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Flashcards in Immunology II Deck (151)
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1
Q

What are the 4 major agents of human disease?

A

Bacteria
Virus
Fungi
Parasites

2
Q

The loosely organized DNA in Prokaryotes is called…

A

Nucleoid

3
Q

T/F

Both Eukaryotes and Prokaryotes have mitochondria, lysosomes, and other organelles.

A

False

Only Eukaryotes have organelles

4
Q

What is the rigid cell wall of prokaryotes made of?

A

Peptidoglycans

*polymer of AA’s and sugars

5
Q

What encompasses the Eukaryotic cell?

A

Flexible cell membrane or Chitin (fungi, rigid)

6
Q

What is common in Eukaryotic membranes and lacking (with one exception) in Prokaryotic membranes?
What is the exception?

A

Sterols

Wall-less Mycoplasma

7
Q
Motility of the following:
Protozoa
Bacteria
Fungi
Viruses
A

Protozoa - mostly motile (flagella, cilia, pseudopodia

Bacteria - some motile (flagella only)

Fungi/Viruses - non motile

8
Q

What are the 3 general shapes of bacteria?

A

Cocci - balls
Bacilli - pills
Spirochetes - spirals

*shape determined by rigid cell wall
(peptidoglycan)

9
Q

Name for cocci:
Pairs
Chains
Clusters

A

Diplococci
Streptococci
Staphylococci

10
Q

What is the smallest bacteria?
What is the largest virus?
(they are about the same size)

A

Mycoplasma

Poxvirus

11
Q

What are the largest Bacteria rods?

What fungus are they similar to in size?

A

Bacillus
Candida

*also same size as RBC’s

12
Q

What is the range of size for bacteria?

A

0.2 - 5 micrometers

13
Q

Gram positive stains ______.

Gram negative stains ______.

A

Purple

Pink

14
Q

What two characteristics will Gram staining reveal?

A

+/- gram

shape

15
Q

What are the 4 steps to the Gram stain?

after heating

A
  1. Crystal Violet Stain - 60 seconds
  2. Water, Iodine - 60 seconds
  3. Water, 95% EtOH or Acetone
  4. Safranin counterstain (red) - 60 seconds, then water
16
Q

What step removes Cresyl Blue from a Gram Negative bacteria?

Why?

A

95% EtoH or Acetone

This extracts dye from a lipid rich, thin wall

17
Q

What in the cell wall makes bacteria Gram Positive?

Gram negative?

A

Positive: Thick wall, Lipid poor

Negative: Thin wall, Lipid rich

18
Q

What type of cell wall is Mycoplasma covered with?

A

None. It is bound by a cell membrane.

*only bacteria that has just a cell membrane

19
Q

What is a normal bacteria bounded by?

A

Cytoplasmic membrane
Cell Wall

*cell wall multilayered structure

20
Q

What is a bacterial cell wall composed of?

A

Inner - Peptidoglycan

Outer - Capsule

21
Q

What is the Peptidoglycan layer of a bacterial cell wall composed of?

A

Repeating disaccharides, each with a 4 AA chain

*AA’s covalently bind to other chains, creating cross linkages

22
Q

How does the peptidoglycan layer differ in Gram -/+ bacteria?

A

Positive - thick peptidoglycan multi-layer

Negative - thin peptidoglycan single layer

23
Q

What surface antigen, made up of polysaccharide fibers, is seen only in Gram+ ?

*useful in serologic identification

A

Teichoic Acid

24
Q

What 3 layers are present in the Cell Walls of both Gram+ and Gram- bacteria?

A
  1. Inner cytoplasmic mem. (lipid bilayer)
  2. Peptidoglycan
  3. Capsule
25
Q

Describe the Cell Wall of a Gram negative bacteria.

A

Lipid bilayer
Periplasmic Space
Thin peptidoglycan layer (no Teichoic Acid)
LPS (Lipopolysaccharide)

26
Q

What is the Periplasmic space filled with?

What type of bacteria is it found in?

A

Beta-lactamases (degrade beta-lactam drugs)

Gram Negative

27
Q

What surface element is seen only in Gram+?

What is seen only in Gram-?

A
Teichoic Acid (+)
Lipopolysaccharide (-)
28
Q

What 3 components make up the LPS seen in Gram-?

A

1-50 oligosaccharide outer carbohydrate

center polysaccharide

Lipid A

29
Q

Why is the Lipid A component of the LPS in Gram- bacteria of interest?

A

Lipid A is an Endotoxin

*responsible for Fever and Shock upon cell lysing

30
Q

What bacteria can’t be Gram stained?

A

Mycobacteria

*TB, Leprosy, MAI

31
Q

What doesn’t Mycobacteria stain well?

A

Acid-Fast
(Mycolic Acids in lipid cell wall)

After being stained with Carbolfuchsin, they resist decolorization with acid alcohol

32
Q

Why doesn’t TB stain well with Gram techniques?

A

It is “acid fast”

33
Q

What is the capsule made of?
What is its function?

note: this is the same in Gram+/-

A

Simple sugar residues

Makes more virulent
macrophage and neutrophils unable to phagocytize sugars

34
Q

Why are the sugars in the capsule useful?

A

Used as antigens in vaccines

35
Q

What 2 tests enable visualization of Capsules?

A

India Ink (doesn’t stain - transparent halo)

Quelling rxn
Methylene Blue, capsule swells, Pneumococcus

36
Q

What bacteria is identified with India Ink stain?

A

Cryptococcus

37
Q

What bacteria is identified with the Quelling rxn?

A

Pneumococcus

38
Q

T/F

Both Gram+ and Gram- bacteria can have flagella.

A

True

39
Q

What is the process of attractants of bacteria with flagella?

A

Chemotaxis

40
Q

Why are P. mirabilis and E. coli common causes of UTI’s?

A

They have flagella

41
Q

Do spirochetes move?

A

Yes.

Axial Filament undulates

42
Q

What bacterial structure acts as an adherent?

A

Pili

Fimbriae

43
Q

What type of bacteria are Pili/Fimbriae mostly found on?

A

Gram negative

44
Q

What is an example of a bacteria that uses Pili for adhereence?

A

Gonorrhea

also E.cole, Campylobacter jejuni, Bordetella pertussis

45
Q

What does Strept mutans secrete?

A

Glycocalyx on teeth

slime layer

46
Q

What DNA containing structure forms when nutrients are depleted?

A

Endospore

47
Q

What is responsible for endospore resistance?

A

Dipicolinic Acid

Calcium chelator found only in spores

48
Q

What is a neurotoxin?

A

Exotoxin that acts on nerves

49
Q

What are enterotoxins?

A

Exotoxin that acts in GI tract

50
Q

What are 2 diseases caused by enterotoxins?

A

Diarrhea

Food poisoning

51
Q

What makes up an Endotoxin?

A

Lipid A of the LPS

*Seen only in Gram negative

52
Q

How is Endotoxin different from Exotoxin?

A

Endotoxin isn’t secreted, it’s part of the outer membrane

53
Q

T/F

Internal organs have local flora

A

False

organs usually sterile

54
Q

What is normal flora on the skin that might be problematic if it reaches the circulation?

A

Staph epidermidis

*wreaks havoc on artificial heart valves

55
Q

Where does Staph aureus normally live?

A

Nose

56
Q

What species of bacteria in the throat inhibit the following:
Strept pyogenes
Neisseria menigitidis
Staph aureus

A

Viridans Strept
Neisseria species
Staph epidermidis

57
Q

What organisms can potentially invade circulation and attach to damaged heart valves?

A

Viridans strept

58
Q

What oral flora is associated with human bites and clenched fist injuries?

A

Eikenella corrodens

59
Q

What can anaerobic bacteria found in gingival crevices cause if aspirated?
(e.g. Bacteroides, Fusobacterium, Clostridium)

A

Lung abcesses

60
Q

What percentage of feces is bacteria?

A

20%

61
Q

What is the leading cause of UTI’s?

A

E.coli

62
Q

What bacteria is associated with intestinal perforation?

A

B. fragilis

63
Q

What is an important cause of UTI’s and endocarditis?

A

Strept faecalis

64
Q

What is the normal flora of the vagina?

A

Lactobacillus species

65
Q

What vaginal bacteria can be dangerous to newborns?

A

Group B Streptococci

66
Q

What acid fast bacteria is found in women and uncircumcised males?

A

Mycobacterium smegmatis

67
Q

What can urine become contaminated with?

A

Staph epidermidis and Coliforms

68
Q

What are the 5 Cardinal signs of Inflammation?

A
Heat
Redness
Swelling
Pain 
Loss of function
Calor
Rubor
Tumor
Dolor
Functio laesa
69
Q

What regulates the inflow of blood to capillaries upon trauma?

A

Smooth muscle on pre-capillary arterioles

70
Q

Why does dilation of capillaries cause swelling?

A

Because they’re one simple squamous cell thick and leak

*causing edema

71
Q

What is the response to injury in the capillaries in the first few seconds?

A

vasoconstriction

vasodilation

72
Q

What causes hyperemia (warmness) in inflamed tissue?

A

Large quantities of blood pumped in after arteriole smooth muscle relaxes

73
Q

Why is blood flow congested in traumatized areas?

A

Release of plasma into surrounding tissue concentrates cells in vasculature

74
Q

What do RBC’s form in congested vasculature?

What do WBC’s do?

A

Stacks “Rouleaux”

Margination and Pavementing

75
Q

Describe pavementing

A

WBC’s stick to vasculature walls via activated adhesion molecules

76
Q

What activates the adhesion molecules on Leukocytes in response to inflammation?

A

Interleukins

77
Q

Where is the greatest concentration of Interleukins and what are they derived from?

A

Inflammation site

Platelets and Leukocytes

78
Q

What anchors leukocytes to vessel walls during inflammation?

What initiates this process?

A

Fibrin strands

Platelets

79
Q

The process of increased vessel permeability that creates edema is called?

A

Transudation

*Edema is rich in protein but few cells

80
Q

Pus is an example of an…

A

Exudate

81
Q

PMN =

A

neutrophils

82
Q

What makes up pus?

A

Mostly a neutrophil exudate

83
Q

What is the lifespan of neutrophils in response to inflammation?
What comes after?

A

2-4 days

Macrophage, Lymphocytes, Plasma cells

84
Q

How do leukocytes migrate through endothelial cells?

A

Pseudopods

85
Q

What type of substance stimulates PMN’s to an inflamed site through a concentration gradient?

A

Chemotactic substances

86
Q

What two things facilitate opsonization in phagocytosis?

What specific receptors do they use?

A

Immunoglobulins (Fc)

Complement (C3)

87
Q

Why do many PMN’s die in their battle with bacteria?

A

They discharge their specific granules kamikaze like

and make pus

88
Q

What are inflammations called if they’re dominated by pus formation?

A

Purulent

or suppurative

89
Q

What cells are dominant in Chronic Inflammations?

A

Lymphocytes
Macrophages
Plasma Cells

90
Q

T/F

All infections have an acute phase

A

False

TB has slow onset and is long lasting
Silica dust exposure
Rheumatoid arthritis

91
Q

Aside from infectious pathogens, what can cause inflammation?

A

Chemical, physical, or immune factors

92
Q

What is a fever in celsius?

A

above 37

93
Q

What are 2 examples of an endogenous pyrogen (a fever producing cytokine)?
Where do they act?

A

IL-1 (Interleukin) and TNF

on thermoregulatory centers in Hypothalamus

*Hypothalamus serves as a thermostat

94
Q

Define pyrogen:

A

fever inducing Cytokine released by PMN’s and macrophages during inflammation

95
Q

What mediates pyrogen action in the hypothalamus?

A

Prostaglandins

96
Q

What is the normal range of Leukocytes in the blood?

What is the range of leukocytosis?

A

10,000 /mm3

12-15,000 WBC’s/mm3

97
Q

What is the mildest form of inflammation?

A

Serous

98
Q

Fibrinous inflammation occurs through ______ vessels than serous inflammation.

A

Larger

99
Q

What are 3 examples of bacterial infections that cause fibrinous inflammation?

A

Strept throat
Pneumonia
TB pericarditis Bread and Butter

100
Q

T/F

Fibrinous inflammation never resolves.

A

False

blood vessels grow into exudate

101
Q

What type of inflammation forms pus?

A

Purulent

102
Q

What is the term for a localizes collection of pus?

A

Abscess

103
Q

Why don’t abscesses heal spontaneously?

What happens when they rupture?

A

Purulent matl surrounded by capsule of Fibrotic Granulation Tissue

create sinus

104
Q

An abscess that creates a channel between two pre-existing cavities is knows as a…

What is the accumulation of pus in this area?

A

Fistula

Empyema

105
Q

What type of inflammation creates a hole in epithelium?

A

Ulcers

*peptic best example

106
Q

What type of inflammation does C. difficile create?

What are the components of this inflammation?

A

Pseudomembranous inflammation

fibrin, pus, cellular debris, and mucous

107
Q

What is often seen in chronic inflammation?

What causes this?

A

Scarring

lymphs, macrophage, and plasma cells stimulate fibroblasts

108
Q

What is a Granulomatous Inflammation?

Best example?

A

No acute phase, caused by Type IV cell-mediated hypersensitivity (or by persistent antigens)

TB
(also certain fungal diseases)

109
Q

What are epitheloid cells?

Where are they seen?

A

Interconnected macrophage
(immobile)

Granulomatous inflammation

110
Q

What accumulates in granulomatous inflammation?

A

T-lymphocytes and Macrophages

111
Q

How do macrophage and epitheloid cells differ?

A

Epitheloid cells immobile and not phagocytic

*they produce inflammatory mediators

112
Q

What forms multi-nucleated giant cells on the rim of granulomatous inflammations?

A

Epithelioid cells

113
Q

T/F

Granulomas tend to be transitory

A

False

necrotic and persistent

114
Q

What is an example of a granulomatous inflammation of the lung?

A

Pulmonary tuberculosis

115
Q

What are the 3 classifications of cells vis a vis their proliferation?

A

Continuously dividing (aka Labile)
Quiescent
Nondividing

116
Q

What type of cells divide throughout lifespan?

*aka?

A

Labile (continuously dividing) cells

*Stem Cells

117
Q

What type of cell can divide but normally doesn’t?

A

Quiescent

118
Q

What are some examples of Permanent (nondividing) cells?

A

Neurons and Myocardial

119
Q

What cell, integral to wound healing, have hybrid properties of smooth muscle and fibroblasts?

A

Myofibroblasts

120
Q

What stimulates blood vessels to come to an area under repair?

A

Angioblasts

121
Q

What are the 2 components of Granulation tissue?

A

Collagen and Angiogenesis

122
Q

What two healing substances to fibroblasts secrete?

A

Fibronectin (glue)

Collagen (III > I)

123
Q

Describe the progression of First Intention wounds.

A
Coagulated blood forms Scab
PMN's scavenge
Macrophage (2-4 days later) stimulate:
Myofibroblasts
Angioblasts
Fibroblasts 

Granulation tissue (collagen and angiogenesis)

Fibronectin/III > I
Scar
Remodeling (III>I)

124
Q

What 3 cells does Macrophage stimulate in wound healing?

A

Myofibroblasts
Angioblasts
Fibroblasts

125
Q

What is the difference between First Intention wound healing and Secondary intention?

A

Collagen doesn’t progress from I to III

126
Q

Define ischemia

A

poor O2 supply

127
Q

T/F

Corticosteroid hormones have been implicated in inadequate collagen formation.

A

True

128
Q

Define dehiscence:

A

Separation of wound margins

lack of tensile strength

129
Q

Keloids are composed mostly of…

A

Type III collagen

130
Q

What do mucous, saliva, tears, and prostatic secretions contain?

A

IgG and secretory IgA

131
Q

Why is the vaginal pH low?

A

Lactobacillus

*inhibits Candida

132
Q

What chemical barrier is found in tears and saliva?

A

Lysozyme

133
Q

Name 4 antimicrobial chemical barriers.

A

Lysozyme (degrades peptidoglycan)
Peroxidase
Lactoferrin (takes Fe from microorganisms)
Defensins

134
Q

How do Defensins operate?

Where are they found?

A

Insert peptides into microbial membrane

found in mucous membranes and phagocytes

135
Q

What lines lymphatic vessels?

A

Endothelium

136
Q

What does lymph transport?

A

WBC’s, fats, cellular debris, infectious agents

137
Q

Where does metastasis occur?

A

through lymph

138
Q

What are low molecular weight proteins whose main function is communication?

A

Cytokines

139
Q

What are 5 types of Cytokines?

A
Interleukins
TNF
Chemokines
Colony stimulating factors
Interferons
140
Q

What are the pivotal cells in direction of inflammation through expression of cytokines?

A

Macrophages

141
Q

What 2 cytokines are produced by macrophage in response to inflammation?
(amplify inflammation)

A

IL-1 and TNF-alpha

142
Q

What are some functions of IL-1 and TNF-alpha?

A

activate endothelium to release more cytokines

Mediate fever, catabolism of muscle, hemodynamic effects

143
Q

What protein is produced by a subset of T-cells and NK cells that stimulates macrophage and cytokine production?

A

Interferon-gamma

144
Q

What type of cytokines direct cell migration?

A

Chemokines

145
Q

What are 2 functional classes of chemokines?

A

Inflammatory (IL-1, TNF, Interferon)

Homing

146
Q

What is the function of Colony Stimulating Factor?

A

Stimulates production of White blood cells

*binds hematopoietic stem cells

147
Q

What are the 3 types of Colony Stimulating Factor?

A

CSF-1 macrophage
CSF-2 granulocyte/macrophage
CSF-3 granulocyte

(CSF-3 = G-CSF)

148
Q

What is one of the most potent activators of Macrophage, Endothelial cells, and neutrophils?
(to produce cytokines)

A

LPS - Lipopolysoaccharides

*Gram negative cell walls

149
Q

How does LPS activate various cells?

A

Cells have LPS-binding protein receptors

150
Q

Too much LPS can create…

A

Septic shock

151
Q

Describe septic shock pathway.

A

LPS > LPS binding protein > CD14 > TNF-alpha > directly injures endothelial cell walls

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