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i and d mcqs Flashcards

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1
Q

the lymphoid tissue most closely associated with immune responses to gut pathogens is the:
A- MALT
B lymph nodes
C secondary lymph nodes
D mucosal tissue
E M cells

A

MALT

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2
Q

the cell type most closely associated with chronic inflammation is the
A basophil
B b cell
C Mast cell
D Nk cell
E macrophage

A

macrophage

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3
Q

the area of the lymph node closely associated with class switching of antibodies
A medullary sinus
B primary follicle
C secondary follicle
D germinal centre
E paracortex

A

D germinal centre

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4
Q

the most important target site for penicillin is the
A plasma membrane
B cell wall
C DNA gyrase
D ribosome
E dihydrofolate reductase

A

B cell wall

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5
Q

one of the following is only found in the uk as an imported fungal infection
A cryptococcosis
B histoplasmosis
Cinvasive candidiasis
D invasive aspergillosis
E pneumocystis infection

A

b histoplasmosis

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6
Q

the pathogenesis of severe malaria is a consequence of
A reduced circulating levels of inflammatory mediators
B macrophage activation
C over production of tumour necrosis factor il1 il2 and interferon gamma
D toxins produced during infection
E activation of hosts immune system

A

over production of tumour necrosis factor il1 il2 and interferon gamma

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7
Q

following a routine non complicated surgical procedure scar formation is a result of
A basement membrane disruption as part of surgery
B early mobility
C infection
D healing by secondary infection
E wound dehisence

A

a basement membrane disruption

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8
Q

the most rapid means of spread of infection in a population is
A sexual transmission
B faecal oral route
C congenital from mother to foetus
D insect bite
E respiratory route via infectious aerosols

A

E respiratory route via infectious aerosols

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9
Q

negative staining using india ink is used with a light microscope to visualise
A spirochaetes
B capsules
C endospores
D flagella
E pili fimbriae

A

b capsules

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10
Q

aspergillus species are important in medicine because they
A can invade lung and blood vessels in immunocompromised people
B are ubiquitous environmental fungi
C are thermophiles that can survive being at 55
D produce asexual spores known as conidia
E grow as filaments in a mycelium

A

A can invade lung and blood vessels in immunocompromised people

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11
Q

the most important characteristic of entamoeba histolytica is that it
A produces cysts which survive in the environment
B can cause mild or asymptomatic diarrhoea
C can cause severe dysentery
D may be acquired via anal sexual activity
E is common in tropical and subtropical countries

A

c entamoeba histolytica can cause severe dysentery

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12
Q

urinary tract infections have an important impact in the community because they
A can cause recurrent infections in 20-30% women
B rarely caused by anaerobes
C associated with minor anatomical abnormalities of the urinary tract and kidneys of baby boys
D most frequently caused by e coli
E arise because urine is an excellent growth medium

A

can cause recurrent infections in 20-30% women

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13
Q

capnophiles are bacteria that
A commonly occur in human commensal microflora
B are able to grow in an environment with 2-10% oxygen
C grow in an environment that contains 78% nitrogen
D are aerobic organisms
E require 5-10% of carbon dioxide

A

E

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14
Q

which one of the following statements is correct
A vertical transmission of viruses between siblings is common in the uk
B most human viruses are readily transmitted to farm animals but the converse is not true
C faeco oral transmission of hepatitis C virus typically occurs in intravenous drug abusers
D transmission can always be prevented by strict personal hygiene
E blood borne viruses may be transmitted noscomially

A

E

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15
Q

which one of the following statements is correct
A) herpesvirus divides within host cell membranes
B) uncoating is the term used to describe the release of the viral genome from the nucleocapsid
C) negative sense rna acts as viral mrna
D) viral early genes are transcribed after replication of the genome encode structural proteins
E virus replication inevtiably leads to host cell lysis

A

B

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16
Q

what kind of rna does picornviruses have and what are they

A

picorn viruses have positive sense single stranded rna which means their rna can directly be used as mrna for protein synthesis by the host’s ribosomes
examples of picornaviruses are
polio
rhinovirus
hepatitis a
coxsackievirus- myocarditis associated

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17
Q

what viruses have reverse transcriptase

A

hiv
hepatitis b- partially double stranded dna

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18
Q

what kind of symmetry do adenovirus particles exhibit

A

icosahedral
240 capsomeres

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19
Q

what is pemphigus

A

rare group of autoimmune diseases which can cause blisters and erosions on the skin and mucous membranes
bodys immune system produces antibodies desmogleins which are proteins that help skin cells stick together
this leads to separation of skin cells acantholysis causing blisters that can rupture and result in painful sores

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20
Q

how many forms of nucleic acid can a single virus agent contain

A

1

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21
Q

example of aminoglycosides

A

gentamicin

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22
Q

example of macrolide

A

erythromycin

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23
Q

example of beta lactam

A

penicillin

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24
Q

example of tetracycline

A

doxycycline

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25
example of quinolone
ciprofloxacin
26
example of glycopeptide
vancomycin
27
example of anti folate
trimethoprim inhibits bacterial enzyme dihydrofolate reductase
28
what can aminoglycosides cause
ototoxicity teratogenicity
29
prevalence
number of people with disease at one point in time/ number of people in the population at that point in time
30
rate
number of new people with the disease in a defined period/ person years at risk of disease
31
what kind of individuals is the live attenuated not recommended to be used on
immunocompromised patients due to the live nature of the vaccine
32
what are examples of a live attenuated vaccine
bcg measles, mumps,rubella mmr influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid
33
what are inactivated preparations vaccines
employ pathogens that have been killed often by heat or chemicals to elicit an immune response
34
why do inactivated preparation vaccines require boosters
to maintain immunity as the induced immune response is generally weaker than the live attenuated vaccine
35
what are examples of inactivated preparation vaccines
rabies influenza (intramuscular) hepatitis A
36
what are toxoid (inactivated vaccines)
these vaccines are designed around the toxins produced by certain bacteria. these toxins are detoxified and used as antigens in the vaccine. when the immune system encounters these non toxic toxoids, it learns to combat natural toxins the bacteria produce, providing immunity against the toxic effects of infections
37
why do toxoid inactivated vaccines require boosters
to maintain immunity since like inactivated vaccines the immune response they induce can wane over time
38
what are some examples of toxoid inactivated vaccines
tetanus diptheria pertussis
39
what are sub-unit and conjugate vaccines
subunit means that only part of the pathogen is used to generate an immunogenic response. a conjugate vaccine is a particular type that links the poorly immunogenic bacterial polysaccharide outer coats to proteins to make them more immunogenic
40
what are examples of sub-unit conjugate vaccines
pneumococcus (conjugate) haemophilus (conjugate) meningococcus (conjugate) hepatitis B human papillomavirus
41
what is a mrna vaccine
introduce a piece of mrna into cells which then produce a protein to trigger an immune response
42
what are examples of a mrna vaccine
covid 19 vaccines
43
what are viral vector vaccines
use a harmless virus (different from target pathogen) to deliver critical parts of the target pathogen to stimulate an immune response can be produced more rapidly in response to emerging threats
44
what are examples of viral vector vaccines
-ebola covid 19
45
how does the hepatitis B vaccine work
contains hbsag antigen onto aluminium hydroxide adjuvant and is prepared from yeast cells using recombinant dna technology
46
what is the life cycle of malaria (brief)
sporozoites sporozoites mature into schizonts schizonts contain thousands of merozoites which are released when the liver cell ruptures inside the rc merzoites develops into trophozoites which matures into schizonts schizonts undergoes asexual reproduction which produces new merozoites into the bloodstream to infect more rbcs continuing the cycle
47
what is the dormant form of the malarial parasite found in liver cells and what two forms of malaria are hypnozoites characteristic of
hypnozoites plasmodium vivax plasmodium ovale
48
what are the two malarial drugs
quinine chloroquine
49
when someone is infected with malaria what does the release of hemozoin ( a byproduct of haemoglobin digestion) and other waste products stimulates the immune system causing
cytokine release interlukins and tumour necrosis factor fever chills and rigors (classic malaria symptoms during paroxysms) systemic inflammation
50
what is haptoglobin
protein produced by the liver. binds to free haemoglobin that is released when rbcs are broken down. by binding to haemoglobin haptoglobin helps prevent toxic effects of free haemoglobin in the bloodstream such as kidney damage. it also facilitates removal of haemoglobin-haptoglobin complex by liver and spleen
51
in phagocytic killing, what is the enzyme that converts hydrogen peroxide and halide ions into bleach
myeloperoxidase
52
which components form the membrane attack complex
c5b c6 c7 c8 c9
53
what are three complement pathway outcomes
inflammation opsonisation lysis
54
what components of the complement pathway make up inflammation
c3a c5a
55
what components of the complement pathway make up opsonisation
c3b c4b
56
what components of the complement pathway make up membrane attack complex/lysis
c5b, c6 , c7, c9, c8
57
which cells can produce type 1 interferons
epithelial cells keratinocytes fibroblasts
58
how do scientists differentiate between yeast and mould
moulds are multicellular and filamentous with hyphae whereas yeast are not
59
at what ph does candida switch from a single cell to a hyphae producing cell
ph8
60
what is a common cause of vaginal candiadisis
antibiotic usage e.g use of amoxicillin
61
how does antibiotic usage cause vaginal candiadisis
the typical ph of the vagina is 4 due to lactobacilli producing acids through lactic acid fermentation. antibiotic usage can kill lactobacilli causing the ph to increase and so th candida cells switch to hyphal mode and so infection of mucosal surface
62
what is a cause of invasive candiadiasis
broad spectrum use antibiotics causing overgrowth of candida
63
what are virulence factors for streptococcus pyogenes
streptolysin s and o collagenase hyaluronidase
64
what are two examples of cytotoxins (directly poison the cells)
shiga toxin (can cause haemolytic uremic syndrome HUS) diptheria toxin
65
what is an example of a neurotoxin
botulinum toxin can cause flaccid paralysis by inhibiting the release of ach neurotransmitter at a neuromuscular junction Clostridium tetani
66
what is an example of a enterotoxin
cholera
67
what is an example of endotoxin
lipopolysaccharide (gram negative bacteria) e coli
68
how does diptheria toxin cause disease
directly damages the pharynx, myocardium and axons as the toxin inactivates elongation factor -2 which means no proteins are synthesised by ribosomes. this leads to cell death
69
how can syphilis infection be detected
antibody detection
70
what is fish
flourescent in situ hybridisation used to detect genetic sequences
71
what are the stages of wound healing
haemostasis inflammatory proliferative remodelling
72
what are the stages of viral replication
attachment penetration uncoating expression of viral material viral assembly
73
explain the haemostasis phase of wound healing
damaged blood vessel constricts, platelets stick together to seal the leak and coagulation to reinforce platelet plug
74
explain the inflammatory phase of wound healing
inflammatory blood vessel leaks transudate and removal of damaged cells, pathogens and bacteria,
75
explain the proliferative phase of wound healing
rebuilding the wound with fibroblasts and ecm fibroblast migration and angiogenesis which results in granulation tissue, release of growth factors, and the epithelisation of wounds and then differentiation of fibroblasts to myofibroblasts myofibroblasts allow the wound to draw in and contract
76
explain the remodelling phase of wound healing
remodelling involves collagen fibres realigning along tension lines, the replacement of type 3 collagen by type 1 cross linking of collagen fibres and closure of the wound
77
what intention injury is a surgical wound
primary intention
78
what intention injury is a burn
secondary intention
79
what intention injury is a surgical wound complicated by infection
primary delayed closure
80
what intention wound is pancreatitis surgical wound
primary delayed closure
81
are osteoclasts multinucleated
yes
82
what is the most common cause of delayed wound healing
infection
83
which class of antibiotics inhibit transpeptidases and transglycosylases involved in cross-linking NAG and NAM subunits with short chains of amino acids thus reducing strength of cell wall and leading to osmotic rupture
beta lactams
84
what is the mechanism of action of tetracyclines
binds to 30s ribosome inhibits aminoacyl trna from binding to mrna ribosome by binding to 30s subunit
85
what is an adverse affect of tetracyclines
teeth discolouration as they bind to calcium ions in developing teeth and bones
86
mrsa has mutated so what antibiotic is it no longer effected by
beta lactams
87
what is a morphological pattern of chronic inflammation
granulomatus inflammation
88
what kind of infection out of latent chronic and acute can hepatitis b and hiv lead to
chronic infection
89
what kind of infection can sars cov 2 lead to
acute infection
90
what kind of infection can epstein barr and hepes simplex to out of acute latent and chronic
latent infection
91
what is the order in size of bacteria protozoa viruses helminths
viruses bacteria fungi protozoa helminths
92
what is giardia
protozoa commonly found in bodies of water inhabited by beavers. beavers are carriers and cysts contaminate water
93
what type of exotoxin is clostridium tetani and how does it cause disease
clostridium tetani is a neurotoxin and inhibits release of gaba and glycine at neuromuscular junction causing spastic paralysis lockjaw respiratory paralysis tetanospasmin toxin
94
what type of exotoxin is cholera and how does it cause disease
enterotoxin damages sodium glucose co transporter in the gut epithelium
95
what type of exotoxin is shiga toxin and how does it cause disease
destroys ribosomes cytotoxin when it gets to gut epithelium it can lead to bloody diarrheoa when it destroys endothelium it can cause haemolytic uremic syndrome
96
what type of exotoxin is diptheria and how does it cause disease
cytotoxin directly damages the pharynx the myocardium and axons as the toxins inactivate elongation factor -2 which means no proteins are synthesised by ribosomes this leads to cell death
97
what is rna dependent rna polymerase
converts negative sense rna to positive sense rna so that it can be translated
98
what viruses contain reverse transcriptase
hiv hepatitis b
99
how are cryptococcus, streptococcus pneumoniae neiserria mengitidis detected
antigen testing
100
what do follicular t helper cells do
help b cells make specific antibodies
101
what do th17 cells do
they activate nuetrophils
102
what do th1 cells activate
macrophages, cytotoxic t cells
103
what do th2 cells activate
mast cells, eosinophils, ige
104
what atypical organisms is beta lactam ineffective against
mycoplasma pneumoniae chlamydia legionella
105
what is the mechanism of action of beta lactams
inhibit transpeptidases and transglycosylases involved in cross linking of NAG and NAM sub units with short chains of amino acids- affects cell wall
106
what is the mechanism of glycopeptides
physically obstruct the cross linking of NAM and NAG sub units acts on cell wall
107
what is the mechanism of tetracyclines
binds to the 30s sub unit of the mrna- ribosome prevents aminocyl -trna from binding to mrna ribosome
108
what does bacteriostatic mean
stops bacteria from growing but doesnt kill the bacteria outright
109
what is the mechanism of action of the aminoglycosides
binds to 30s ribosome causing inaccurate translation (mrna) and therefore a non functioning protein
110
what is the mechanism of action of the macrolides
binds to p site on bacterial ribosome inhibits protein synthesis, prevents peptidyl transferase from adding aminoacyl-trna onto the next amino acid and so stops polypeptide chain from growing
111
whats the mechanism of action of quinolones
inhibits dna gyrase and topoisomerase with relieve topical stress during bacterial dna replication, interferes with dna replication and translation
112

key cases i and d (7 decks)

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