Anderson Immuno/Micro Flashcards
(106 cards)
1
Q
Acid tolerant organisms…
A
Lactobacillus, Strep, H. Pylori
2
Q
Endo or exo toxin: LPS Denatured by boiling Antigenic Form Toxoid Pyrogenicity High specificity Protein Extracellular Part of outer membrane
A
Endo Exo Both Exo Endo, sometimes Exo Exo Exo Exo Endo
3
Q
What are the three responses of the body to cold temperature?
A
Thyroid hormone - increased metabolism
Sympathetic nervous system - activates beta-receptors in brown fat to increase metabolism
Shivering - activated by posterior hypothalamus
4
Q
What part of the hypothalamus is responsible for the body temperature set point?
A
Anterior hypothalamus
5
Q
How do pyrogens affect the set-point temperature? How do they do that?
A
They increase it.
IL-1 triggers fever, via prostaglandins
6
Q
How do aspirin and steroids reduce fever?
A
Aspirin - cox inhibitor - reduce prostaglandins
Steroids - block release of arachidonic acid from phospholipids
7
Q
Heat exhaustion vs. stroke
A
Exhaustion - dehydrated from sweating, syncope, wet
Stroke - body temp approaches tissue damage, dry
8
Q
All the immune cells mature in the bone marrow except ______ cells.
A
T-cells
Mature in the thymus
9
Q
Name the immune cell:
Cell-mediated immunity
Ab (Humoral) immunity
Immunological surveillance
A
T-cells
B-cells
NK Cells, Macrophages
10
Q
What is the classical vs. alternate activation of complement?
A
Classical - Ag/Ab rxn, strong
Alternate - activated w/o Ag/Ab rxn, weaker, starts at C3 locus
11
Q
Name the interferon:
Made by leukocytes, inhibits tumor cell growth, stimulates NK cells
Made by fibroblasts
Made by T-cells, activates NK, killer-T cells, activates phagocytic cells
A
IF- alpha
IF - beta
IF -gamma
12
Q
What does TNF-alpha do? TNF-beta?
A
Alpha - stimulates apoptosis
Beta - induces IL-10
13
Q
Name the interleukin:
Fever, t-cell proliferation
Promote cellular immunity, secreted by CD4
Promote humoral immunity, secreted by CD4
Promote humoral immunity, secreted by T-cells
Fibroblast secretion, megakaryocyte potentiator
A
IL-1 IL-2 IL-4 and 5 IL-10 IL-11
14
Q
Which MHC:
Present viral antigen to CD8, activate CD8
Docking protein on MO which hooks to a CD4
A
MHC1
MHC2
15
Q
Definition: Incomplete antigen, unable to stimulate immune response on its own. Reacts with other proteins making them antigenic.
A
Haptens
16
Q
Name the antibody and their response: "Allergy" "Secretory" "First Responder" "Long Term"
A
IgE - Type 1 Hypersensitivity, parasitic infection
IgA - Mucosal, dimer
IgM - basis for ABO-blood type antigen rxn, short-lived, pentamer
IgG - MC, focuses NK cells, immunization
17
Q
Name the hypersensitivity rxn: Immune complex mediated Antibody mediated IgE mediated, anaphylaxis Delayed, cytotoxic type
A
Type III, humoral
Type II, humoral
Type I, humoral
Type IV, cell-mediated (e.g. PPD TB test)
18
Q
Name the AI dz:
Thymic hypoplasia, absences of T-cell immunity
Excessive systemic collagen/fibrosis of microvasculature
AI destruction of salivary/lacrimal glands
Type III and II auto-Ab, remitt/relapse, ANA
Inflammatory myopathy w/ skin involvement
Inflammatory myopathy w/o skin involvement
A
DiGeorge's Syndrome Scleroderma/Systemic Sclerosis Sjogren's Syndrome SLE Dermatomyositis Polymyositis
19
Q
What are the primary and secondary responses of T-cells?
A
Primary: T-cells are activated by APC, signaled directly to site of antigen
Secondary: T-cells cloned and stored in lymph nodes
20
Q
What are the primary and secondary responses of B-cells?
A
Primary: Interleukin, prostaglandin, TNF, IF production
Activate complement, and draw MO to area
Secondary: memory B-cells respond, IgG produced, complement activated
21
Q
Beta-hemolytic vs. alpha-hemolytic
A
Beta - complete hemolysis
Alpha - incomplete hemolysis
22
Q
T/F: Gram + cocci tend to have NO flagella and are NON-motile, and NON-spore-forming.
A
T
23
Q
Staph or Strep: Beta-hemolytic Toxic Shock Syndrome, Food Poisoning Impetigo Coagulase positive ASO titer +
A
Staph and Strep Staph Staph or Strep Staph Strep
24
Q
Type of staph that is coagulase negative and usually due to surgical or wound infections and can cause subacute endocarditis.
A
S. epidermidis
25
Type of staph that is the least common and associated with UTIs. Also coagulase negative.
S. saprophyticus
26
What type of strep is grp A? grp B? What is each more closely associated with?
S. pyogenes - pharyngitis, impetigo, scarlet fever, rheumatic fever
S. agalactiae - post-partum infection, neonatal sepsis/meningitis
27
Name the strep:
Pneumonia, sinusitis, meningitis, otitis media
Endocarditis, bacteremia, dental caries
S. pneumoniae
| S. viridans
28
What family are the Gm - diplococci?
Neiserria
29
MC STD in US? Second MC?
Chlamydia
| N. gonorrhea
30
T/F: N. gonorrhea produces an IgG that neutralizes the IgA of humans.
N. gonorrhea produces a neutralizing IgA
31
What is the histological finding of N. gonorrhea?
Intracellular gm- diplococci inclusions in neutrophils
32
What is the difference between n. meningitidis and gonorrhea?
gonorrhea - can ferment in glucose
| meningitidis - can ferment in glucose and maltose
33
```
M/C organisms causing meningitis in each age grp:
0-4wks
4-12wks
3mo-18yr
18yr-50yr
>50yr
```
Grp B strep, E. coli, Listeria monocytogenes
S. pneumoniae, grp B strep, E. coli, L. monocytogenes
S. pneumoniae, N. meningitidis
S. pneumoniae, N. meningitidis
S. pneumoniae, N. meningitidis, L. monocytogenes, aerobic gm - bacilli
34
What are the families of gm- spore-forming rods?
Clostridia and Bacillus
35
Name the clostridium:
Anti-cholinergic neurotoxin, descending paralysis
Gas gangrene
Inhibit glycine and GABA, tetanus
Pseudomembranous colitis, post-antibiotic therapy
Botulinum
Perfringens
Tetani
Difficile - MC, often normal flora
36
```
Name the Bacillus:
Found in soil (around animals), highly fatal
GI and eye infections
Chinese food poisoning
Highly fatal - cutaneous, inhalation, GI
```
anthracis
cereus
cereus
anthracis
37
What are the families of gm+ non-spore forming rod?
Corynebacterium and Listeria
38
Name the corynebacterium:
Pseudomembrane, gray coating which can cause severe hemorrhage.
Acne, cutaneous infections
C. diptheriae
| Other
39
Name the infection:
Targets pregnant women, neonates, elderly, immunocompromised. Granulomotosis infatiseptica. Replicates in MO, with help from listeriolysin O and thus avoids Ab and other bactericidal agents. Likes to go to heart and brain.
Listeria monocytogenes
40
All members are facultative anaerobes, ferment glucose, oxidase negative, reduce nitrates to generate energy.
Gm - rods (salmonella, eschericia, shigella, klebsiella pneumoniae, enterobacter, citrobacter, yersinia, proteus, pseudomonas, legionella)
41
What sugar does E. coli ferment?
Lactose
42
What are the four groups of E. Coli and where do they live?
Enterotoxigenic and Enteroaggregative - small intestine
Enteropathogenic - large intestine, infantile non-bloody diarrhea
Enteroinvasive - large intestine/colon, watery diarrhea w/ small bloody stools
Enterohemorrhagic - colon, verotoxin (shiga-like toxin), blood stool
43
What is the worse variety of E. coli and why?
E. Coli 0157:H7
44
Name the salmonella:
Typhoid fever, rigid belly, rose spots on stomach
More acute onset, egg shells, resolves 2-7d
S. typhi
| S. enteritidis - MC
45
What are the two types of shigella? How do they create sx?
S. dysenteriae
S. sonnei (MC in US)
Shiga-toxin - more aggressive than salmonella
Transmitted via four F's
46
Name the organism:
Alcoholics, "currant jelly" sputum
Nosocomial usually
Transmitted via flea bite, 75-90% fatal, pneumonia or bubonic
Looks like appendicitis, w/ polyarthritis, close proximity to large animals
Klebsiella pneumoniae
Enterobacter aerogenes
Y. pestis
Y. enterocolitica
47
Name the organism for diarrhea according to incubation time, type of diarrhea, and presence of emesis:
4-12hr, watery/profuse, ++emesis, no fever
2-7d, watery/profuse, +emesis
1-4d, variable/bloody, mild emesis, severe abd pain, + fever
1-3d, bloody, mild emesis, severe abd pain, mild fever
8-72hr, variable/watery, mild emesis/abd pain, no fever
```
S. aureus, C. perfringens
E. coli, giardia
Salmonella, Campylobacter, Shigella, Enteroinvasive E. coli, Entamoeba histolytica
Hemorrhagic E. coli, C. difficile
V. cholerae, Enterotoxigenic E. coli
```
48
Name the organism:
UTI, elevated pH, increased stone formation, "urea-splitting"
Burn infections, resistant to antibiotics, fruity odor, CF
Transmitted via standing water, pneumonia or flu-like
```
Proteus mirabilis and vulgaris
Pseudomonas aeruginosa
Legionella pneumophilia (Pontiac fever, Legionnaires dz)
```
49
Gm - curved rods
H. pylori, Campylobacter jejuni, V. cholerae
50
Name the organism:
Gastric ulcers, risk for adenocarcinoma of the stomach
Shellfish vector, MC cause of bacterial enteritis in US, fecal-oral transmission, self-limiting
"Rice-water" stools, 20L/day fluid loss
24hr incub, explosive diarrhea for 72hr
H. pylori
C. jejuni
V. cholerae (O1 more deadly than non-O1 antigen)
V. parahemolyticus
51
Gm - coccobacilli
Hemophilus, bordetella
52
Name the organism:
Childhood sinusitis, meningitis, epiglottitis, otitis, COPD pneumonia
Painful genital ulcer "Chancroid"
Assoc w/ BV, "strawberry cervix", + whiff test
"Whooping cough", death can occur due to hypoxia/pneumonia
H. influenzae
H. ducreyi
H. vaginalis
53
Acid-fast rods
Mycobacterium
54
Name the mycobacterium:
Gohn complex, granulomatous, can go to any organ
Leprosy/Hansen's dz
Lung dz in immunocompromised patients, bird vector
M. tuberculosis
M. leprae
M. avium
55
Spirochetes
Treponema, borrelia, leptospira
56
Name the treponema:
Syphilis
Trench mouth
Yaws
T. pallidum
T. pertenue
T. vincentii
57
Describe the stages of syphilis.
Primary: painless chancre, regional LA
Secondary: general rash, fever, disseminated, highly infectious
Late (tertiary): Gumma, tabias dorsalis, encephalitis
Congenital: no sx. at birth, onset of rash/systemic dz later
58
Erythema migrans, tick-borne dz, two stages of infections.
Borrelia burgdorferi (Lyme)
59
Biphasic illness beginning w/ fever, chills, and intense HA. Can resemble aseptic meningitis, uncommon
Leptospira interrogans (Weil's dz)
60
Wall-less bacteria - smallest free living bacteria
Mycoplasma pneumonia, ureaplasma urealyticum
61
What does the cellular membrane of M. pneumonia contain that no other bacterial membrane does?
Cholesterol
62
```
M. pneumonia or U. urealyticum:
Gm -, strictly aerobic
Non-specific urethritis in men
"walking pneumonia"
"Fried egg" appearance on agar
Resp/sexual transmission (w/ Chlamydia)
```
```
M. pneumonia
U. urealyticum
M. pneumonia
M. pneumonia
U. urealyticum
```
63
Name the Rickettsia:
Louse borne, Typhus, severe fever/HA, macular rash
Tick borne, Rocky Mountain Spotted Fever, MC in US
Flea borne, Murine (endemic) typhus, chest maculopapular rash, flu sxx
R. prowazeki
R. rickettsii
R. typhi
64
Obligate intracellular bacteria
Chlamydia, Rickettsia
65
Name the chlamydia:
Preventable blindness, MC STD in US
Pharyngitis, bronchitis, sinusitis
Parrot fever, myocarditis, encephalitis, hepatitis
C. trachomatis
C. pneumoniae
C. psittaci
66
What two organisms would you be concerned about with someone handling birds?
C. psittaci
H. avium
Cryptococcus neoformans
67
Name the fungal infection:
Ohio/Mississippi valley, flu-like resp illness, similar to TB
California desert/SW, cough, fever, chest pain, "Valley fever"
Chicago, ulcerative granulomata of the skin/bone
Histoplasma capsulatum
Coccidiodes immitis
Blastomyces dermatiditis
68
Name the opportunistic fungal infection:
Normal in small quantity, problem in immunocompromised (IC)
Allergic trigger, "fungus balls" that is movable, lung function
Fungal CNS infections in IC, pigeon carrier
"Cosmopolitan organism", AIDS, pneumonia
Candida albicans
Aspergillus
Cryptococcus neoformans
Pneumocystis carinii
69
```
Name the herpes virus and pathogenesis:
HSV I
HSV II
HSV III
HSV IV
HSV V
HSV VI
```
Oral herpes - vesicles, live in trigeminal nerve
Genital herpes - vesicles, live in lumbar/sacral ganglia, can also cause aseptic meningitis
Varicella zoster - chicken pox/shingles - LPS
Epstein Barr virus - Mono, Burkitt's Lymphoma, B-cell lymphocytes in salivea, histo: downey cell
Cytomegalovirus - likes neuro/eye tissue, infantile meningitis, "Mono-like", saliva/sexual secretions/vertical transmission
Roseola infantum
70
Most common cause of diarrhea in children
Adenovirus - DNA virus
71
```
Which HPV:
Warts
Condylomata
Cervical HPV
Vulvar HPV
```
HPV 1-4
HPV 6, 11
HPV 16, 18, 31, 33
HPV 16, 18
72
```
Measles or Mumps
Rubeola- RNA virus
Viral parotitis
Koplik's spots, maculopapular rash
Resp droplet transmission
Cough, coryza, conjunctivitis (3 C's)
Sequelae: sterility, DM
Sequelae: subacute sclerosing pan-encephalitis (SSPE)
```
```
Measles
Mumps
Measles
Both
Measles
Mumps
Measles
```
73
Paramysoviruses
RSV, measles, mumps, parainfluenza
74
Most common cause of FATAL acute resp infxn of infants.
Resp syncytial virus - bronchiolar necrosis and mucus plugging, small airway susceptible to distress
75
Organism that causes croup, SUB-epiglottic swelling. What is your DDX?
Parainfluenza virus
DDX: H. influenza epiglottitis
76
```
Name the hepatitis:
Fecal-Oral transmission, abrupt onset
DNA virus
Endemic to Mexico, Africa, Indochinese
Fatality in women 15-25%
RNA virus
Can become chronic
Requires Hep B infxn
High risk of cirrhosis, hepatocellular carcinoma
```
```
Here you go!
Hep A and E
Hep B
Hep E
Hep E
Hep A, C, D, E
Hep B, C, D
Hep D
Hep C and B
```
77
When is foreign travel more likely to be relevant in a case?
If travel occurs 30-60d ago.
78
Common cold virus.
Rhinovirus
79
T/F: Influenza virus has no GI symptoms.
T
80
Adult vs. child influenza
Adult: rapid onset high fever, malaise, myalgia, pharyngitis, non-productive cough
Child: same sx, higher fever, otitis, GI pain/vomiting, croup (non-productive cough)
81
Which type of influenza (A, B, or C)
Pandemic
Local epidemic
Mild URT infxn
A
B
C
82
What are the polio vaccines? Which is live/dead?
Salk (dead) and Sabin (live)
83
What virus causes Hand-Foot-Mouth Dz?
Cocksackie
84
What is the most common viral cause of myocarditis?
Cocksackie B
85
What aspect of the spinal cord can be infected by polio virus?
Anterior horn producing paralysis
86
What is the pathognomonic histo finding of rabies?
Negri bodies
87
What virus causes German Measles?
Rubivirus (Rubella)
88
Togaviruses
Rubella, alpha/flavi viruses ( West Nile, Eastern Equine, Dengue, Yellow fever)
89
Which alpha/flavi viruses are transmitted via mosquito?
Dengue, Yellow Fever (black vomit), West Niles, Eastern Equine, Japanese/St. Louis/Russion Encephalitis
90
Describe the timeline of HIV in terms of sx and CD4 counts.
Infection: 1-8mo, mono-like illness, resp signs
Stage 1: 8-36mo, CD4 drop from 700 to 2500, latent sx, chronic LA, some opportunistic infxn
Stage 2: 36-60mo, CD4 150-250, sub-clinical immune dysfunction
Stage 3: 60-72mo, CD4 50-150, AIDS
Stage 4: 72+mo, CD4 0-50, AIDS
91
What is the clinical diagnosis of AIDS?
HIV + and CD4 count less than 200
92
What is the only DNA virus that replicates in the cytoplasm?
Poxvirus
93
```
Name the condition:
Variola major (15-40% mortality) and minor (1% mort)
Resp droplet spread
Lesions extend to deep dermis (scarring)
All lesion at same stage of development
Centrifugal that moves peripherally
```
Smallpox
94
```
Name the condition:
Molluscipoxvirus
Small raised papule w/ crater or pus center
Self-limited, in kids
Assoc w/ HIV patients
```
Molluscum contageosum
95
T/F: Parvovirus is the ONLY dsDNA virus.
F. ssDNA
96
What is the smallest DNA virus and what condition does it cause?
Parvovirus B19, Fifth Dz- slapped cheek rash, arthritis in adults
97
What is the ONLY dsRNA virus?
Reovirus (Rotavirus)
98
What are some prion dz?
Kuru, Creutzfeld-Jacob, Scrapie, Wasting syndrome, BSE
99
What are the TORCH conditions?
```
Toxoplasmosis
Other - Syphilis, Varicella-Zoster, Parvo B19
Rubella
Cytomegalovirus (CMV)
Herpes
```
100
```
Name the flagellated protozoa: Giardia or Trichomonas
Non-bloody foul diarrhea/flatulence
Sexual transmission
Foul-smelling green vaginal d/c
Water-borne
```
Giardia lamblia
Trichomonas vaginalis
Trich
Giardia
101
What disease is caused by trypanosomes?
African Sleeping Sickness or Chagas Dz - unilateral eye swelling, cardiomegaly, megaesphogus, megacolon
102
What are sz of leishmania? What is the vector?
Cutaneous (Oriental sore) or visceral manifestation,
Sandfly
103
Sporozoa
Plasmodium, Toxoplasma gondii, cryptosporidium, babesia
104
```
Name the parasite:
Malaria
Kitty litter infxn
Water borne diarrhea
Tick-borne, arthralgia/fatigue, attacks RBCs
```
Plasmodium spp.
Toxoplasmosis gondii
Cryptosporidium parvum
Babesia bigemina - can look like Lyme
105
Name the worm:
Roundworm, likes liver/lung, LONG (20-35cm)
Pinworm
Hookworm, microcytic anemia
Trichinosis, via pigs, cardiac/nervous tissue infxn
Ascaris lumbricoides
Enterobius vermicularis
Necator americanus
Trichinella spirilis
106
Name the worm:
Elephantiasis, clog lymphatics
Snail host, bladder/bowel/liver dz
Tapeworms, long, cause nutrient def (esp B12)
Filariasis
Schistosoma spp. (blood fluke)
Taenia spp (T. solium (pork), T. saginata (beef))
