Test 1 Flashcards
(203 cards)
1
Q
Does innate immunity have memory?
A
no
2
Q
According to Steele, what triggers viral fusion with host DNA entry into cells?
A
acidification of lysosome
3
Q
What type of virus does bile destroy?
A
Enveloped
4
Q
Which two types of interferon do virus infected cells produce?
A
alpha and beta
5
Q
What are the two anti-viral interferons?
A
alpha and beta
6
Q
Which type of interferon do leukocytes produce?
A
Alpha
7
Q
Which type of interferon do fibroblasts produce?
A
beta
8
Q
What does interferon do to MHC One levels?
A
increase
9
Q
By which two mechanisms does interferon inhibit protein synthesis?
A
RNA degradation
inhibiting eIF2
10
Q
What activates NK cells on a potential target cells?
A
down-regulation/absence of MHC one
11
Q
By what mechanism can NK cells undergo ADCC?
A
Fc receptors are cross-linked by IgG bound to target cell
12
Q
Through which two cytokines can macrophages kill viruses?
A
TNF-alpha
nitric oxide
13
Q
What site of the body has short-lived immunity?
A
mucosal sites
14
Q
Is humoral protection more important in early or late part of an infection?
A
early
15
Q
According to Steele, which two bacteria can survive in macrophages?
A
Listeria and Mycobacteria
16
Q
Which cells produce IL12? What is the function of IL12?
A
macrophage
NK cells to produce interferon-gamma
17
Q
Interferon-gamma can induce a macrophage to produce which antimicrobial cytokine?
A
nitric oxide
18
Q
What is the function of IL4?
A
mediate a TH2 response
19
Q
Is the formation of a granuloma a TH1 or TH2 response?
A
TH1
20
Q
How do mycobacteria invade the immune system?
A
inhibit fusion of phagosome and lysosome
21
Q
Is tuberculoid leprosy a TH1 or TH2 response?
A
TH1
22
Q
Is lepromatous leprosy a TH1 or TH2 response?
A
TH2
23
Q
Which immunoglobulin isotype can compensate for IgA during IgA deficiency?
A
IgM
24
Q
Which bacteria can make C3 Protease?
A
S. pneumoniae
25
Which bacteria has a Type 3 Secretion System?
Salmonella typhi
26
What gene is turned down by a bacteria that has a T3SS? What cytokine is subsequently turned down?
NFKB
TNF
27
Which two cytokines mediate septic shock?
TNF and IL1
28
Which two proteins are linked by superantigens?
MHC II and TCR
29
Which organelle is targeted during Rheumatic Fever?
Sarcolemma
30
Is a TH1 or TH2 response better at clearing Syphillis?
TH1
31
Is a TH1 or TH2 response better at clearing Borrelia?
TH1
32
Which two human components may syphillis possess molecular mimmicry with?
fibronectin and collagen
33
Is a TH1 or TH2 process better for clearing fungi?
TH1
34
What does histamine do to lymph flow?
increase
35
What amino acid can be decreased due to IFN? Protect against?
tryptophan
Parasites
36
Is a TH1 or TH2 process better for clearing Schistosoma?
TH1
37
IL12 can be downregulated by what parasite?
Leishmania
38
Which cytokine is a bad prognostic indicator for a P. falciparum infection?
TNF
39
Filarial worms lodged in lymphatic channels induce what sort of immunity?
TH1
40
Are more cases of otitis media caused by viral or bacterial origins?
viral
41
What are treatment for otitis media?
Amoxicillin
42
What antibiotic is used for H. flu?
ampicillin
43
What antibiotic is used for recurrent otitis media?
Amoxicillim/Clavulanate
44
What must be used to diagnose serous otitis media?
pneumoscopy
45
What is used for treatment of fungal otitis externa?
azole
46
What three drugs are used to treat bacterial otitis externa?
neomycin
polymyxin B
hydrocortisone
47
What drug is used to treat otitis externa if worried about tissue penetration?
cipro
48
What drug is not used to treat acute sinusitis?
anti-histamines
49
What antibiotic is used for acute sinusitis?
amoxicillin
50
What drug does Benzoni say is used to treat pseudomonas sinusitis?
Cipro
51
What are the two gamma-hemolytic bacteria?
Enterococcus
Peptostreptococcus
52
What drug is used to treat Strep throat?
Penicillin
53
Antibiotics decrease the risk of what post-streptococcal complication? Which one doesnt decrease?
decrease = rheumatic fever
doesnt decrease = glomerulonephritis
54
Are antibiotics used to treat Salmonella?
no
55
What are the three non-lactose fermenting, oxidase-negative gram-negative rode?
Shigella
salmonella
Proteus
56
Is ribavirin used for tolerated RSV?
no
57
Is herpes painful or painless?
painful
58
Does HIPPA apply to public health?
no
59
What pathogen is the most common cause of fungal esophagitis?
Candida
60
What appearance would candida esophagitis have imaging?
"cobblestone"
61
What specific drug is used to treat oral candidiasis?
Fluconazole
62
What two drugs are used to treat oral candidiasis is fluconazole fails?
IV echinocandin
Amphotericin B
63
What is the common suffix for echinocandins?
-fungin
64
What drug is used to treat herpes esophagitis?
acyclovir
65
What two drugs are used to treat CMV Esophagitis?
gangciclovir or valgangciclovir
66
Why doesnt serology work for H. pylori?
cant distinguish acute vs. chronic infection
67
Raspberries from Guatamala may be indicative of what bug?
Cyclospora
68
Are fecal leukocytes present in inflammatory or non-inflammatory diarrhea?
non-inflammatory
69
Which three bacteria are known to cause inflammatory diarrhea?
Shigella
Salmonella
Campylobacter
70
What is the best tool for C. difficile?
stool sample
71
What drug is used for C. difficle with a white count over 15K?
oral vancomycin
72
What drug is used for C. difficle with a white count under 15K?
metronidazole
73
What drugs are not included in the treatment of C. difficile?
rifampin or rifaximin
74
What type of vancomycin treatment is equal in efficacy for C. difficile?
low or high dose oral
75
What is the time-frame for Metronidazole treatment for C. diff?
only for first occurrence
76
What drug is used for recurring C. diff?
vancomycin
77
What is the preferred imaging modality for meningitis?
MRI
78
What is the most important parameter in choosing an agent for CNS infections?
penetration
79
Bactericidal or bacterostatic for CNS infections?
cidal
80
Would an antibiotic with low or high protein binding be better for CNS infections?
low
81
When are surgeons called for a CNS infection?
abscess
82
What are the two most common bacterial causes of CNS infections in the elderly?
S. pneumo and Neisseria
83
What is measured during a Cryptococcal infection?
opening pressure
84
What two drugs are used to treat Cryptococcus infection?
Fluconazole and Ampho B
85
What can complicate chronic meningitis?
hydrocephalus
86
Are UTIs more common in male or female neonates?
male
87
What is the occurence for UTIs in individuals over 50?
equal
88
Treat asymptomatic UTI in elderly?
no
89
Treat a UTI with a foley in?
no
90
What type of ratio cannot be relied on for a urinalysis regarding Epi/WBC?
equal
91
How is chlamydia found during a UTI?
PCR
92
Two drugs for STDs?
Ceftriaxone
Azithromycin
93
According to Benzoni, foley with pyelonephritis?
no
94
What temperature for SIRS criteria?
> 38C or
95
What is the respiratory rate and PCO2 for SIRS?
> 20 or less than 32 PCO2
96
What is the HR for SIRS?
greater than 90
97
What are the two white cell counts for SIRS?
> 12K or less than 4K
98
What is the bandemia for SIRS?
> 10%
99
How many SIRS criteria are required for sepsis? With what else?
2/4
suspicion of infection
100
How much liquid should be given to a person before we diagnose them with septic shock?
30 mL/Kg
101
What is done before antibiotics regarding sepsis?
cultures
102
What is the test for Rhabdomyolysis?
Creatinine kinase
103
What mean arterial pressure is maintained during sepsis?
65
104
What is the formula for MAP regarding sepsis?
(systolic)(2xDBP)/3
105
What is the fluid of choice for sepsis?
Crystalloids
106
What is the first-line pressor?
NorE
107
What is the first alternative for NorE?
epinephrine
108
Which pressor can decrease NorE requirements? What else does this pressor do?
Vasopressin
raise MAP
109
Antibiotics should be administered within how long of a suspicion of septic shock?
one hour
110
Narrow or broad spectrum antibiotics for sepsis? Do what as soon as possible?
broad
de-escalate
111
What is urine output goal for sepsis?
> 0.5 mL/Kg/Hr
112
Is Rectal temperature higher or lower than oral?
higher
113
Broad spectrum antibiotic for age 3-36 months with fever of unknown origin?
Ceftriaxone
114
What does Listeria to do the phagosome of macrophages?
disrupt it
115
Does tuberculoid or lepromatous Mycobacteria infection have disseminated bacteria?
Lepromatous
116
Bacteria express what nucleic acid antigen to activate macrophages?
unmethylated CpG dinucleotide
117
What does complement do to gram-negatives?
lyse
118
What does complement do to gram-positives?
opsonize
119
Which two bacteria express M-protein?
Strep pneumo
Strep pyogenes
120
What are the two cytokines to induce DIC?
TNF and IL1
121
Adaptive immunity clears what fungal pathogen?
Candida
122
What is the normal CSF/Serum glucose ratio ?
0.6
123
A CSF/Serum glucose ratio less than what is suspicious?
0.5
124
Steroids could be administered during meningitis to target inflammation in what area?
Subarachnoid space
125
Dexamethasone can be used to target which bacteria causing meningitis? Which broad class?
Strep pneumo
gram-positive cocci
126
What drug for all patients with encephalitis?
Acyclovir
127
WHo can be treated for a UTI based on symptoms?
sexually active females
128
What does pyelonephritis with a stone equal?
intra-abdominal abscess
129
According to Aoki, what are the three most common causes of sepsis?
UTI
pneumonia
GI infection
130
Fluids should be continued to be administered to a patiet in shock as long as?
there is hemodynamic improvement
131
What is superior for gram-negative sepsis, combination therapy or monotherapy?
combination
132
What would be the bandemia for SIRS?
greater than 10%
133
What infection may cause patients to be leukopenic?
Neisseria Meningitidis
134
What are the four catergories for Fever of Unknown Origin?
Neutropenic
Nosocomial
HIV-associated
classical
135
Which type of patient may require trials of antibiotics with an FUO?
Neutropenic
136
Would quarantine or isolation be used if someone was suspected of having the disease?
Isolation
137
Would quarantine or isolation be used if someone was exposed to the disease?
quarantine
138
What does complicated mean?
involvement of tissue structures
139
What does recurrence mean regarding a UTI?
3 or more per year
140
What does relapse mean regarding a UTI?
treatment failure
141
What does reinfection mean?
new organism
142
According to Benzoni, does UTI in a male neonate correlate with hypospadias or epispadias?
hypospadias
143
What is a gold UTI specimen?
catheter
144
Concentrated urine will have a specific gravity higher than what?
1.010
145
What is better, a urethral wash or a urethral swab?
urethral wash
146
Does pyelonephritis get a foley?
no
147
What is systolic pressure under for severe sepsis?
90
148
What is MAP under for severe sepsis?
70
149
Creatinine above what for severe sepsis?
2.0
150
PT/INR above what for severe sepsis?
1.5
151
Platelet count under what for severe sepsis?
100,000
152
According to Aoki, what doesn venous oxygen saturation have to be greater than to be considered adequate ?
70%
153
What two areas dont have major physical barriers to infection?
eye and genito-urinary
154
What immune cell is the first defense against virus infected cells?
NK cells
155
Where do plasma cells reside?
bone marrow
156
What causes a memory Bcell to differentiate into a plasma cells?
reencountering antigen
157
When are CTLs needed in a virus infection?
established infection
158
What cytokine is produced by CTLs to interfere with viral replication?
TNF-alpha
159
Which cell is constantly active, memory Bcell or memory Tcell?
memory Bcell
160
Would lepromatous of tuberculoid leprosy have hypergammaglobulinemia?
Lepromatous
161
Which amino acid sequence can be recognized by phagocytes?
Arg-Gly-Aspartate
162
Phagocytic cells have receptors for which opsonization proteins?
C3b and IgG
163
What is the only thing the alternative pathway of complement requires?
microbial surface
164
Would humoral or cell-mediated response predominate for bacterial infections?
Humoral
165
Which three bacteria would a neonate have increased susceptibility to after disappearance of maternal antigens?
S. pneumo
HiB
Neisseria men.
166
Which spirochete can be killed by complement?
Borrelia
167
Which spirochete coats itself with host proteins? What does this help it evade?
Borrelia
Phagocytosis
168
Do fungi elicit humor, CTL or both?
both
169
Is cryptococcus cleard by TH1 or TH2?
TH1
170
Is Histo cleard by TH1 or TH2?
TH2
171
According to Steele, which two parasites survive in macrophages?
Leishmania
Trypanosoma
172
According to the GI guy, what species of Candida is most concerning?
Candida cruzii
173
Repeat urea breath test and stool antigen how long after quadruple therapy?
6-8 weeks
174
What bug for home canned foods?
Clostridium perfringens
175
What bug for caesar salad?
Salmonella
176
Which virus can be from shellfish?
Hep A
177
What three bugs have preformed toxins?
C. perfringens
S. aureus
B. cereus
178
Is vibrio inflammatory or non-inflammatory?
non-inflammatory
179
Is stool testing required to measure treatment of C. diff?
no
180
What drug is the three drugs for C. diff?
Metronidazole/Vancomycin/Fidoximycin
181
IV or oral vancomycin for C. diff?
oral
182
What is the normal CSF cell count?
0-5
183
What condition can produce a transient increase in CSF white count that is non-infectious?
Seizure
184
Would fungal or bateria have a higher WBC white count?
bacteria
185
Draw serum glucose before or after spinal tap?
before
186
CSF protein above what is abnormal?
50
187
Drug for S. epi meningitis?
vancomycin
188
Drug for pseudomonas meningitis?
Ceftazadime
189
What drug usually used for sepsis does not cross the BBB?
Piperacillin
190
What drug for neuro Lyme?
Ceftriaxone
191
What is normal opening pressure?
50-180
192
How long must chronic meningitis last?
four weeks
193
What are the three bugs for chronic meningitis?
Borrelia
T. pallidum
M. TB
194
Where are the temperature sensors in the body?
skin and muscle
195
What are the two non-classical neoplastic causes of unknown fever?
RCC
Hepatoma
196
Does lepromatous leprosy have present or absent Tcell responses?
Absent
197
What is used to correctly Dx Serous Otitis Media?
Pneumoscopy
198
Who did the analysis and didnt like Snow?
Farr
199
How long on bactrim for UTI?
3 days
200
Is cystitis usually afebrile or febrile?
afebrile
201
What correlates with severity of sepsis?
Lactate
202
Two drugs for empirical coverage in suspected acute bacterial meningitis?
Ceftriaxone
Vanc
203
What cause hyperthermia?
insufficient dissipation
