Microbiology Ch 12 case studies

Immune System Weakness and COVID-19 Skip to question Immune System Weakness and COVID-19 In Sept 2020, S released an article, "Hidden immune weakness found in 14% of gravely ill COVID-19 patients," highlighting two research papers that were published in the Science journal that week. Both research articles reported a relationship between the interferon response of patients and their severity of COVID-19 disease. These findings may help explain why men and the elderly are more at risk of severe disease. How Interferons Work Please watch the video below, and then use what you have learned from the chapter to answer the questions, demonstrating your understanding of how interferons work as a second line defense. H. pylori and Ulcers Skip to question Bacteria Cause That? Read the case file below and complete the activities that follow. I was working in an endoscopy unit as a registered nurse when I met Natasha, a 20-year-old college student. Natasha was having a gastroscopy to determine the cause of her persistent stomach pain. Natasha had been having episodes of epigastric pain intermittently for 5 years. Approximately every 4 to 6 weeks, she would experience intense upper abdominal pain that left her unable to engage in her usual activities, including her classes and work. She would experience what she described as intense hunger, but pain would worsen immediately after eating so she learned to avoid eating during the worst of her “attacks,” which could last as long as 5 days. She had been admitted to the emergency room after a particularly intense bout of pain. She was dehydrated and weak and her pain was constant. Lab studies revealed an elevated hemoglobin level, indicative of dehydration, and a normal white blood cell count. She had no fever. Her epigastric area was moderately tender on palpation. Her heart rate was elevated, likely as a response to the pain she was experiencing. The ER physician who examined her had admitted her to the hospital and arranged an urgent gastroscopy. Once in the endoscopy unit, Natasha was given medications to induce conscious sedation. The back of her throat was anesthetized and the gastroscopy scope was passed down her throat. The esophagus was visualized as normal. The stomach, however, was inflamed, with evidence of prior healed ulcerations. One small, unhealed lesion remained. Just as the ER physician had expected, Natasha had a gastric ulcer. Biopsies of the inflamed area were obtained, as well as photographs of the lesion, and the scope was removed. Natasha was then given medication to reverse the effects of the sedatives. Once fully recovered, Natasha was released to go home. A week later, Natasha had an appointment with the gastroenterologist, who told Natasha that biopsies had revealed the presence of Helicobacter pylori in her stomach, which had caused the ulcers. She was prescribed a combination of antibiotics and an acid reducer and was given an appointment to follow up after she had completed the therapy to confirm the efficacy of the treatment. She was also instructed to contact them again if she experienced any more episodes of stomach pain. H. pylori is a gram-negative bacterium found in the stomach. It is estimated that more than half of the world’s population harbors this bacterium in their upper gastrointestinal tract. However, most people are asymptomatic and may never know that they carry the microorganism. Symptoms occur in about 20% of infected people. Symptoms may include stomach pain, bloating, belching, and nausea. The stomach’s acidic environment is usually very efficient at killing microorganisms that are swallowed. How does H. pylori survive and thrive in this harsh environment? H. pylori uses its flagella to burrow into the mucous lining of the stomach until it reaches a more neutral area. In a process known as chemotaxis, H. pylori can sense areas of acidity and can move to more hospitable areas. It also has the ability to neutralize acid in its immediate environment by using urease to break down urea into ammonia and carbon dioxide. The ammonia neutralizes harmful stomach acid. An inflammatory response by the body tries to combat the invasion by H. pylori. A significant part of this response is for the stomach to produce even more acid. Unfortunately, the extra acid sometimes damages the lining of the stomach and the duodenum, causing ulcerations (ulcers). Treatment of H. pylori usually involves taking the antibiotics amoxicillin and clarithromycin, along with a proton pump inhibitor, which reduces the production of excess stomach acid. This is commonly called triple therapy and is usually effective at eradicating H. pylori, as it did in Natasha’s case. Data Analysis The Helicobacter pylori Antimicrobial Resistance Program (HARP) is a network of centers in the United States that tracks the rates of antimicrobial resistance across the nation. Read the graph and answer all questions presented below. H. pylori and Ulcers Skip to question Bacteria Cause That? Read the case file below and complete the activities that follow. I was working in an endoscopy unit as a registered nurse when I met Natasha, a 20-year-old college student. Natasha was having a gastroscopy to determine the cause of her persistent stomach pain. Natasha had been having episodes of epigastric pain intermittently for 5 years. Approximately every 4 to 6 weeks, she would experience intense upper abdominal pain that left her unable to engage in her usual activities, including her classes and work. She would experience what she described as intense hunger, but pain would worsen immediately after eating so she learned to avoid eating during the worst of her “attacks,” which could last as long as 5 days. She had been admitted to the emergency room after a particularly intense bout of pain. She was dehydrated and weak and her pain was constant. Lab studies revealed an elevated hemoglobin level, indicative of dehydration, and a normal white blood cell count. She had no fever. Her epigastric area was moderately tender on palpation. Her heart rate was elevated, likely as a response to the pain she was experiencing. The ER physician who examined her had admitted her to the hospital and arranged an urgent gastroscopy. Once in the endoscopy unit, Natasha was given medications to induce conscious sedation. The back of her throat was anesthetized and the gastroscopy scope was passed down her throat. The esophagus was visualized as normal. The stomach, however, was inflamed, with evidence of prior healed ulcerations. One small, unhealed lesion remained. Just as the ER physician had expected, Natasha had a gastric ulcer. Biopsies of the inflamed area were obtained, as well as photographs of the lesion, and the scope was removed. Natasha was then given medication to reverse the effects of the sedatives. Once fully recovered, Natasha was released to go home. A week later, Natasha had an appointment with the gastroenterologist, who told Natasha that biopsies had revealed the presence of Helicobacter pylori in her stomach, which had caused the ulcers. She was prescribed a combination of antibiotics and an acid reducer and was given an appointment to follow up after she had completed the therapy to confirm the efficacy of the treatment. She was also instructed to contact them again if she experienced any more episodes of stomach pain. H. pylori is a gram-negative bacterium found in the stomach. It is estimated that more than half of the world’s population harbors this bacterium in their upper gastrointestinal tract. However, most people are asymptomatic and may never know that they carry the microorganism. Symptoms occur in about 20% of infected people. Symptoms may include stomach pain, bloating, belching, and nausea. The stomach’s acidic environment is usually very efficient at killing microorganisms that are swallowed. How does H. pylori survive and thrive in this harsh environment? H. pylori uses its flagella to burrow into the mucous lining of the stomach until it reaches a more neutral area. In a process known as chemotaxis, H. pylori can sense areas of acidity and can move to more hospitable areas. It also has the ability to neutralize acid in its immediate environment by using urease to break down urea into ammonia and carbon dioxide. The ammonia neutralizes harmful stomach acid. An inflammatory response by the body tries to combat the invasion by H. pylori. A significant part of this response is for the stomach to produce even more acid. Unfortunately, the extra acid sometimes damages the lining of the stomach and the duodenum, causing ulcerations (ulcers). Treatment of H. pylori usually involves taking the antibiotics amoxicillin and clarithromycin, along with a proton pump inhibitor, which reduces the production of excess stomach acid. This is commonly called triple therapy and is usually effective at eradicating H. pylori, as it did in Natasha’s case. Characteristics of Inflammation Complete the sentences below by dragging the correct term from the choices on the left to each blank. Fighting Off the Sniffles Skip to question Fighting Off the Sniffles A Daily M article, titled "How to Beat Coughs and Sneezes: The Reason You Get Every Cold Going . . . and Ten Ingenious Ways to Fight Off the Sniffles," the authors correctly explain the viral causes of colds, the fact that the symptoms are usually due to your own body's immune response, and how a sneeze can be involved in transmission. The article also offered lots of tips for avoiding the common cold and included the research behind each piece of advice. Suggestions included using fist bumps to greet others rather than handshakes, irrigating your nose with a salt solution, and making sure to get at least 8 hours of sleep. During the COVID-19 pandemic, the Centers for Disease Control and Prevention gave similar suggestions to lower the risk of infection with SARS-CoV-2. Common Cold vs Influenza The common cold and the "flu" (influenza) are often confused by patients suffering from symptoms that are similar between the two infections. Read the sections on these two infections in the respiratory disease chapter, and conduct additional research as necessary to complete the activity below. Place the relevant descriptions into the correct boxes to compare and contrast these two respiratory diseases. You do not need to place all of the labels as some may not apply to either disease.