing T-cell to “think” it is
activated, results in release of lg. amounts of IL-2
1.) 1st: Incubation Period
2nd: Prodormal Period
3rd: Acute Stage
4th: Convalescent Stage
2.) 1st = time between infection by pathogen & the
onset of symptoms (pathogen is multiplying)
2nd = first, non-specific symptoms appear (fever,
headache, fatigue) Usually not diagnostic.
3rd = period of characteristic clinical manifestations
(full effect of the pathogenic effects)
4th = The recovery period. (some people become
carriers w/ no symptoms, others develop
chronic/latent infections that resurface later)
1.)
Types of Infections: Define each
2.)
1.)
2.)
3.)
4.)
5.)
6.)
7.)
3.)
Localized
Systemic
Focal
Primary
Secondary
Acute
Chronic
Pathogenesis Summary: *KNOW*
1.)
2.)
3.)
4.)
5.)
T or F? If someone is infected, they are colonized.
The capacity of a bacterium to cause disease?
What is a qualitative measure of Pathogenicity?
Bacterial constituents that promote infection?
A pathogen that infects via inhalation or ingestion gained
which type of entry?(ingress or penetration)
6.) Severity of a disease depends on what 2 things?
7.) If a Bacterial surface protein helps it invade tissues it is
known as?
8.) Part w/in bacterial exotoxin that determines cell specificy.
9.) Part within bacterial exotoxin that determines the mechanism
of action of bacteria.
10.) Infection type that is rapid onset, sever but short-lived.
11.) Infection type that is slow to progress and not completely
cleared from the host.
4.)
5.)
6.)
7.)
Infection does NOT have to be at the portal of entry, but although it
spread beyond the initial entry point, the infection is limited to
specific location or tissue.
Organisms spread to several sites, fluids, or tissues. Spread usually
occurs via bloodstream.
Organisms from a localized infection are carried to other specific
tissues.
The initial infection caused by particular organism.
A subsequent infection. Does NOT need to be same site as primary
infection. MAY be result of DIFFERENT infectious agent.
Generally indicate depressed or altered host defenses.
Rapid onset, generally more severe, short lived. Organism is
cleared from the host.
Slower to progress, may persist for a lifetime. Can be mild to very
severe. Tend to have “flare-ups”, especially during times of
stress/compromised immune system. Organism is NOT completely
cleared from host, but may kept @ minimal # to prevent symptoms.
1.) True! You must be colonized in order for it to
result in a disease. (but colonized ≠ infected)
2.) Pathogenicity
3.) Virulence
4.) Virulence Factors
5.) Ingress (did NOT cross any epithelial barriers)
6.) ~Virulence of the organism
~Susceptibility of the host
7.) Active Invasion
8.) B-Domain (contains binding properties)
9.) A-Domain (contains enzyme activity)
10.) Acute
11.) Chronic
Epidemiology:
1.)
2.)
3.)
4.)
5.)
6.)
Define Epidemiology
Define Carrier
Define Etiologic Agent
Define Reservoir
Define Vector
Define Vehicle
Classifications of Infectious Diseases: Define them
1.)
2.)
3.)
4.)
5.)
Sporadic
Outbreak
Endemic
Epidemic
Pandemic
Methods of Transmission:
1.) Direct Contact requires what?
2.) There are 2 types, Horizontal & Vertical, describe
each:
3.) Indirect contact can be via a ____ or a _____.
4.) Give some examples of Vehicles (non-living):
5.) Indirect contact from a Vector (living) can also be
Direct or Indirect. Describe both:
6.) Which type of Vector Transfer, Direct or Indirect
is the pathogen usually a part of the vector’s life
cycle?
1.) If an infectious disease is acquired during a
hospital stay it is called _____.
2.) List the most common bacteria that are responsible
for nosocomial infections: (5) *KNOW*
1.) The study of the distribution & determinants of
health-related states in specific populations &
application of this study to control health problems.
2.) An infected individual who is a potential source of
infection (there can be chronic & acute carriers)
3.) Entity responsible for the disease
4.) The primary habitat in which agent is normally
found & from which infection may result.
5.) Living transmitters of the pathogen
6.) Non-living transmitters of a pathogen.
1.) disease that occurs at irregular intervals & in
unpredictable locations
2.) The sudden & unexpected occurrence of disease,
focally or in a limited segment of population (ex:
15 cases of meningitis on a college campus)
3.) Disease that is maintained @ a steady frequency
over a long period in a particular population or
geographic location
4.) A sudden increase in the occurrence of a disease in
a population, usually w/in specific geographic
region or population. (ex: USA, China, etc…)
5.) The spread of an epidemic over a very large
population of geographic region (other continents)
1.) physical contact
2.) Horizontal = (1) person  person ex: kissing
(2) self  self ex: not washing hands
Vertical = Parent  Child ex: sperm, egg, across
placenta, birth canal, breast feeding
3.) Vehicle ; Vector
4.) Waterborne, Airborne, Foodborne, and Fomites
(nonliving objects that harbor & transmit disease)
7.) Biological/Direct = Active Transmission of the
pathogen! (ex: insect bite)
Mechanical/Indirect = Passive Transmission (ex:
fly feeds on garbage then lands on your food.)
8.) Biological/Direct Transmission
1.) Nosocomial
2.) ~E. coli
~Klebsiella pneumoniae
~Psuedomonas aeruginosa
~Staphylococci
~Streptococci
3.)
Controlling the Spread of Infectious Disease:
1.) What 4 areas may be targeted, depending on which
approach will be most effective?
Etiology Summary: *KNOW*
1.) A transmitter of a pathogen that is NON-living.
2.) A transmitter of a pathogen that is Living.
3.) T or F? If you get an infectious disease while
visiting your friend in the hospital, it was
nosocomially transmitted.
Diagnostic Techniques:
1.) What are the four approaches to bacteriologic
work?
2.) Identify which type of Microscopy each of the
following describe:
a.) Forms an image w/ a beam of electrons
b.) Light passes through the specimen & allows internal
details to be observed.
c.) Light is reflected off the specimen.
d.) Light is passed through the specimen. Used for
bacterial staining.
e.) UV light used to excite fluorochrome labels or dyes
attached to the sample.
1.) Which of the above Microscopy types will show
the most detail?
2.) There are 2 basic types of Electron Microscopy.
Which type requires that you cut the sample into
very thin sections? This same sample is then
showered w/ electrons.
3.) Which type requires that the sample be left intact?
This sample is also bombarded w/ electrons which
get deflected to create a 3-D image.
1.) ~Specific Agent
~Reducing or eliminating the Source
~The Host (reducing # of those susceptible)
~The Spread (reducing/eliminating mode of
transmission)
1.) Vehicle (a vehicle, such as a car, is NOT alive) 
2.) Vector (kinds sounds like the name Victor, and
Victor would be alive) 
3.) False! Nosocomial is only during YOUR hospital
stay. This type could be from either a Vector or a
Vehicle and could have been direct or indirect.
1.) ~Microscopic Observation
~Obtaining a Pure Culture by inoculating it
onto/into bacteriologic medium
~Molecular Techniques performed on pure culture
~Identification of organism
2.) Types of Microscopy:
a.) Electron Microscopy
b.) Phase-Contrast Microscopy (different
densities of various internal structures
retard the light)
c.) Dark Field Microscopy
d.) Light Microscopy
e.) Fluorescence Microscopy
1.) Electron Miscroscopy
2.) TEM (Transmission)
3.) SEM (Scanning)
Staining: Positive & Negative Stains
1.) Which type changes color of the specimen itself?
2.) Which does NOT color the specimen, but changes
the background color?
3.) What are the 4 types of Positive stains?
4.) What are the 2 types of Negative stains?
5.) ____ stains can be either Simple or Differential.
6.) Describe a Simple Stain.
7.) What can a Simple Stain distinguish?
8.) Describe a Differential Stain.
9.) What can it distinguish?
10.) Give 2 important examples of Differential stain:
1.)
2.)
3.)
4.)
5.)
6.)
7.)
Positive Staining
Negative Staining
Gram, Acid Fast, Methylene Blue & Crystal Violet
India Ink & Nigrosin
Positive! (b/c they both dye the specimen)
Utilizes a single dye, Entire specimen stained same color.
Size, Shape, arrangement useful in preliminary
identification (Basic stuff)
8.) Utilizes 2 different colored dyes. One is Primary dye,
other is Counterstain. Cells of different types become
different colors.
9.) Shape, Size, Arrangement, Cell Type & some structural
components (depends on staining technique employed)
10.) Gram (utilizes differences in cell wall structure) & Acid
Fast Staining (differentiates acid fast from non)
Bacteriologic Cultures – Name the type described:
1.) Three 10ml (minimum) blood samples in a 24hr period are
added to a rich growth medium.
2.) Gram stain is performed & sample is swabbed onto
chocolate agar. (Swab of urethral canal, penile or cervix
discharge when STD suspected)
3.) Gram stain of centrifuged CSF & swab onto blood &
chocolate agar.
4.) Primarily when pneumonia or TB expected.
5.) Sample inoculated directly onto blood agar plate.
6.) Methylene blue stain reveals leukocytes (Gram stains not
done due to normal flora)
7.) Variety of techniques used to count the bacteria present.
8.) Samples should be swabbed onto variety of media & grown
under both aerobic & anaerobic conditions.
Molecular Diagnosis:
1.) Each genus & species of bacteria has some _____,
allowing for distinct recognition & identification.
2.) Which method of molecular diagnosis utilizes these
specific regions in order to i.d. bacterium?
3.) Describe it:
4.) Which method of molecular diagnosis determined the
exact order & identity of bases in the DNA sequence?
5.) Which method rapidly increases the amount of DNA in
even a small sample? (this amplified DNA can then be
sequenced)
6.) Which method utilizes the recognition & specificity of
antigen/antibody interactions?
7.) T or F? In Serologic test, the product being recognized
can be either the antigen or the antibody (Ab).
Antimicrobial Susceptibility Testing – Name the type
described:
1.) The highest dilution (lowest qty of drug) required to kill
99.9% of the organism.
2.) The highest dilution (lowest qty. of drug) that is able to
inhibit growth of the organism.
3.) Uses discs impregnated w/ specific concentrations of a
single antibiotic. Overnight incubation reveals “Zones
of Inhibition”
4.) Version of Kirby-Bauer, but this uses paper strips w/ a
concentration gradient of the chosen antimicrobial agent
along the strip.
5.) Which is considered the “Gold Standard”?
6.) Which test will give you the MIC?
1.)
2.)
3.)
4.)
5.)
6.)
7.)
Blood Culture
Genital Tract Cultures
Spinal Fluid Cultures
Sputum Cultures
Throat Cultures
Stool Cultures
Urine Cultures (count bacteria present in the
urine)
8.) Wound/abscess Cultures (need wide variety of
media b/c there is a variety of possible causes for
the wound/abscess)
1.) Genetically unique regions
2.) Nucleic Acid Hybridization & Probes
3.) Specific “probes” are incubated w/ the sample &
visualized to determine if hybridization occurred (if
probe recognized the genetically unique region)
Can be seen b/c probes carry Reporter Molecules
(fluorescent dyes, radioactive labels, enzyme
labels)
4.) DNA Sequencing
5.) PCR (Polymerase Chain Reaction)
6.) Serologic Tests
7.) True
1.) MBC (Minimum Bactericidal Concentration)
2.) MIC (Minimum Inhibitory Concentration)
3.) Disc-Differentiation Test OR Kirby-Bauer (size of
the Zone of Inhibition corresponds to the
susceptible, intermediate, or resistant)
4.) E-Test
5.) MIC (BUT rarely used b/c expensive & time
consuming)
6.) Well, the MIC test (duh!) & also the E-Test!
*In the E-test, the MIC is read at the point where
growth intersects with the strip.
Diagnostic Techniques Summary: *KNOW*
1.) A type of Electron Microscopy where a LIVE sample
can be examined.
2.) Type of Electron Microscopy where the sample MUST
be dead.
3.) Type of Electron Microscopy that gives 3-D images.
4.) Gram staining is a type of ______ stain.
5.) Acid Fast staining is a type of ______ stain.
6.) A type of stain that utilizes the differences in cell wall
structures.
7.) A type of stain that distinguishes acid-fast bacteria
(Myobacterium & Nocardia spp.) from non acid-fast
bacteria (almost everything else).
8.) Which Susceptibility Test types will give MIC?
Controlling Microbial Growth: Define the following
1.)
2.)
3.)
4.)
5.)
6.)
Antiseptic
Bactericide
Bacteriostatic
Disinfectant
Sanitizer
Sterilization
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
SEM (Scanning)
TEM (Transmission)
SEM (Scanning)
Positive (Differential)
Positive (Differential)
Gram Stain (type of Positive Differential stain)
Acid Fast Stain (type of + Differential stain)
MIC & E-Test
1.) Chemical agent that can be safely used externally on
living tissue.
2.) Agent that kills bacteria (most DON’T kill spores)
3.) Agent that inhibits the growth of bacteria (does NOT
kill)
4.) Chemical agent used on inanimate objects to kill
microorganisms
5.) Reduction in the number of pathogenic organisms to
point where they no longer pose threat of disease
6.) Chemical agent, typically used on food prep tools n
surfaces to reduce number of bacteria to meet
accepted public health standards.
7.) Killing or removal of ALL microorganisms
(including spores)
1.) Potency of the antimicrobial agent is affected by
what 4 things?
2.) Name the 4 areas that these agents target in
bacteria:
1.) ~Time (more exposure = more organisms affected)
~pH (↑ ionization = ↑ ability to penetrate cell)
~Temperature (raising temp. 10°C can double
death rate for given time period)
~Concentration (↑ concentration can make a
bacteriostatic agent bactericidal)
2.) >Cell Wall (block its synthesis or digest it)
>Cell Membrane (disrupts its integrity)
>Proteins (denature them)
>Nucleic Acids (denature, mutate, or damage)
1.) Name the 3 types of physical control:
2.) Name the 1 method for mechanical control:
3.) List the 6 methods for chemical control:
1.) ~Irradiation (UV light sterilizes surfaces, but cannot
penetrate, not even a piece of paper)
~Heat (Dry heat, Incineration, Boiling, Autoclaving)
~Pasteurization (kills most vegetative bacterial cells)
2.) Filtration (used for disinfecting agents than cannot b
heated. Ex: HEPA filter, liquid membrane filter)
3.) >Chlorine (liquid or gas form)
>Iodine (2-2.% = antiseptics ; 5% = disinfectant)
>Phenolics (denature proteins & disrupt cell
membranes. Many toxic, so not antiseptics!
>Alcohols (must have water to work properly)
>Detergents (surfactants, disrupt cell membranes)
>H2O2 (produces toxic oxide radicals. Can be sporicidal
@ high concentrations)
Controlling Growth Summary: *KNOW*
1.) List the methods that will kill spores:
2.) T or F? Irradiation will ONLY kill bacteria on a
surface.
3.) Which is the most commonly uses method for
controlling microorganisms?
4.) ___ can be used on humans.
5.) ____ is used on inanimate objects.
6.) T or F? 100% alcohol would be ideal to kill
bacteria b/c it is the strongest available.
Therapy– Define the following:
1.)
2.)
3.)
4.)
5.)
Antibiotic (Narrow Definition)
Antibiotic (Broad Definition)
Chemotherapeutic Agent
Antimicrobial
Spectrum of Activity:
a.) Broad Spectrum
b.) Narrow Spectrum
c.) Extended Spectrum
1.) List some properties that are desirable in an
antimicrobial agent: (6)
2.) Therapeutic agents attack what 5 areas of bacteria?
Agents affecting Cell Wall Synthesis:
1.) List all that do:
2.) What generalizations can we make about some of
the drugs in this category?
1.) Sterilization, Irradiation, Autoclaving, Chlorine,
Iodine, H2O2 (higher concentrations)
2.) True! (UV will not penetrate ANYTHING, not
even a piece of paper)
3.) Heat!
4.) Antiseptics
5.) Disinfectants
6.) False! It would not work properly b/c it does NOT
contain water. (must have water to kill properly)
1.) Antimicrobial agents produced by microorganisms
that kill or inhibit other microorganisms.
2.) Any chemical or agent (regardless of origin) that
has effect of killing/inhibiting growth of other
types of cells.
3.) Antimicrobial agents of synthetic origin useful in
treatment of microbial or viral disease.
4.) Spectrum of Activity:
a.) effective against many types of bacteria
b.) effective against a few types of bacteria
c.) effective against most Gm(+) & (-) bacteria
1.) ~Selective Toxicity (harms pathogen, not you)
~Solubility in fluids (functions even when highly
diluted & remains active once soluble)
~Susceptible organisms don’t readily become
resistant
~Should not produce adverse side effects
~Should be bactericidal (not just bacteriostatic)
~Stable (remains active in tissues, not broken down
or excreted too quickly)
2.) Affect the Cell Wall, Membrane, Nucleic Acid
Synthesis, Protein Synthesis or are Competitive
Inhibitors/Metabolic Antagonists.
*know which agents do what (detailed below)!
1.) Penicillins (G & V), β -lactamase resistance
penicillins, Aminopenicillins, Extended Spectrum
penicillins (anti-pseudomonals), Cephalasporins,
Carbapenems/Carboxypenems, Monobactams, β lactamase Inhibitors, Non-β-lactam Cell Wall
Inhibitors.
2.) ~ALL “penicillins” affect cell wall synthesis
~Anything w/ “β” in the name affect cell wall syn.
~So the only names in this category we actually
have to memorize are: Cephalosporins,
Carbapenems/Carboxypenems, Monobactams.
Agents affecting Cell Wall Synthesis cont…: Tell which
agent is being described:
1.) Thiozolide ring joined to a β -lactam ring.
2.) Are β -lactamase sensitive & can penetrate the outer
membrane of some gram(-) bacilli.
3.) Nearly all pathogenic staphylococci r resistant.
4.) Are B-lactamase sensitive & used to treat Pseudomonas
aeruginosa infections.
5.) Extremely Broad spectrum agents w/ a β-lactam ring. Must
be IV admin (low BA).
6.) Narrow Spectrum agents. Active against many Gm(-)
aerobic organisms & is essentially resistant to βlactamase/cephalosporinase degredation.
7.) Useful for treating individuals allergic to penicillins.
8.) Semisynthetic derivatives made by adding particular
synthetic side chain to a penicillin core.
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
Penicillins (Penicillin G, Penicillin V)
Aminopenicillins
Penicillins (G & V)
Broad Spectrum Penicillins (anti-pseudomonals)
Carbapenems/Carboxypenems
Monobactams
Monobactams
Penicillins (G & V)
1.)
2.)
3.)
4.)
5.)
6.)
7.)
Penicillins
Cephalosporins
Cephalosporins
β-lactamase Inhibitors
Cephalosporins
Penicillins (G & V)
Penicillins (G & V)
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
β-lactamase Inhibitors
β-lactamase Resistant Penicillins
Aminopenicillins
β-lactamase Inhibitors
Carbapenems/Carboxypenems *all have “penem”
Extended Spectrum Penicillins
Monobactams
Non β-lactam cell wall inhibitors
Cont…
1.) ONLY effective against Gm(+) bacteria.
2.) Contain a β -lactam ring linked to a 6-member
dihydrothiazide ring.
3.) Same mechanism of action as penicillins, but has a broader
spectrum than penicillins.
4.) Proteins designed to inhibit or destroy the effectiveness of β lactamase enzymes & are combined w/ a β-lactam antibiotic
since they have little antimicrobial activity alone.
5.) Classified into “generations”
6.) Many bacteria are resistant to this drug b/c β-lactamase is
capable of hydrolyzing the β-lactam ring, rendering drug
ineffective.
7.) They work during the last stage of bacterial cell wall
synthesis by interrupting completion of cell wall.
Cont…
1.) Consists of Clavulanic Acid, Sulbactam, Tazobactam.
2.) Consists of Oxacillin, Methicillin, Dicloxacillin, Nafcillin,
Cloxacillin, Fluclocillin.
3.) Consists of Ampicillin, Amoxicillin, Carbenicillin
4.) Consists of Clavulanic Acid, Sulbactam, Tazobactam
5.) Consists of Imipenem, Meropenem, Ertapenem
6.) Consists of Mezlocillin, Piperacillin, Azlocillin,
Carbenicillin, Ticarcillin
7.) Consists of Aztreonam
8.) Consists of Bacitracin, Vancomycin, Fosfomycin
Cephalosporins:
1.)
2.)
3.)
4.)
Describe 1st generation cephalosporins:
2nd Generation:
3rd Generation:
4th Generation:
1.) ~Activity & spectrum like penicillins
~PEcK drugs (b/c active against Proteus, E. coli, &
Klebsiella pneumoniae)
~Drugs Include: All of the “Ceph” drugs
2.) ~High activity against Gm(-), but Low activity against
Gm(+)
~HENPEck drugs (b/c affective against same as
generation 1 plus Haemophilus influenzae,
Enterobacter aerogenes, & Neisseria.
~Drugs include: see list on pg. 45
3.) ~More active against Gm(-) than 1st or 2nd gen.
~Drugs include: see list on pg. 45
4.) ~Effective against BOTH Gm(-) & (+)
~Drugs include: Cefepime, Cefozopran, Cefoselis, Flomoxef
Non B-lactam Cell Wall Inhibitors:
1.) Which can only be used topically?
2.) Which is bactericidal for staphylococci and is
restricted to treatment of serious infection by Blactam resistant Gm(+) [staph, strep].
3.) Which is now a “Restricted Antibiotic”? Why?
4.) Which is used to treat non-complicated UTI’s?
Agents that Affect Cell Membrane:
1.) These agents act on _____ and are therefore
usually ineffective against Gram __ bacteria.
2.) Name the 2 drugs in this category:
3.) Describe Polymyxin:
4.) Describe Daptomycin:
Agents that Affect Nucleic Acid Synthesis:
1.) Name the 2 categories of drugs that do this:
2.) Name the 3 Fluoroquinolones:
3.) Which is generally used in treatment of Gm(-) & (+) bacteria
that cause UTI’s.?
4.) Which is generally used in treatment of enterococci,
staphylococci & pseudomonas infections?
5.) Which is generally used in treatment of pneumonia,
bronchitis, & sinusitis?
6.) Which is used to treat anthrax?
7.) Why are some quinolones useful in treating infections caused
by intracellular parasites?
8.) How do the quinolones work?
9.) How does Rifampin work?
Agents that Affect Protein Synthesis:
1.) Which bind to the 50S subunit of the bacterial
ribosome?
2.) Which bind to the 30S subunit?
3.) T or F? Chloramphenicol is the drug of choice for
many infection types.
4.) What is a major problem w/ Clindamycin?
5.) Which is the only common antibiotic that will treat
Legionnaire’s disease?
6.) Which is used to treat Respiratory infections
caused by MDR Streptococcus pneumoniae?
1.) Bacitracin (due to nephrotoxicity)
2.) Vancomycin (Bacitracin is also bactericidal for
staphylococci)
3.) Vancomycin – due to recent emergence of resistant
organisms
4.) Fosfomycin
5.) Phosphatidylethanolamines ; Gram(+) – b/c they
lack phosphatidylethanolamines.
6.) ~Polymyxin
~Daptomycin
7.) ~Clinically useful compound in Colistin
(Polymyxin E)
~Effective against mainly Gm(-) & usually limited
to topical use (nephrotoxicity & neurotxicity)
~Inhibits cell membrane phospholipids (increases
permeability of cell membrane = loss of metabolites)
8.) ~Depolarizes the membrane of Gm(+) bacteria
1.)
2.)
3.)
4.)
5.)
6.)
7.)
Quinolones/Fluoroquinolones & Rifampin
Sparfloxacin, Norfloxacin & Ciprofloxacin
Ciprofloxacin
Norfloxacin
Sparfloxacin
Ciprofloxacin
b/c some can penetrate macrophages & neutrophils
better than most antibiotics.
8.) Inhibit bacterial DNA synthesis by blocking DNA
Gyrase (enzyme which allows DNA to relax for replication)
9.) Inhibits RNA synthesis by binding to RNA
Polymerase, preventing transcription.
1.) Chloramphenicol, Clindamycin, Macrolides
(Ertythromycin, Azithromycin), Ketek (Telithromycin)
& Linezolid
[CLEAn Tag = “Clean” part means binds 50S]
*note: Ketek not in the memory trick cuz too new.
2.) Aminoglycosides (Gentamycin, Kanamycin,
Streptomycin, Spectinomycin, Tobramycin),
Tetracyclines (tetracycline & doxycline)
[Clean TAg = “Tag” part means binds 30S]
3.) FALSE! NOT anymore.
4.) Causes Antibiotic-associated pseudomembranous colitis.
5.) Macrolides (Erythromycin, Azithromycin)
6.) Ketek (Telithromycin)
Agents that Affect Protein Synthesis cont…:
1.) Which group has narrow margin of safety & primarily
used to treat infections by aerobic Gm(-) bacteria?
2.) What treats walking pneumonia?
3.) What can treat anthrax & Lyme disease?
4.) Which class that interferes w/ protein synthesis is
considered the only bactericidal class?
5.) Which class bacteriostatic, w/ widest activity spectrum?
6.) Which can prevent the formation of the 70S ribosomal
complex? (also binds 50S subunit)
7.) Which treats mycoplasma & Chlamydophila infections?
8.) Which binds the 50S subunit in 2 places?
9.) Which can replace Synercid in treatment of penicillinresistant Streptococcus pneumoniae, methicillingresistant Staphylococcus aureus (MRSA), & VRE?
Competitive Inhibitors/Metabolic Antagonists:
1.) Name the classes in this category:
2.) Which is an anti-metabolite for the vitamins
nicotinamide & pyridoxal?
3.) Which work via competitive inhibition of paminobenzoic acid (PABA) b/c they compete for
binding in the synthesis of hihydrofolate (DHT)?
4.) Which work by interrupting the synthetic pathway
of tetrahydrofolic acid (THFA)?
5.) Which is unusually effective against myobacteria?
(b/c it also inhibits synthesis of mycolic acid)
6.) Which gets its selective toxicity from fact that
mammal’s utilize preformed folates from diet?
Therapy Summary: *KNOW*
1.) ALL penicillins do what to kill bacteria?
2.) T or F? B-lactamase is a part of antimicrobial agents that makes
them more effective.
3.) Generation of cephalosporins that are most active against Gm(-)?
4.) Generation are active against BOTH Gm(-) & (+)?
5.) Generation that closely resembles penicillins?
6.) Generation that’s more active against Gm(-) than Gm(+).
7.) Generation where all drugs start w/ Ceph…? (others are Cef…)
8.) Which of the agents that affect cell membranes can treat Gm (+)
bacteria? (& thus MRSA)
9.) Class of drugs more effective @ treating infections caused by
intestinal parasites?
10.) Class of drugs more effective @ treating infections caused by
intracellular pathogens?
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
9.)
Aminoglycosides
Tetracycline
Doxycycline
Aminoglycosides
Tetracyclines (Tetra & Doxycycline)
Linezolid (only drug in the Oxazolidinones class)
Macrolides (Erythromycin & Azithromycin)
Linezolid – helps it avoid resistance 
Linezolid
1.) ~Sulfonamides
~Trimethoprim
~Isoniazid
2.) Isoniazid
3.) Sulfonamides
4.) Trimethoprim
5.) Isoniazid
6.) Sulfonamides
1.) Affect the Cell Wall
2.) FALSE! It is an enzyme that bacteria have, which
allows them to be resistant to many types of
antimicrobials (renders drug ineffective).
3.) 3rd generation (more than 1st or 2nd)
4.) 4th generation
5.) 1st generation
6.) 2nd generation [but 3rd generation is even more potent
against Gm(-)]
7.) 1st generation
8.) Daptomycin (NOT polymyxin)
9.) Quinolones (& Fluoroquinolones)
10.) Rifampin (b/c can penetrate phagocytic cells)
Therapy Summary Cont…: *KNOW*
1.) Agent affecting nucleic acid synthesis that inhibits RNA?
2.) Agent affecting nucleic acid synthesis that inhibits DNA?
3.) T or F? Clindmycin is the drug of choice for treating
antibiotic-associated pseudomembranous coltitis.
4.) Agents that affect protein synthesis, which are bactericidal?
5.) Class of antimicrobials with the widest spectrum of activity?
6.) Which binds the 50S subunit in 2 places?
7.) Can replace Synercid in treatment of penicillin-resistant
Streptococcus pneumoniae, methicilling-resistant
Staphylococcus aureus (MRSA), & Vancomycin-resistant
enterococcus faecium & faecalis (VRE)?
8.) Prevents the attachment of the charge tRNA (“blocks docking
site”)
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
Rifampin (inhibits RNA)
Quinolones/Fluoroquinolones
False! It CAUSES that!!!
ONLY Aminoglycosides
Tetracyclines
Linezolid
Linezolid
Tetracyclines
Mechanisms of Antimicrobial Resistance – Describe
each of the 4 basic mechanisms bacteria use:
1.)
2.)
3.)
4.)
Decrease Accumulation of Drug in the cell:
Changes in the Target for the drug
Inactivation of the Drug
Modification (by-pass) of the targeted metabolic
pathway
1.) Two ways:
~Decreased Penetration of drug into cell:
altered cell surface receptor
downregulation of gene for cell-surface receptor
~Increased Removal of Drug out of cell:
Drug efflux pumps excrete drug out of cell so there is
insufficient drug qty to be effective.
2.) Leads to decreased affinity or binding of drug to the
target or active site.
3.) Bacteria produce enzymes that permanently alter the
structure of the drug (β-lactamases, Penicillinases,
Cephalosporinases)
4.) Bacteria produce new enzymes that allow it to
circumvent the affected pathway. Activity of other
pathways may increase to compensate.
1.) Give an example of a drug that is susceptible to
Antimicrobial resistance due to changes in target.
2.) Give an example of some bacteria that possess
Penicillinases.
3.) Give an example of some bacteria that possess
Cephalosporinases.
Vaccines:
1.) ~Erythromycin (bacteria alter their 50S subunit
to resist this)
~Penicillin & Streptomycin (bacteria alter their
binding proteins to resist these)
2.) Staphylococcus aureus, PPNG (penicillinaseproducing Neisseria gonorrhoerae)
3.) Klebsiella pneumoniae, Streptococcus
pneumoniae
1.) similar a vaccine antigen is to the disease-causing form of
the organism
2.) Active
1.) The more ____, the better the immune response to
the vaccine.
2.) Vaccines give ___ immunity through the
stimulation of antibody production.
3.) Describe the main features of Live Attenuated
vaccines:
3.) ~Modify disease-causing organism into non-pathogenic form
~Cells are alive so can multiply & emulate actual infection
~CANNOT be given to immunocompromised people (alive)
~Induces Humoral & Cell-mediated Immunity
~Immune response is virtually identical to that produced
by natural infection.
~Usually effective w/ 1 dose
~May cause inflammatory response; can revert back to
pathogenic wild-type
~Circulating Ab’s can eliminate organism, reduces immunity
[so don’t give till 1 yr old b/c of maternal Ab’s (antibodies)]
~Fragile (killed by heat & light)
1.) Describe the main features of Inactivated Vaccines:
2.) There are 2 types of Fractional – protein based
vaccines. Name & describe both:
3.) There are also 2 types of Fractional –
polysaccharide based vaccines. Name & describe:
1.) ~Composed of EITHER whole organism or fractions of the
organism
~Produced Humoral Response ONLY
~B/c organisms is dead, more antigens are required for
immunity (usually multiple doses needed or boosters)
~Can be given to immunocompromised people
~Types: (1) Killed Whole Cell
(2) Fractional – protein or polysaccharide based
(3) Recombinant (genetic engineering)
2.) Subunit = single or multiple antigenic proteins
Toxoid = inactivated toxin or only the B subunit (remember:
the B subunit = Binding part)
3.) Conjugate = links the non-immunogenic polysaccharide to
an antigenic component.
Pure = purified polysaccharide (not consistently
immunogenic in children less than 2 yrs. Old)
General Rules for Vaccination:
1.) ___ are generally NOT affected by circulating Ab’s & can be
given to children less than 1 yr.
2.) T or F? Some vaccines are contraindicated with the
administration of others on the US.
3.) T or F? Increasing the interval between doses does NOT
diminish the effectiveness of a series.
4.) T or F? Decreasing the interval between doses of a multiple
dose vaccine does NOT interfere w/ the Ab response & level
of immunity.
5.) T or F? If there is an extended interval between doses, you
may want to add an extra dose or restart the series.
6.) T or F? The only contraindication for ALL vaccines is
allergy to the vaccine or component.
7.) T or F? NEVER mix vaccines in same syringe.
1.) Inactivated vaccines
2.) False! (simultaneous admin. does NOT increase
chance for adverse effects nor does it decrease
efficacy of the vaccines given)
3.) True!
4.) False! Decreasing the interval may interfere with
Ab response and level of immunity
5.) False! EXCEPT Oral Typhoid!!!
6.) True! (pregnancy & immunodeficiency are
contraindicated in SOME vaccines)
7.) Kinda tricky…False! CAN ONLY when directed
by the FDA to do so.
1.) What is the Vaccine Information Statement?
2.) T or F? It is considered Informed Consent.
3.) T or F? Permanent documentation that is was
provided is required.
4.) T or F? A new vaccine, which has not developed a
VIS, cannot be given until the VIS is written and
can be provided to the patient/guardian.
5.) What is VAERS?
6.) T or F? VAERS wants you to report any medical
events occurring after a vaccination even if you are
not sure the even was due to the vaccine.
1.) Form that must be provided to the patient or
guardian with EACH DOSE.
2.) False! (so no signature needed)
3.) True! (w/ the date given & date of VIS must be
recorded in patient’s chart)
4.) False! Even is a new vaccine has no VIS, you can
still provide vaccine.
5.) Vaccine Adverse Event Reporting System –
monitoring system jointly administered by the
CDC & FDA.
6.) True!
Vaccine Examples:
1.) List some common vaccines that are Live
Attenuated.
2.) List some that are Killed Bacteria:
3.) List some that are Toxoid:
4.) List some that are Polysaccaride Conjugate:
Vaccine Summary: *KNOW*
7.) T or F? Vaccines give passive immunity.
8.) Vaccine type uses Live organisms?
9.) Vaccine type gives Humoral Immunity ONLY.
10.) Can NOT be given to immunocompromised
patients.
11.) Response is virtually identical to that produced
during an infection.
12.) Usually required multiple doses.
1.)
2.)
3.)
4.)
TB, Typhoid, Pertussis (old type)
Cholera, Plague
Diptheria, Tetanus
Meningicoccal meningitis, Pneumonia
1.)
2.)
3.)
4.)
5.)
6.)
False!
Live Attenuated
Inactivated
Live Attenuated
Live Attenuated
Inactivated