4/4/2019 Chapter 22 Homework

Chapter 22 Homework
Due: 1:59pm on Monday, April 15, 2019
You will receive no credit for items you complete after the assignment is due. Grading Policy

Video Tutor: Influenza

Watch the Video Tutor on Influenza and then answer the questions below.

Part A
Which of the following signs or symptoms is characteristic of an infection with the flu virus?

Hint 1.

The sign or symptom may be painful.

ANSWER:

Vomiting

Diarrhea

Rash

Myalgia

Correct
Muscle pain is common during infection with influenza virus.

Part B
What are the two categories of influenza virus?

Hint 1.

They are grouped according to letters.

ANSWER:

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DNA and RNA

group B and group C

Gram + and Gram –

type A and type B

Correct
The two strains of flu include type A and type B influenza viruses.

Part C
What type of genome is found in influenza viruses?

Hint 1.
The type of material found in the genome is also found in the host cell cytoplasm.

ANSWER:

DNA and RNA

Single-stranded RNA

Retroviral DNA

Single-stranded DNA

Correct
Influenza viruses have 8 segments of single-stranded RNA.

Part D
What is the role of neuraminidase during infection of the host?

Hint 1.

The defenses of the host cells must be overcome before the virus can infect the cells.

ANSWER:

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It binds to host cells.

It kills the host cell.

It hydrolyzes mucus.

It binds to antibodies inhibiting immunity.

Correct
Hydrolyzing mucus provides the virus access to cell surfaces.

Part E
Major mutations in influenza viruses that occur approximately every decade are known as __________ and result in new
strains of virus.

Hint 1.
The changes affect the surface of the virus.

ANSWER:

mutational variation

antigenic drift

lysogenic conversion

antigenic shift

Correct
The surface antigens of two very different viruses may recombine to form a new strain resulting in epidemics.

Part F
Which strain of influenza virus has become resistant to all currently approved antiviral drugs?

Hint 1.

It is a newer strain of virus.

ANSWER:

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H7N9

H3N2

H1N1

Type B

Correct
The strain of influenza H7N9 is incredibly resistant to drugs.

Part G
Typically, antiviral therapy must begin within __________ of infection to be effective.
ANSWER:

5 days

2 weeks

12 hours

48 hours

Correct
After two days the treatment will not produce very effective results.

Video Tutor: Tuberculosis

Watch the Video Tutor on Tuberculosis and then answer the questions below.

Part A
Mycobacterium tuberculosis is considered a(n) __________.

Hint 1.

Think about the habitat of Mycobacterium tuberculosis.

ANSWER:

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facultative anaerobe

anaerobe

microaerophile

aerobe

Correct
Mycobacterium tuberculosis requires oxygen to survive.

Part B
One of the primary reasons the disease is able to evade the body’s immunity is that it __________.

Hint 1.
Macrophages are typically the primary defense against Mycobacterium tuberculosis.

ANSWER:

produces a capsule

is camouflaged in hyaluronic acid

resists digestion by phagocytes

hides within host epithelial cells

Correct
Mycobacterium tuberculosis is capable of inhibiting phagocytosis.

Part C
In approximately 10% of patients tubercles rupture and reactivate infection. This is known as _____ tuberculosis.

Hint 1.

Reactivation of the infection can only occur after initial infection.

ANSWER:

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secondary

disseminated

primary

tertiary

Correct
Secondary tuberculosis or reactivated tuberculosis results when tubercles release the bacteria back into the lungs.

Part D
It is estimated that _____ of the world’s population may be infected with tuberculosis.

ANSWER:

33%

5%

75%

1%

Correct
Tuberculosis is very prevalent around the world, especially in Africa and Asia.

Part E
How do clinicians primarily screen for tuberculosis in patients?

ANSWER:

Tuberculin skin test

Urinalysis

Blood test

Throat swab

Correct
A positive result on a tuberculin skin test would result in a raised lesion.

Part F
Why does tuberculosis involve months of antibiotic treatment?
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Hint 1.

The length of treatment involves the mycolic acid cell wall.

ANSWER:

The bacteria become resistant to the medications after only a month of treatment.

The bacteria go into a dormant state.

The bacteria grow very slowly.

The antibiotic treatment is so toxic, it can only be given in very small doses.

Correct
Because mycolic acid is so time consuming to produce, Mycobacterium tuberculosis grows very slowly.

Part G
What is the name of the vaccine given to prevent TB in countries where it is endemic?

ANSWER:

RTS vaccine

Pneumovax vaccine

DTaP vaccine

BCG vaccine

Correct
The BCG vaccine is given to patients in countries where TB is common.

Clinical Case: The Coughing Cousin

The Coughing Cousin

Twenty-one-year-old Marjorie comes to the family practice office for evaluation of a dry cough that has not gotten better over the
last seven days. Before she started coughing, she had a mild fever, runny nose, and sneezing for 10 days, but she was able to
carry out her usual routine. She reports “coughing spells” frequently during the day and recalls one episode in which she gagged
and vomited. She has a mild coughing episode while in the office, and although it is paroxysmal, there is no “whoop” noted.
Marjorie is a part-time college student attending evening classes and helps her aunt with her younger cousins during the day.
Her cousins are five years old and six weeks old and also come to the same office for health care. Both cousins appear well,
without any signs or symptoms, and a review of their charts reveals they are current for all scheduled vaccines. Marjorie’s last
vaccine was at age 16.

Part A

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Should a lower respiratory infection such as pertussis be considered the cause of the symptoms instead of rhinitis or
sinusitis for this patient? Why?

Hint 1.

Consider the sequence of symptoms for a pertussis infection.

ANSWER:

No, pertussis is a disease of young children.

Yes, pertussis may occur in older individuals.

No, she is not presenting with the characteristic deep “whoop” cough.

No, this patient would have had the DTP vaccine as a child.

Correct
Pertussis begins with symptoms similar to those of rhinitis, but after two weeks it will progress to include cough.

Part B
Which of the stages listed is NOT considered one of the clinical stages associated with pertussis?

Hint 1.

There are three recognized clinical stages associated with a pertussis infection.

ANSWER:

paroxysmal

latency

convalescence

catarrhal

Correct
Bordetella pertussis has not been shown to have a latent period in humans. A latent period is commonly
associated with bacterial respiratory infections such as tuberculosis.

Part C
To diagnostically confirm the presence of Bordetella pertussis and the diagnosis of whooping cough, which medium should
be used to cultivate respiratory samples in the morning at the bedside of the patient?

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Hint 1.

B. pertussis is extremely sensitive to drying and requires an enriched medium for cultivation.

ANSWER:

chocolate agar

Bordet-Gengou agar

eosin methylene blue agar

sheep’s blood agar

Correct
Bordet-Gengou agar is highly enriched for the growth of B. pertussis and has additives for selection against other
bacteria in the normal flora.

Part D
Should any of Marjorie’s family members whom she comes into contact with be considered at risk of pertussis? If so, who?

Hint 1.

Age and vaccination history will be a factor.

ANSWER:

Yes, the aunt should be considered at risk.

Yes, the five-year-old cousin should be considered at risk.

Yes, the six-week-old cousin should be considered at risk.

No, no one should be considered at risk.

Correct
At this age, the cousin may not have begun the series of DPT vaccinations.

Part E
How is B. pertussis and whooping cough transmitted from one person to the next?

Hint 1.

B. pertussis is highly contagious but also highly fragile.

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ANSWER:

inhalation of respiratory droplets

ingestion of respiratory secretions

inhalation of bacterial endospores

insertion into wound

Correct
Inhalation of respiratory droplets formed during a coughing episode of someone who has pertussis will transmit
the bacteria.

Score Summary:
Your score on this assignment is 100%.
You received 2 out of a possible total of 2 points.

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