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Host and Defense > Week 15 > Flashcards

Week 15 Flashcards

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1
Q

___ developed during the primary response provide protective immunity for the first few weeks. This prevents the activation of the adaptive immune response

A

Antibodies (but the antibody levels decline with age)

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2
Q

What are the 3 types of memory cells

A

memory B cells

Memory plasma cells

Memory T cells (both central and effector)

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3
Q

When a T cell is activated and proliferates, does it produce more effector T cells or memory cells?

A

Effector T cells outnumber memory cells

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4
Q

Which, primary effector cells or memory cells have a broad antigen response?

A

Primary effector

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5
Q

Which, primary effector or memory cells are easily activated (the dont require costimulatory signals or cytokines)?

A

Memory cells

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6
Q

Which, primary effector cells or memory cells must undergo target refinement by somatic hypermutation and class switching?

A

Primary effector cells

Memory cells may undergo somatic hypermutation

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7
Q

How long can immune memory cells persist for?

A

Decades

Antibodies are produced at a steady state

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8
Q

The secondary immune response activates ___ but inhibits ___. Why?

A

Memory B cells

Naive B cells

It does this so that energy is only spent producing the high-affinity IgGs instead of spending unnecessary energy

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9
Q

Activated memory B cells replicate into ___ and ___

A

Plasma cells

More memory cells

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10
Q

True or false… memory T cells do not require CD-28 co-stimulation

A

True, they do not

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11
Q

Describe how highly mutable pathogens erode immune memory

A

If first viral infection is ABCD, then later you are infected with ABCE, the ABC memory cells inhibit the naive B cells to produce memory against the E antigen.

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12
Q

Name 7 different types of vaccines

A

Live-attenuated

Inactivated

Subunit

Conjugate

Toxoid

DNA

Recombinant vector

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13
Q

What was the first live attenuated virus vaccine? Explain how live attenuated vaccines work?

A

Cowpox

This is a virus raised in a different species. For example, there are some similarities in the antigens of cowpox and smallpox viruses. When you are infected with a smallpox virus, the cowpox antibodies will neutralize it

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14
Q

What is an attenuated virus (not live)?

A

Pathogenic human virus is isolated, then grown in another species. The virus gains mutations that allow it to infect the other species. Then, the mutated virus is used for a vaccine as it shares viral components with the pathogen but is unable to infect human host

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15
Q

Define adjuvant

A

A compound that incites an adaptive immune response

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16
Q

Explain how adjuvants can be used to broaden vaccine targets and improve efficacy

A

If the adjuvant is paired with a typically non-reactive antigen, it enhances the immune response so that it recognizes the antigen as pathogenic

Many vaccines include adjuvants

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17
Q

In regards to recombinant protein vaccines… normally bacterial ____ binds factor ___ to inactivate ___ deposited on the bacterial surface. However, in the presence of specific anti-___, ___ cannot bind factor ___, causing ___ to be fixed and target the bacteira for destruction

A

Lipoprotein fHbp

H

C3b

FHbp

FHbp

H

C3b

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18
Q

Name 5 ways pathogens can evade the immune system

A

Stereotype diversity

Antigenic drift

Antigenic shift

Gene conversion

Latency

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19
Q

Name 6 ways pathogens can subvert (take advantage of) the immune system

A

Endocytic hijacking

Protein mimicry

Humoral inhibition

Inflammation inhibition

Immunosuppression

Superantigens

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20
Q

What is stereotype diversity and how can it allow pathogens to evade the immune system?

A

A serotype is an antigenically different strain of the same pathogen.

This means that you can be infected with one serotype of a bacteria, but then be infected with another serotype of the same species, giving you the same infection. You must develop completely new antibodies for the new serotype

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21
Q

True or false… stereotypes are formed from high mutation

A

False! Serotypes have high genetic variability, they are not necessarily due to mutations.

These are useful for tracking outbreaks

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22
Q

What is antigenic drift and how does it allow pathogens to evade the immune system?

A

Antigenic drift - mutation in the viral genome driven by selective pressure as the virus infects a population

Viral genomes are highly mutable, thus are tied to memory erosion

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23
Q

Antigenic drifts are responsible for viral ___ whereas antigenic shifts are responsible for viral ___

A

Epidemics

Pandemics

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24
Q

What is an antigenic shift?

A

Genetic recombination that leads to significant change in viral antigens.

Usually involves recombination with multiple species (bird flu, swine flu, human flu).

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25
What is gene conversion and how does it allow pathogens to evade the immune system?
VSG (variable surface glycoprotein) is altered by trypanosomes to evade antibodies. V VSG genes are rearranged to express one dominant VSG at a time
26
What is latency?
A viral dormant state in host tissue This allows the virus to persist with a reduced viral load and with an absent/reduced interferon response and MHC-1 expression. Also allows NK and CD8 T cell evasion
27
What are some common viruses with latent periods?
Cytomegalovirus Varicella zoster Epstein Barr Herpes Paroviruses Adenoviruses
28
What is endocytic hijacking? How is it used to subvert the immune system?
Utilizes endocytosis to enter cells. Here, it prevents prevents lysosome fusion, escapes the phagosome, or survive the autolysosomal envionrment of lysosome
29
What is antigen mimicry? How is it used to subvert the immune system? What pathogens do this commonly?
Pathogens coat themselves with host proteins to evade the immune system (since it uses host factors, it is considered subversion) Worms do this a lot -surface antigens are regularly shed
30
What are superantigens? How are they used to subvert the immune system?
It binds to MHC 2, so that when it binds to TCR it activates the T cell, yet hides the antigen. This causes an enormous, nonspecific CD4 response. - this can lead to autoimmunity - will also inactivate antibodies and complement
31
What bacteria have superantigens?
Staphylococcus Streptococcus
32
By binding ___ to ___ and ___, it prevents the host from recognizing the Fc fragment of antibodies, preventing phagocytosis. Thus the pathogen subverts the immune system
SSLP7 IgA C5.
33
What is primary immunodeficiency?
Genetically caused immune system deficiency can be dominant, recessive, X-linked
34
What is secondary immunodeficiency? What can cause it?
Immune deficiency caused by environmental factors ``` Caused by... Chronic disease Immunosuppressive drugs Viral (HIV) Environmental toxins ```
35
What is an example of an X-linked immunodeficiency disorder? Describe it.
Agammaglobulinemia BTK (bruton's tyrosine kinase is necessary for B cell signaling BTK on the X chromosome BTK negative males or BTK homozygous negative females do not develop B cells Note that heterozygous females will have less B cell development, but not noticibly, they are carriers
36
What are the 5 classes of primary immunodeficiency ? What percentage of primariy immunodeficieny are of each type?
Humoral immunity - 60% Cellular immunity - 10% Combined - 20% Phagocytic cells - 10% Complement - <2%
37
Name four examples of primary cellular immunodeficiencies.
Digeorge syndrome ZAP-70 deficiency X-linked lymphoproliferative syndrom Chronic mucocutaneous candidiasis
38
Name three examples of phagocytic immunodeficiencies
Chronic granulomatic disease Leukocyte adhesion deficeincy Chediak-higashi syndrome
39
In the immune response to HIV, you see a spike in the level of virus within the 4-8 weeks. Then it goes down, fluctuating for a while, but then it rises up again after how long?
2-12 years
40
Name the three bacteria that cause STDs
Gonorrhea Syphilis Chlamydia
41
Name one protozoan that causes an STD
Trichomonas vaginalis
42
Name two Arthropoda that cause STDs
Lice Scabies
43
Name three viruses that cause STDs
HIV HPV HSV
44
Name 7 syndromes associated with STDs
Urethritis Cervicitis Genital ulcers Epididymititis Procititis Vaginitis Pelvic inflammatory disease (PID)
45
What three groups of people get screened for STDs?
People who have had sexual contacts of persons with proven STDs Symptomatic persons Persons concerned about having an STD
46
What is urethritis?
Visible drip from the penis or WBCs seen on a urethral gram stain
47
What is cervicitis?
Vaginal discharge or friable cervix on exam Asymptomatic infections are common in both sexes (neither urethritis nor cervicitis)
48
Chlamydia is most prominent in what population?
Young women in urban areas
49
What is the most common reportable STD in utah?
Chlamydia trachomatis
50
What is the epidemiology of mycoplasma genitalia?
Urethritis, cervicitis, PID, endometritis
51
How do you diagnose gonorrhea for males and females?
Symptoms: white/green/grey purulent discharge, can disseminate Male: urethral gram stain, nucleic acid amplification testing Female: nucleic acid amplification testing
52
True or false... you only do a gram stain for males for gonorrhea
True
53
Is gonorrhea more prevalent in males for females?
Males
54
What are two symptoms from STDs that can cause infertility?
Epididysis - males PID - females
55
What are the symptoms of PID (pelvic inflammatory disease)?
Vaginal discharge Cervical motion tenderness Uterine tenderness Adnexal tenderness
56
True or false... PID is an underdiagnosed syndrome
True, many cases are missed and therefore go untreated often with serious consequences.
57
What is bacterial vaginosis?
White vaginal discharge Presence of clue cells PH>4.5 Frisky odor with KOH
58
What are the symptoms of genital herpes? How do you diagnose it?
Bumps/blisters Dysuria Vaginitis PCR with typing as HSV-1 or HSV-2
59
Syphilis is caused by ___. Most cases are __ patients that are ___+. How do you diagnose it?
Treponema pallidum MSM HIV Diagnosis - unculturable agent!
60
What is secondary syphilis?
Syphilis can disseminate to other parts of the body causes a rash (spots on palms). Note that it is still contagious!
61
What is another name for HHV-8?
Kaposi's sarcoma herpesvirus
62
HHV-6 creates a specific pattern called ___
Roseola
63
Primary latency of HHV6 and HHV7 reside in ___
CD4 lymphocytes
64
Kaposi's sarcoma (HHV-___) primary infection via ___ contact, especially in ___. Primary infection is ___.
8 Sexual Homosexual males Asymptomatic
65
What does the primary infection look like for HSV-1
80% are asymptomatic Occurs at a young age
66
In the case of symptomatic primary HSV-1 infections, age affects the clinical presentation. Describe this difference
Young = gingivostomatitis 18+ = pharyngotonsillitis
67
Describe acute herpetic gingivostomatitis
Primary HSV-1 infection 90% due to HSV-1 Most cases occur before age 5 Both movable and attached oral mucosa affected Affected mucosa develops pinhead vesicles. Rapidly collapse and form small, red lesions. Initial lesions enlarge and develop central areas of ulceration covered by yellow fibrin. Adjacent ulceration coalesce
68
Describe primary herpes- pharyngotonsillitis
Initial symptoms - sore throat, fever, headache Numerous small vesicles develop on tonsils posterior pharynx. Rapidly rupture to form shallow coalesce. Diffuse grey-yellow exudate forms Can be due to HSV-1 or HSV-2
69
Describe recurrent herpes simplex
AKA secondary herpes Can occur anywhere along the surface epithelium supplied by the involved ganglion Most common site of recurrence for HSV-1 is vermilion border
70
Recurrent herpes simplex intraoral lesions almost always occur where?
Keratinized, bound mucosa Symptoms are less intense
71
What are the histopathology features of HSV?
Multinucleation Ballooning degeneration Tzanck cells
72
What does it mean If you see shingles at the tip of the nose?
It is a sign that ocular infection may occur
73
What is Ramsay hunt syndrome? What is it caused by?
Cutaneous lesions of the external auditory canal. May involve facial paralysis, hearing deficits, vertigo Caused by VSV (shingles)
74
What virus causes infectious mononucleosis?
EBV
75
What kind of virus may cause herpangina, hand-foot-and-mouth disease, or acute lymphonodular pharyngitis
Coxsackie virus Which is a type of enterovirus
76
What virus causes rubeola (measles)?
Paramyxovirus
77
Which hypersensitivity reactions are humoral and which are cell-mediated?
Humoral - 1, 2, 3 Cell-mediated - 4
78
True or false.. hypersensitivity reactions are mutually exclusive, meaning that you only have one type of reaction per allergin
False, they cross over
79
As part of a type 1 hypersensitivity reaction, ___ are Th2 effectors in parasite immunity
Granulocytes
80
In a type 1 hypersensitivty reaction, ____ degranulation drives inflammation. It's toxic mediators are ___ and ___which function to...
Mast cell Histamine Heparin Poison parasites, increase vasculature permeability, cause smooth muscle contraction (it increases fluid secretion and peristalsis in the GI tract, decreases diameter in airways, and increases blood flow)
81
True or false... Eosinophils degranulation is toxic. They are activated/recruited by mast cells and Th2 cytokines.
True
82
What is the hygiene hypothesis?
Reduced early developmental immune pressure causes poor immune education and an inappropriate pathogen identification, leading to allergy and autoimmune disorders
83
Allergic reactions occur in two phases. Describe these phases
Immediate: occurs within an hour and causes a deep drop in their expiratory flow rate In the late phase, eosinophils are involved
84
What are the symptoms of anaphylactic shock?
Due to mast-cell degranulation and release of inflammatory mediators Causes significant drop in arterial blood pressure, constriction of airways, contraction of smooth muscel in GI tract
85
___ halts anaphylactic shock
Epinephrine
86
What is hyposensitization?
Repeated exposure to escalating dosages of allergens to reduce type 1 responses
87
What is a type 2 hypersensitization reaction?
Antibody-mediated IgG response to small molecules bound to cell surfaces.
88
Type ___ hypersensitivity causes newborn hemolytic disease. Describe how.
Rh- mother carries a Rh+ fetus so the mother develops anti-Rh+ IgG. Next pregnancy with Rh+ child is attacked by the anti-Rh+. Rhogam prevents this from occurring (erythroblastis fatalis)
89
Describe type 3 hypersensitivity reactions.
Inefficient immune complex clearance. Complexes are deposited in blood vessels and tissues Innate inflammatory response Inflammatory lesions occur (clot formation, fever, skin rash, rheumatoid arthritis)
90
Type ___ hypersensitivity is considered the delayed type hypersensitivy. It is cell mediated, not humoral. Primarily CD4 and macrophage mediated. Two phases: sensitization and effector
4
91
Name three keystone pathogens in periodontitis
P. Gingivalis Treponema denticola Tannerella forsythia
92
Type three hypersensitivity involves what two immunoglobulins?
IgG and IgM
93
True or false... T cells need a costimulatory signal in order to recognize the allergin as pathogenic to create memory
True

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