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Uworld > Test 27: Immunology/Microbiology > Flashcards

Test 27: Immunology/Microbiology Flashcards

1
Q

acute hemolytic transfusion reaction is what type of hypersensitivity? Caused by

A

Type II

pre-existing anti-ABO antibodies

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2
Q

what is the clinical presentation for acute hemolytic transfusion reaction

A
  • fever and chills
  • Chest and/or back pain
  • hemoglobinuria
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3
Q

hemoglobinuria

A

red-to-brown colored urine

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4
Q

Acute hemolytic reactions occur within what timeframe

A

minutes to hours of staring blood transfusion

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5
Q

What do you do if you realize a patient has acute hemolytic reactions

A

immediate cessation of transfusion

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6
Q

Type II hypersensitivity activates what process

A

complement

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7
Q

role of C3a and C5a

A

vasodilation and symptoms of shock

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8
Q

role or MAC (C5b-C9)

A

complement-mediated cell lysis

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9
Q

Humoral component for Type I Hypersensitivity

A

IgE

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10
Q

Humoral component for Type II Hypersensitivity

A

IgG

IgM

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11
Q

Humoral component for Type III hypersensitivity

A

antibody-antigen complexes

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12
Q

Humoral component for Type IV hypersensitivity

A

NONE

Cellular component: T-cell & macrophages

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13
Q

Major adaptive immune mechanisms that prevent reinfection with influenza virus include what?

A

anti-hemagglutinin antibodies

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14
Q

What is the function of meningococcal pili (fimbriae)

A

bacterial attachment to epithelial surfaces

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15
Q

Meningococci (Niesseria meningitidis) attach to and conolize where

A

pharynx via pilus-mediated adherence to mucosal epithelial cells

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16
Q

What allows Niesseria Meningititidis to destroy mucosal antibodies

A

produced IgA protease

- inhibits bacterial attachment and penetration

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17
Q

What is the impact of Epstein-Barr virus on B cells

A
  • infect them
  • proliferate B cells continuously (immortalization)
  • Then infected B cells maintain ability to secrete immunoglobulins
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18
Q

How do you test for EBV

A

Monospot test: heterophile IgM antibodes detected by agglutination of sheep or horse RBC

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19
Q

What are cryoglobulins? It can detect what virus

A

cold-precipitable serum proteins that contain Igs

-Hep C infection

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20
Q

What is Hemadsorption

A

hemagglutinins or glycoproteins with high affinity for erythrocytes expressed on the host cell surface.

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21
Q

Papanicolaou test is used to screen what

A

cervical cytology specimens for dysplasia caused by oncogenic strains of human papillomavirus

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22
Q

How do you use Tzanck smear

A

scrape ulcer base, prepare with Wright-Giemsa stain

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23
Q

When are interferons alpha and beta produced

A

by most human cells in response to viral infections

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24
Q

Role of interferon alpha and beta

A

suppress viral replication by halting protein synthesis and promoting apoptosis of infected cells

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25
Q

Interferon gamma is produced by who

A

T cells and NK cells

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26
Q

Role of interferon gamma

A
  • promotes Th1 differentiation
  • increases expression of class II MHC molecules
  • improves intracellular killing ability of macrophages
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27
Q

Streptococcus gallolyticus former name

A

Strep. bovis

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28
Q

Strep. gallolyticus causes what? associates with what

A

bacteremia and subacute endocarditis (no preexisting valvular abnormality)
-associated with colon cancer

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29
Q

How is Strep. viridans impact the heart

A

subacute bacterial endocarditis following dental work

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30
Q

how does staph aureus impact heart

A

right-sided endocarditis

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31
Q

onset of acute transplant rejection

A

weeks to months

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32
Q

What is used to prevent acute transplant rejection

A

calcineurin inhibitors

-cyclosporine or tacrolimus

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33
Q

What is used to treat acute transplant rejection

A

systemic corticosteroids

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34
Q

What is the pathogenesis for hyperacute transplant rejection

A

Preformed antibodies against graft in recipient’s circulation

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35
Q

What happens to the organ in acute transplant rejection

A
  • mononuclear infiltrate on histopathology

- graft dysfunction

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36
Q

What is the cellular component of acute transplant rejection

A

host T-lymphocytes sensitization against graft (foreign) MHC antigens

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37
Q

What is graft T-cell sensitization against Host MHC antigens

A

graft vs. host disease

- after bone marrow transplant

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38
Q

Chronic renal allograft rejection is characterized in the patient as ( kidney transplant)

A
  • worsening hypertension

- progressive rise in serum creatinine

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39
Q

Chronic renal allograft rejection is characterized in kidney as

A
  • fibrous intimal thickening
  • tubular atrophy
  • interstitial fibrosis
40
Q

Vascular fibrinoid necrosis and neutrophil infiltration of the arterioles, glomeruli, and peritubular capillaries are characteristic of what type of organ transplant rejection

A

hyperacute

41
Q

achlorhydria

A

inadequate gastric acid production to maintain the normal gastric pH of less than 4

42
Q

Pregnant women with HIV do what for prevention? how does this work

A

antiretroviral therapy

- reverse transcriptase inhibitor

43
Q

What are baby symptoms for mother-to-child vertical transmission of HIV-1

A
  • oral thrush
  • interstitial pneumonia
  • severe lymphopenia
    during first year of life
44
Q

Patient with central vascular catheter and receipt of parenteral nutrition is at risk for

A

candidemia

45
Q

what is the morphology/shape of candida

A

branching pseudohyphae with blastoconidia

46
Q

morphology/shape of blastomyces

A

borad-based budding

47
Q

morphology/shape of coccidiodies

A

spherules with endospores

48
Q

morphology/shpae of cryptococcus

A

capsule

49
Q

morphology/shape of histoplasma

A

small oval yeast within macrophages

50
Q

Where do T cells reside in lymph nodes

A

paracortex

51
Q

agammaglobulinemia prevents what from forming in lymph nodes

A
  • primary lymphoid follicles

- germinal centers

52
Q

In order, the pathogens most often responsible for secondary bacterial pneumonia are

A

strep. pneumoniae
Steph aureus
H. Flu

53
Q

Localized bony back pain, low-grade fever, and recent staphylococcal bacteremia suggests what

A

vertebral osteomyelitis

54
Q

What is the most common way bacteria can reach in the spin in adults

A

hematogenous

55
Q

What diagnosis tools should be used if vertebral osteomyelitis is suspected

A

blood culture

MRI

56
Q

What are 3 major causes of neonatal meningitis

A
  1. Group B strep
  2. E. Coli
  3. listeria monocytogenes
57
Q

What strain of e. coli causes neonatal meningitis ? how does it work

A

K1 capsular antigen

- allows survival in bloodstream

58
Q

In older infants ( greater than 3 months) and adults, most common pathogens for meningitis

A

Strep. pneumoniae

Neisseria meningitidis

59
Q

verotoxin is what type of toxin

A

Shiga-like toxin

60
Q

Lipid A unit in lipopolysaccharides is similar for all enteric bacteria, what does it cause

A

activation of macrophages

  • release IL-1 and TNF-alpha
  • septic shock
61
Q

Primary infection with vericella-zoster typically occurs in who and as what

A

children

chickenpox

62
Q

Where does herpes zoster reside in body

A

dorsal root ganglia

63
Q

Vericella IgG antibodies have immunity against what? and what does it now have immunity against

A

immunity for chickenpox

not- herpes zoster

64
Q

Classical complement cascade begins with binding of what

A

C1 complement component to either

-2 IgG or 2 IgM

65
Q

Which immunoglobulin is a better activator of complememtn

A

IgM

66
Q

C1 molecule of complement binds to thwat region of the immunoglobulin chain

A

Fc region of heavy immunoglobulin chain in region near the hinge point

67
Q

Who get rubella vaccine and what type of vaccine is it

A
  • children and non-pregnant females of childbearing age

- live, attenuated rubella virus vaccine

68
Q

A patient gets a blunt abdominal trauma and then dies. See Step. pneumo on blood cultures. What happened

A

Spleen did not work

69
Q

Characterize Mononucleosis-like syndrome? seen in what

A 
fever
malaise
myalgia 
atypical lymphocytosis 
elevated liver transaminases 
-CMV
70
Q

What is severe combined immune deficiency

A

combined T and B cell dysfunction

71
Q

Patient comes in with

  1. Severe bacterial and viral infections in infancy
  2. chronic diarrhea
  3. mucocutaneous candidiasis
A

SCID

Severe combined immunodeficiency

72
Q

Patient comes in with

  1. congenital heart disease
  2. dysmorphic facies
  3. hypocalcemia
A

DiGeroge sydnrome

73
Q

Neisseria is grown on what media? what is special about this media

A

Thayer-Martin VCN (vancomycin/colistin/nystatin)

- inhibits gram +, gram - other than neisseria and fungi

74
Q

Name a selective media for growth

A

Thayer-Martin agar

75
Q

how does differential media help identify cultured oragnisms

A

metabolic and biochemical properties

76
Q

type I hypersensitivity what immunoglobin and cells are used

A

IgE bound to basophils and mast cells

77
Q

what process activates type I to release histamine and heparin

A

cross-linking of surface IgE molecules, signals cell to degranulate

78
Q

initial symptoms of malaise and fever and then bone pain/abscesses. What is this

A

osteomyelitis

most common cause is staph aureus

79
Q

Immunity against Neisseria meningitids is provided by antibodies against what virulance factor

A

polysaccharide capsules

80
Q

What is the primary virulence factor of Strep. pneumoniae

A

polysaccharide capsule–> inhibits phagocytosis

81
Q

Name a bacteria that is positive diplococci and is alpha-hemolytic

A

Strep. Pneumo

82
Q

What bacteria causes atypical pneumonia

A

Mycoplasma pneumoniae
Chlamydophila pneumoniae
legionella

83
Q

What is the agent that can cause hepatic abscesses via hematogenous seeding of the liver

A

Staph aureus

84
Q

What agents cause hepatic abscesses by ascending the biliary tract, portal vein pyemia, or direct invasion from adjacen area

A

Enteric bacteria

85
Q

presence of fluid-filled cavity in liver in conjunction with fevers, chills, and right upper abdominal pain

A

hepatic abscess

86
Q

what causes hepatic abscess in underdeveloped countries and developed countries

A

underdeveloped countries: parasitic infection

developed: bacterial infection

87
Q

how can staph aureus gain acess to the liver

A

biliary tract infection

portal vein pyemia

88
Q

parotitis

A

inflammation of parotid gland

89
Q

What does the parotid gland release

A

amylase

90
Q

what is the most common bacterial etiology for acute parotitis

A

staph aureus

91
Q

what diagnostic tools determine acute bacterial parotitis

A
  • elevated amylase levels

- imaging

92
Q

Bacterial genetics: transformation

A

direct uptake of naked DNA

93
Q

Bacterial genetics: conjugation

A

one-way transfer of material

94
Q

what do donor cells have in conjugation

A

F factor: codes for sex pilus

95
Q

Bacterial genetics: transduction

A

transfer of DNA from one bacterium to another by means of a bacteriopahge

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