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Host and Defense COPY > Bracken's FInal Cram Sesh > Flashcards

Bracken's FInal Cram Sesh Flashcards

1
Q

The outer protein sheath of the virus is called what?

A

capsid

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2
Q

when speaking about viruses, what is the difference between viropexis and direct fusion which are both methods of entry of enveloped viruses into a cell.

A

Viropexis involves endocytosis and then the fusion of the envelope with the endocytic membrane to release the viral contents

direct fusion just fuses its envelope with the host cell’s membrane

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3
Q

naked viruses always use what method to enter a cell?

A

viropexis

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4
Q

when virus DNA encodes for the same necessary proteins over and over again and then is split after it is replicated that DNA is called what?

A

concatemer

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5
Q

RNA positive sense viruses usually replicate where because they have no need to enter the nucleus?

A

the cytoplasm

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6
Q 
parvoviruses follow which genetic material type?
Herpes virus?
Picornavirus?
Orthomyxovirues (influenza)?
HIV-1?
A 
single stranded DNA
Double stranded DNA
RNA +
RNA -
Retrovirus (so RNA to DNA)
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7
Q

what letter antigens are associated with LPS, capsule, and flagellin?

A

O - LPS
K - capsule
H - flagellin

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8
Q

what diagnostic tool must we use to diagnose Pneumonia?

A

chest X-ray

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9
Q

what is the organism that is most often the cause of pneumonia? what if I told you it was a gram neg bacteria that caused it this time, then what bacteria would it be? What staph bacteria also causes pneumonia?

A

Strep pneumo

klebsiella pneumo

staph aureus

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10
Q

mycoplasma pneumonia, chlamydophilia pneumonia, legionella pneumophilia, coxiella burnetii, chlamydophilia psittaci

these all cause what?

A

atypical pneumonia like walking pneumonia and environmentally acquired acute pneumonia

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11
Q

what bacterial growth phase is most susceptible to antimicrobial therapy?

A

Log phase where proliferation is extremely rapid

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12
Q

what organisms rarely cause Upper respiratory infections?

A

bacteria

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13
Q

what are two bacterial agents that cause pharyngitis?q

A

group A strep

pertussis

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14
Q

what symptoms will you NOT have if you have a strep infection causing pharyngitis?

A

cough
congestion
conjunctivitis

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15
Q

Otitis is 50% viral and often follows other URI’s. What bacteria can cause it? Are antibiotics useful?

A

penumo, H. flu, moraxella

antibiotics still not useful

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16
Q

do we use Abx with sinusitis?

A

no

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17
Q

which URI is almost exclusively a bacterial infection? which bacteria causes it and is a medical emergency?

A

Epiglottitis

H. Flu

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18
Q

What two URIs do we treat?

A

group A strep

epiglottitis

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19
Q

What are the live attenuated vaccines we need to know?

A 
VZV
Influenza
MMR
Oral Typhoid
Rotavirus
Yellow fever
Oral cholera
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20
Q

Patient must be offered what with every vaccine?

A

Vaccine information statement (VIS)

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21
Q

What is the pathogenesis of Infective Endocarditis?

A 
Turbulent blood flow
endothelial cell activation
fibrin and platelet deposition
silent or clinical bacteremia seed sterile vegetations
bacteria grow within fibrin vegetations
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22
Q

What does the endocardium lack that allows it to be infected so easily?

A

capillaries which is how neutrophils would get access to the area.

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23
Q

Name the top 5 risk factors for getting IE from most risky to least. Do we treat these risk factors with Antibiotics prior to procedures?

A

Prosthetic Heart Valve
Previous IE event
Congential Heart disease
Cardiac Tx patients who develop valvulopathy

treat with Abx before treatment

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24
Q

What 2 cell wall inhibitors are bactericidal, inhibit transpeptidase and are penicillinase sensitive?

A

Penicillin G and Penicillin VK

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25
Q

What is the drug of choice forr staph infections that are not MRSA?

A

nafcillin “naf for staph”

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26
Q

What are the penicillinase-resistant penicillins?

A

nafcillin
methcillin
dicloxacillin

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27
Q

What group of drugs are the drugs of choice for listeria monocytogenes and enetercocci, causes pseudomembranous colitis and are penicillinase sensitive?

A

aminopenicillins which are amoxicilin and ampicillin

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28
Q

What penicillin drug interacts with methotrexate?

A

Amoxicillin

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29
Q

Which drugs do you combine with amoxicillin and ampicillin?

A

amoxicillin and clavulanate - augmentin

ampicillin and sublactam - unasyn

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30
Q

What penicillins do we used to treat pseudomonas?

Which one has the broadest spectrum?

A

ticarcillin
carbenicillin
piperacillin - has the broadest spectrum

Take Care of Pseudomonas

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31
Q

What are the generational lines of Cephalosporins?
Which generation is effective against MRSA?
Which generation cross the Blood brain barrier?

A

1st gen - Cefazolin and Cephalexin
2nd gen - cefoxitin, cefaclor, cefuroxime
3rd - ceftriaxone, cefotaxime, ceftazimide, cefdinir - cross the BBB
4th cefepime
5 - ceftaroline - effective against MRSA

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32
Q

Which beta lactam has the broadest spectrum known to man? Hint, it is a carbapenem

A

Imipenem

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33
Q

Bacitracin is a non beta lactam antibacterial. How is it administered?

A

topically

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34
Q

Which non beta lactam drug causes Redman syndrome?

A

Vancomycin

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35
Q

if bacteria is vancomycin and methicillin resistant what drug do we use?

A

Daptomycin

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36
Q

What parasite is spherical and is higher prevalence in MSM patients, travelers, and institutionalized patients and causes Amebiasis?

A

Entamoeba histolytica

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37
Q

What parasite must be distinguished from entamoeba histolytica and lives in the gingival pocket of mouths?

A

entamoeba gingivalis

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38
Q

What parasite has worldwide distribution; transmitted fecal/oral in freshwater with beavers being a known source?

A

Giaria lamblia

causes Giardiasis

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39
Q

What is the most common protozoan pathogen in the industrialized world that has no cyst form? It is asymptomatic in men unless there is urinary inflammation and in women it causes burning, itching, and purulent discharge?

A

trichomonas vaginalis

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40
Q

What parasite causes symptoms that resemble a mild cold or mononeucleosis, can cross the placental barrier, and is found in cat feces?

A

toxoplama gondii

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41
Q

What parasite is transmitted through food and recreational water, spread animal to person, that causes watery stool unless you have HIV where it will cause 50 stools/day?

A

cryptosporidium parvum

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42
Q

what parasite causes pneumonia in imunocompromised patients and is often fatal?

A

pneumocystis carinii

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43
Q

what parasite is the largest protozoan parasite in humans, has cilli, and can cause nausea, vomiting and bloody stools?

A

balantidium coli

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44
Q

What group of parasites are the largest internal human parasites?

A

helminths

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45
Q

Which helminth absorbs nutrients through outer tegment, are ribon shaped? called taneia saginata (beef) taneia solium (pork)

A

cestodes (tapeworms)

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46
Q

Which helminth group is leaf shaped, have mouths and include blood flukes and lung flukes?

A

Trematodes (flukes)

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47
Q

what helminth group includes tissue dwelling worms, have mouths, includ hookworms and strongyloides stercoralis which are the most common helminthic parasites in humans?

A

Nematodes (round worms)

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48
Q

What is pediculus humanus?

A

human head and body louse that can serve as vectors for several disesases

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49
Q

What is cimex lectularius?

A

bed bugs which are not effective vectors of disease

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50
Q

What kind of organism is aspergillis fumigatus? Is it hyphate or psuedohyphate?

A

opportunistic fungi usually in the form of a mold

has hyphae

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51
Q

what kind of organism is Histoplasmosis?

A

dimorphic fungi

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52
Q

What kind of organism is cryptococcus neoformans? Who does it cause disease in?

A

opportunistic fungi

causes disease only in compromised hosts.

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53
Q

T/F rhinocerbral mucormycosis is angioinvasive and is a medical emergency.
What kind of environment does it thrive in?

A

true

thrives in high glucose and high acid environments like diabetics in ketoacidosis

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54
Q

mycobacterium bovis causes TB. T/F What is its stain

A

true

acid fast gram positive bacilli

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55
Q

is pseudomonas aerugenosa pos or neg and what shape? what are its oxygen needs?

A

gram neg bacilli

obligate aerobe

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56
Q

what is the gram stain of staph aureus? What are its oxygen needs

A

gram positive cocci

facultative anaerobe

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57
Q

What organism forms biofilms within air conditioning towers, causes legionnaires disease and causes environmentally acquired acute pneumonia?

A

legionella pneumophilia

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58
Q

what is the gram stain of H. Flu? Does it have a vaccine? What URIs does it cause?

A

Gram positive bacilli
has a vaccine
can cause otitis/sinusitis and EPIGLOTITIS

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59
Q

what bacteria usually causes Impetigo and folliculitis?

A

staph aureus

impetigo can also be caused by group A strep

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60
Q

What virus causes MOlluscum contagiosum in the epidermis? What is the specific histology for this infection?

A

poxvirus

manifest Henderson-paterson bodies (molluscum bodies) in the epidermis

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61
Q

Verruca vulgaris, plantaris, and plana as well as genital warts are all caused by what family of viruses?

A

HPV

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62
Q

If a rash is scaly, what test do we do? What type of organisms do we usually find?

A

KOH preparation usually identifies fungal infections like dermatophytes and pityrosporum orbiculare

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63
Q

what fungus causes tinea versicolor?

A

pityrosporum orbiculare

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64
Q

What two organisms do we need to know that cause necrotizing faciitis?

A

group A strep and S. aureus

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65
Q

What causes erysipelas and cellulitis most often?

A

group A strep

66
Q

What staph toxin causes scalded skin syndrome?

A

alpha toxin

67
Q

what gene gives MRSA resistance to penicillins?

A

mecA gene

68
Q

What bacteria group produces streptolysins O and S and Pyrogenic exotoxins A and B?

A

Strep bacteria

69
Q

Pasteurella multocida comes from what? What is the gram stain?

A

gram neg rod coming from animal bites

70
Q

what is the gram stain of pseudomonas aeruginosa?

A

gram negative rod

71
Q

What is a gram negative rod that comes from salt water environments that causes hemorrhagic bullae?

A

vibrio vulnificus

72
Q

What organism causes Rose gardener’s thumb?

A

sporthrix schenckii

73
Q

What do lyzozymes do as a chemical barrier in the body?

A

they break down peptidoglycan layers of bacteria

74
Q

What does psoriasin, cathelicidin, Defensins (alpha and beta) all do?

A

disrupt membranes of bacteria.

defensins also protect against fungi, protozoan, parasites and viruses

75
Q

What does calprotectin do?

A

binds and sequesters divalent cations limiting the growth of bacteria and fungi

76
Q

What cells produce alpha defensins? What produces beta defensins?

A

neutrophils produce alpha defensins

beta defensins are produced by mucosal surfaces.

77
Q

defensins must have access to what in order to do their function?

A

the plasma membrane of the organisms they are attacking. Lysozyme usually gives access to this for them.

78
Q

T/F Commensal bacteria induce IgA and antimicrobial peptide secretion. They also interact with PRRs to prevent inflammation.

A

true

79
Q

in the lectin pathway, what binds to Mannose binding lectin to then cleave C4 and start the cleaving party?

A

MASP 1 or 2

80
Q

anaphylatoxins (the a subunit from a cleaved complement protein) do what two things for the immune system?

A

they increase permeability of the vasculature as well as chemoattract inflammatory cells to the area as well as activate those inflammtory cells

simply - drive vasodilation and extravasation and activation

81
Q

if C3 coats a pathogen and then binds to a macrophage to signal phagocytosis, what also has to bind so that the pathogen is phagocytosed?

A

C5a

82
Q

Factors H and I and DAF and MCB are utilized by self tissue to prevent themselves from being phagocytosed after being labeled with C3b. T/F

A

True

83
Q

3 periodontal pathogens manipulate with complement, what are they?

A

P gingivalis
T Denticola
P intermedia

84
Q

acute bone infections are usually how old?

A

less than 2 weeks

85
Q

how do we best test for osteomyelitis of the bone?

A

culture of bacteria from bone biopsy unless there are positive blood cultures then we can just use those

86
Q

what is the treatment for acute and chronic osteomyelitis?

A

acute is 3-6 weeks abx and maybe surgery

chronic is 3-6 weeks abx and definitely surgery

87
Q

osteomyelitis of the jaw is spread to the jaw how? Which is more susceptible because of its thinner cortical plates, the mandible or maxilla?

A

contiguously

mandible is more susceptible

88
Q

if you get a surgical infection not at the site of a prosthetic joint, is it likely you will get a Prosthetic joint infection?

A

yes it is very likely

89
Q

most osteomyelitis infections come from what group of bacteria?

A

gram positive cocci - like S. aureus

90
Q

Describe the timeline for Early, delayed, and late PJI

A

1-3 months early
3 months to 2 years delayed
over 1-2 years is late

91
Q

T/F Amputation or fusing of the joint are solutions to PJIs.

A

True

92
Q 
which TLRs recognize Diacyl lipopeptides?
Triacyl lipopeptides?
Flagellin?
LPS?
dsRNA?
ssRNA?
CpG DNA?
A 
Diacyl lipopeptides - 2+6
Triacyl lipopeptides - 2+1
Flagellin - 5
LPS - 4 
dsRNA - 3
ssRNA - 7 and 8
CpG DNA - 9
93
Q

T/F TLR activation requires dimerization that can either be hetero or homo

A

true

94
Q

TLR signaling initiates cytokine production through what?

A

NF-kB

95
Q

When Nucleotide-binding oligomerization domains (NOD) receptors are activated, what do they cause to happen?

A

induce cytokine expression adn release though NF-kB and they also form an inflammasome

96
Q

What is the inflammasome’s purpose?

A

drives cytokine release and enhance other pro-inflammatory signals

97
Q

What are the 6 families of cytokines?

A 
Class 1
Class 2
Interleukin 1
Interleukin 17
TNF
Chemokines
98
Q

What are the systemic effects of IL-1B?
TNF-alpha?
IL-6?

A

IL-1B - Fever and production of IL-6
TNFalpha - fever and mobilization of metaboiltes/shock and causes DCs to migrate to lymph nodes to induce adaptive immunity
IL-6 - Fever and induce LIVER to produce acute phase protein production

99
Q

When a cell detects a virus within it causes NF-kB to be activated which causes what to be produced and secreted?

A

interferons and other cytokines

100
Q

What is the relationship between NK cells and DCs?

A

If there are more NKs than DCs then the NKs kill the DCs so they don’t activate the adaptive immune response. If there are more DCs than NKs then the dendritic cells cause the adaptive immune response to commence.

101
Q

Neurotoxins are preformed toxins that cause enteric symptoms by affecting the autonomic nervous system. What are the 3 bacteria we are concerned about this from?

A

S. aureus
Bacillus cereus
C. Botulinum

102
Q

Entertoxins cause fluid secretion in the gut to give diarrhea. What organism are we worried about his with?

A

Vibro Cholera

103
Q

Cytotoxins destroy gut mucosa and cause dysentery. What organism are we concerned about here?

A

Shigella dysenteriae

104
Q

Billy attaches his ECIG in his gut. What bacteria also attach in the gut?

A

E. Coli
cryptosporidium
Isospora
Giardia Lamblia

105
Q

What gut bacteria are we concerned about with INVASIVENESS?

A

shiggella

106
Q

Campylobacter jejuni and Salmonella are the leading cause of what in the US?

A

bacterial foodborne disease

107
Q

This food poisoning bacteria is found in meats, milk prods, and food handlers.

A

Staph aureus

108
Q

This food poisoning bacteria is in meats and SOIL.

A

C. perfringenes

109
Q

This food poisoning bacteria is in produce and is transferred fecal/oral between humans.

A

Shigella

110
Q

This food poisoning is found in raw milk, poultry, and pets.

A

Campylobacter

111
Q

This food poisoning is found in raw or undercooked seafood

A

Vibro parahaemoyticus

112
Q

This food poisoning bacteria is found in RICE, meat and veggies.

A

Bacillus Cerus

113
Q

This food poisoning is found in Water and water sports.

A

Aeromonas Hydrophilia

114
Q

This food poisoning is found in WATER and contaminated food.

A

vibrio cholera

115
Q

Do we use Abx in food poisoning cases?

A

No, not really useful.

116
Q

what is the funciton of IgE? What type of hypersensitivity is IgE involved in?

A

Sentization of mast cells

type 1 hypersensitivity

117
Q

Which antibody isotype is responsible for sentization of basophils?

A

IgD

118
Q

The flexibility of what antibody isotype is critical for its function of binding to pathogens?

A

IgG

119
Q

what is the enzyme called that adds nucleotides at the jucntions between different genes that are recombined during genetic recombination?

A

TdT - terminal deoxynucleotidyl transferase

120
Q

In the US, what type of bacteria causes most of the sepsis cases?

A

gram positive organisms

121
Q

T/F Sepsis patients have hypertension

A

False! They have hypotension because of the deterioration of the blood vessels systemically

122
Q

how do we monitor tissue perfusion in a patient with sepsis?

A

by monitoring how much lactate is in the blood. If there is a lot of lactate it means that the tissue is not getting enough oxygen.

123
Q

When a B cell is checking to see if it has formed a functional and proper Heavy Chain before it becomes a large Pre B cell, it makes a Pre-B cell receptor with a surrogate light chain and checks to see if it can signal through what proteins?

A

IgB and Ig alpha

124
Q

T/F alpha beta and gamma delta T cells develop and mature in the thymus

A

false - alpha beta does but delta gamma only develops in the thymus and matures elsewhere

125
Q

What signaling proteins do T cell Receptors require?

What signaling proteins do Antibodies on the surface of B cells require for maturation?

A

T cell receptors require a CD3 complex

B cell receptors (antibodies) require Ig alpha and beta

126
Q

MHC class 1 binds what type of T cell? and what are the subunits of it?

A

binds CD8 T cells

has alpha chain and B2microglobulin

127
Q

MHC class 2 binds what type of T cell? and what are the subunits of it?

A

binds CD4 T cells

has alpha and beta chain.

128
Q

MHC class 1 is loaded within the ER of the cell that it is in. What protein delivers the antigen that MHC class 1 will present when it is on the outside of the cell?

A

TAP

129
Q

When a vesicle containing MHC 2 fuses with a vesicle containing peptide antigen, there is a protein that initially prevents the binding of the antigens to the MHC 2. What is that peptide called? What is its overall goal?

A

CLIP - it does this because it wants to prevent binding of self proteins to the MHC 2 so that it does not prevent self antigen to the body.

130
Q

CD8 only bind MHC1 and CD4 only binds MHC 2. What ensures this?

A

co receptors specific for those MHC classes on the cell surfaces of the different T cells.

131
Q

What is the name of T cells as they are developing in the Thymus?

A

thymocytes

132
Q

What does the T cell look like at its first checkpoint (double negative) and second checkpoint (double positive)?

A

First - just has a pre-T cell receptor

Second - has both CD8 and CD4 co receptor as well as a full T cell receptor

133
Q

how do T cells move generally within the thymus as they develop?

A

They go from medulla to cortex and then back

134
Q

When a T cell is double positive for CD4 and CD8 how is it determined which one it will be in the end?

A

Which ever co receptor is activated when the T cell receptor is bound to MHC class associated with that co-receptor. So if it binds a MHC 1 then the CD8 co receptor also binds and then it becomes a CD8 T cell.

135
Q

If you have a bacterial infection in the brain what organism will predominate? If you have a fungal infection in the brain, it could be zygomycetes or candida but it is most likely what species?

A

actinomyces

aspergillus

136
Q

If you got a Zygomycetes (aka mucormycosis) CNS infection what 3 species are likely?

A

Mucor
Rhizomucor
Rhizopus

137
Q

What are the top 2 health care acquired infections in the US? Despite that, what is the leading organism causing HAIs in the US?

A

pneumonia and surgical site infections from inpatient surgery

C. Diff

138
Q

T/F Memory T cells do not need CD28 Co-activation like regular T cells do in order to become active.

A

True

139
Q

The CD28 protein on a T cell interacts with what protein on the APC which provides what signal for the T cell?
What if there is an activation signal from MHC protein but not a co-stimulatory signal?

A

B7
which provides a survival signal

if there is no co stimulatory signal then the T cell will become anergic.

140
Q 
Which Cytokines induce the formation of TH1 cells?
TH17?
Th2?
TFH?
Treg?
A 
TH1 - IL12 and IFN-y
TH17 - IL16, IL23, TGF-B
TH2 - IL4
TFH - IL6 and IL 21
Treg - TGF-B
141
Q 
What are the functions of TH1 cells?
TH17?
Th2?
TFH?
Treg?
A 
TH1 cells - activate macrophages
TH17 - enhance neutrophil response
Th2 - activate cell antibody response of IgE for parasites
TFH- activate B cells and mature them
Treg - suppress other T cells
142
Q

If a baby has a Group B strep infection what do we treat with?
Listeria?
E. Coli?

A

ampicillin
ampicillin plus Gentamycin
Cefotaxime

143
Q

What is the protein on the surface of B cells that interacts with TFH cells during B cell activation?

A

CD40

144
Q

What two bacteria do we know use Superantigens to combat our immune system?

A

staph aureus

strep pyogenes

145
Q

Name the 5 anaerobic bacteria in the oral cavity that Buxton wants us to know.

A 
Fusobacterium
Veilonella
Actinomyces
Porphyromonas 
Prevotella
146
Q

Name the anaerobic bacteria that Buxton wants us to know that is on the skin?

A

propionibacterium

147
Q

Name the anaerobic bacteria that Buxton wants us to know that are in the vagina. 2 of them

A

Lactobacillus

Prevotella biva

148
Q

Name the anaerobic bacteria that Buxton wants us to know that are in the Colon. 2 of them

A

Bacteroides Fragilis

other Bacteroides spp

149
Q

What is the non spore forming gram-positive rod that is a burrowing animal and creates sulfur granules?

A

actinomyces

150
Q

What is the non spore forming gram-positive rod that is part of normal skin and respiratory flora and is found in acne pustules?

A

Propionibacterium species

151
Q

What is the 3rd non spore forming gram positive rod Buxton wants us to know?

A

Mobiluncus

152
Q

What is the gram positive cocci that is found in abscess in the brain or deep lung?

A

peptostreptococcus

153
Q

What is the only gran negative cocci genus implicated as pathogens?

A

Veillonella

154
Q

Where do we usually find Fusobacterium and what is their gram stain?

A

we usually find with Actinomyces

gram neg rod

155
Q

What is the gram stain of bacteroides species as well as Prevotell and porphyromonas species?

A

gram neg rod

156
Q

What are the 5 stages of biofilm formation?

A

attachment (second)
irreversible binding (minutes) cells are sessile
Layering
Maturation (days)
Dispersion (several days) cells are planktonic

157
Q

In the dental pellicle, Who are the primary colonizers?

A

S. Mutans

actinomyces

158
Q

In the dental pellicle, who are the bridge bacteria?

A

fusobacterium

159
Q

in the dental pellicle, who are the late colonizers?

A

S. salivarious, propionibacterium, prevotella, veillonella, selenomonas

160
Q

When the dental plaque is left undisturbed for several days, what are the pathogenic bacteria that now take hold and require the late colonizers to be there in order to attach

A

P. Gingivalis
Bacteroides Forsythia
Aggregatibacter actinomycetemcomitans
T. Denticola

Host and Defense COPY (81 decks)

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