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208 Cards in this Set

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Define Sterilization
Devoid of all live; the destruction of ALL forms of microbial life including endospores.
Sterilization is usually reserved for_________. Why is this?
inanimate objects. Sterilizing parts of the human body would call for such harsh treatment that it would be highly dangerous and impractical.
Define Sepsis
without microbial activity. in living tissues and blood.
Define Antisepsis
a procedure to control growth and replication of microbes on living tissues
Give an example of an antiseptic technique
-Using rubbing alcohol on the skin before getting a shot
-Using mouthwash after brushing to prevent microbial growth
Define Disinfection
a physical procedure used to kill vegetative cells on inanimate objects
Define Sanitation
A chemical process used to reduce microbial activity to safe levels in non-clinical settings. Sanitizer, non-toxic to people
Define: -cide, -cidal
lethal to microbes (fungicide, bactericide, sporicidal, etc)
Define: -stais, -static
controls as long as the agent is present, but does not kill the bacteria (bacteriostatic, fungistatic)
Give an example of a -static technique
maintaining the pH balance of your pool
List 6 factors that affect the activity of antimicrobial agents or procedures
-time (longer the disinfectant, the better chance of disinfection)

-microbial load (how many)

-spore formers

-interfering matters

-pH

-heat
List 4 modes of action antimicrobial agents utilize
-alteration of the cell wall (blocks synthesis and breaks surface down)

-alteration of the cell membrane (utilizes its selective permeability and lowers surface tension)

-disruption of synthetic process (denaturing-the property to disrupt the structure of a microbe)

alteration of protein functioning- stops peptide bonds from forming and inhibits them from multiplying)
Give an example of sepsis
infected wounds, blood infection
Give an example of asepsis
cleansing the skin with iodine prior to surgery using sterile needles
Give an example of an antiseptic
antibacterial soap, chlorhexidine
Give an example of disinfection
5% bleach, boiling water
Give an example of sanitation
dishwashing, laundering clothes
Give an example of sterilization
autoclaving, ionizing radiation
List two methods of Dry Heat disinfection
sterilization and incineration (direct exposure to heat)
Name the minimum require temperature for dry heat. For how many hours?
160 C or 320 F
2 hours
List the 4 methods of moist heat
Boiling (disinfects)
Pasteurization (does not sterilize)
Intermittent (or fractional)
Autoclaving (sterilizes)
Name the min. required temp. for boiling (moist heat disinfection) and for how long you would need to boil a microbe in order to kill most pathogens.
100 C
30 minutes
Explain intermittent (or fractional) sterilization and for how long must be applied to be effective in eliminating most pathogens?
also called tyndalization. this technique requires a chamber to hold the materials in a boiling water bath, repeatedly, exposing the items to free flowing steam.

3 days, 30 minutes per day
Explain pasteurization
a technique in which heat is applied to liquids to kill potential agents of infection and spoilage, while at the same time retaining the liquid's flavor and food value.
List the three temperatures/times required for pasteurization
62 C/30 min (batch method)
72 C/15 sec (flash method)
82 C/3 sec
Explain autoclaving. List the required temp, time, and pressure.
sterilization through the use of moist heat under pressure. but infective in sterilizing substances that repel moisture (oils, waxes, and powders)

121 C, 15 minutes, 15 psi
List the characteristics of cold disinfection
-retards activity of microbes but does not kill it
-preservation (freezing -20 C and refrigeration 4 c)
- does not sterilize
Explain filtration
used to prepare liquids that cannot withstand heat.
-removes microbes from air and liquid
2 types of filters utilized in filtration
-HEPA air filters- used to provide a flow of sterile air to hospital rooms and sterile rooms

- Milipore filters-liquids
List the three pore sizes used in filtration
0.45um
0.22 um
0.02 um
What is ultrasound used for, in terms of microbes?
useful for decontamination, preliminary cleaning

*not useful for killing microbes
Explain the two types of radiation, and give examples of each.
-non-ionizing: excites atoms by raising them to a higher energy state leading to abnormal bonds ex. ultraviolet

ionizing: ejects orbital electrons from an atom, causing ions to form . Ex. gamma, x-rays
What is irradiation?
bombardment with radiation

*kills harmful substances in foods
What is non-ionizing radiation most widely used for? why? what is the source of uv radiation?
surface sterilization bc it does not penetrate, air disinfection, water purification.

-germicidal lamp
Which type of radiation disrupts the DNA sequence?
ionizing
What is ionizing radiation most widely used for? Is it deep penetrating?
used in sterilization of foods, medical supplies, packaged plastic devices and in bone and skin grafts

deeply-penetrating
What is the fundamental principle of the electromagnetic spectrum?
energy content is inversely proportional to wavelength
List the 4 halogens
bromine
flourine
chlorine
iodine
Why are halogens the active ingredient in so many antimicrobial agents?
They are microbicidal and not just microbistastic, and sporicidial with longer exposure
What is the role of halogens as a disinfectant?
they oxidize and halogenate proteins (denaturing)
List the three types of chlorines used in disinfection and their function.
chlorine, hypochlorites, chloramines

they are sanitizers and disinfectants, and are weakly sporicidial
List the 2 types of iodines (halogen)
iodophors
iodine tinctures
What are idiophors? List the two types of idophors. Which are antiseptics/disinfectants?
iodine + detergent

betadine (antiseptic) and wescodyne (disinfectant)
Explain what a tincture does. What is its percentage?
antiseptic, 2-3% in alcohol
Phenols consist of _______
one or more aromatic carbon rings with added functional groups
What are the functions of phenol and phenolics? sporicidal or non-sporicidal?
membrane active agents causing lysis and disrupting transport

not sporcidal
List the three types of phenols and phenolics.
-triclosan: additive in microbial soaps
-chlorophene: disinfectant
-bisophenol: hexachlorophene- restricted for use against staph
Chlorhexidine is an antiseptic. List its characteristics.
-effective on both gram positive and gram negative bacteria ("broad spectrum")
-low toxicity and persists longer
List the compound of chlorhexidine that is used as a surgical scrub and a wound cleanser
hibiclens
Ethanol and Propanol are most effective at what concentration?
70%
Characteristics of alcohols
-membrane-active agents, dissolving lipids and denaturing proteins
-bacteriocidal and fungicial, NOT sporicidal
Alcohols do not inactivate some viruses. Name two in particular.
hepatitis A
polio
Define soaps
long chain salts of fatty acids, some with microbial additives
Hydrogen peroxide is bacteriocidal at ____ and is sporicidal at _____
3%
6-35%
What are anionic detergents? List an example.
a detergent with its active portion negatively charged. (so it attracts to + charges) not highly active

sodium lauryl sulfate
What are cationic detergents?
detergents whose active portion is positively charged (attracts neg. charged bacteria_
List two types of cationic detergents and their features
Quats- antiseptic benzalkonium chloride

Roccal- disinfectant that is wide spectrum but inactivated by organics
What are the roles of aldehydes? sporcidal or non?
they react with functional groups of proteins and nucleic acids

sporicidal
List the properties of formaldehydes
sporicidal, corrosive, allergenic
List the properties of glutaraldehyde. Name two specifically used for clinical setting spores.
sporicidal in 3-10 hours

Cidex and Sporicidin
What is ethylene oxidine?
sporicidal or non?
slow acting, highly penetrable gas

sporcidal
What is ethylene oxidine used for?
sterilization of complex equipment (as in surgical settings)
What is the role of heavy metals?
modification of proteins, precipitate proteins from fluids.
What are the three given heavy metals?
silver nitrate
mercurials
copper sulfate
What is silver nitrate used for?
a bacteriocidal, prophylactic use in eyes of newborns (now replace by erythromycin)
Mercury is bacteriostatic. List the three types of mercurials and its uses
-metaphen and merthiolate: most recently replaced by idophors

-thimerisol: preservative in vaccines that is blamed for autism
What is copper sulfate used for?
an algicide (antimicrobial against algae)
What is the role of acids? Name two types.
denatures proteins

lactic acid and acetic acid (vinegar)
What is the role of alkalis? Name two types.
denature proteins

sanitizers- lye and lime
What is the role of oxidizing agents? Name three types.
oxidize

hydrogen peroxide
peracetic acid
ozone (03)
Name the basic dye. What is it used for?
gentian violet. used on fungi and gram POSITIVE bacteria
Name the acidic dye. What is it used for?
acridine orange. used to alter nucleic acid synthesis.
Antibotics are __________.
How do they differ from disinfectants and antiseptics?
naturally-occurring

they control microbes once they get inside of us
What are semisynthetics? What do they do?
modified antibotics

increase spectrum of activity
What are synthetics?
man-made chemotheraputic agents
What are antimicrobics?
refers to ALL antimicrobical drugs regardless of origin.
Define Therapeutic
treatment

ex. trying to cure infection
Define Prophylaxis. Give an example of an prophylactic procedure.
prevention

ex. being exposed to someone who has TB. Getting treatment to reduce risk of contraction.
List the 4 desirable characteristics of antimicrobial drugs
-selective toxicity (they should be able to kill microbes but not damage host cells)

-spectrum (broad vs. narrow)

-solubility (should be soluble)

-long half-life (bc overtime, effectiveness of drug diminishes)

-non-allergenic
List 5 mechanisms of action antimicrobial drugs utilize.
-cell wall synthesis (osmotic lysis since humans lack a cell wall)

-protein synthesis inhibition (binds to prokaryotic ribosome)

-Antimetabolites (competitive inhibitors)

-Nucleic acid inhibition (inhibits replication and transcription. can not penetrate through eukaryotic nucleus)

-membrane active agents (surface infections, toxic to humans, disrupt integrity of the cell)
Name the two antimetabolites that garner a synergistic effect on bacteria
sulfonamides
trimethoprim
Penicillins are distinguishable by their ___ _____ ring
beta-lactam
What is the spectrum of general penicillins?
narrow: gram positives and neisseria
Name the two forms of penicillin
-penicillin V (oral and acid resistant)
-penicillin G (potent)
Name limitations of penicillin
-narrow spectrum
-destroyed by pencilinase (beta-lactamase produced by bacteria)
-allergenic

Semisynthetic penicillins combat all these problems
Explain cephalosporons
-alternatives to penicillin
-cell wall synthesis inhibitors
-broader spectrum
-concentrate in urine
Explain aminoglycosides
-inhibit protein synthesis
-mostly broad spectrum
What is streptomyocin?
the large spectrum aminoglycoside

gram negatives and mycobacterium (causes TB)
What is neomyocin?
a topical aminoglycoside used in neosporin
What are some limitations of aminoglycosides?
-otooxicity and nephrotoxicity
-one step resistance
Explain the effects of chloramphenicol
-protein synthesis inhibitor
-reserved for severe infections (rock mountain syndrome, typhoid, meningitis)

*can cross blood-brain barrier
List some side effects of chloramphenicol
-aplastic anemia (removes stem cells in bone marrow)
-gray syndrome in children
List the characteristics of tetracycline
-inhibits protein synthesis
-broad spectrum
-used on rickettsiae, chlamydia, mycoplasma, and as acne treatment
List some drawbacks of tetracycline
-superinfections (clodistrum dificile and candida albicans)
-tooth discoloration
-sensitivity to sunlight
List the characterestics of macroclides
-inhibits protein synthesis
-erythromyocin
What is a nosocomial infection?
an infection acquired in the hospital
What is vancomycin? List two types of strains resistant to vancomyocin
a cell wall synthesis inhibitor

VRE
VRSA
What does rifampin do? Name one use.
--inhibits RNA synthesis
used on Mycobacterium TB
Sulfa drugs are man-made antimicrobics. What do they do? Are they broad spectrum or narrow? They can also be used with another drug for a synergistic effect. Name the drug.
-competitive enzyme inhibitors (blocks synthesis of folic acid made by bacteria)
-broad spectrum
-trimethroprim
Name the drug lethal to growing TB, used as a prophylactic.
Isoniazid (INH)
Why are anitfungal and antiviral agents so limited in their effectiveness?
they are limited due to toxicity to eucaryotes
List some important considerations for all levels of defense
-genetic determinants (immune response gene)
-dietary factors (proteins, vitamins, etc)
List five actors in the "1st line of defense".
-anatomic barriers (keratinized skin)

-secretions (stomach acid, bile, mucus)

-macrophages (alveolar macrophage in lungs)

-enzymes (lysozyme in tears)

-mechanical actions (peristalsis, cilia, flushing in urine)
List 4 mechanisms of resistance
-altered permeability of membranes (prevents drug from entering the cell)

-enzymes which destroy the drug

-altered metabolic pathways that evade the mechanism of drug

-biochemical modification of drug by microbe
List 3 ways in which resistance develops
-mutations

-transfer of genes via plasmids (R/resistance factors) through conjugation, transduction or transformation

- antibiotics select for resistant microbes
Gram ______ bacteria are inherently resistant to some penicillins. Why?
negative

they have naturally-occuring beta lactamases
Give another term and explain the procedure for the disk dilution assay.
Kirby-Bauer

test bacterium is spread over a plate and disks are dropped onto the bacterial lawn. "zone of inhibition" is measured. semiquantative and indicates which drugs might be effective
What is the tube dilution assay used for?
to determine dosage of a drug
Explain the MIC
minimum inhibitory concentration

smallest concentration (highest dilution) of a drug that visibly inhibits growth. smallest effective dosage.
What is the MLC? MBC?
minimum lethal concentration

minimum bacteriocidal concentration
List the two major divisions of leukocytes
granulocytes (lobbed nucleus)

agranulocytes
Function of neutrophils? What is their make up?
important for phagocytosis

55-90%
Function of basophils? What is their make up?
mast cells that recruit other inflammatory cells and responsible for histamine and allergenic stimulus

0.5%
List the three granulocytes
basophils
eosinophils
neutrophils
Function of eosinphils? What is their make up?
attacks large eukaryotic pathogens as well as involved in inflammation and allergic reaction
List the two types of agranulocytes
monocytes
lymphocytes
Function of monocytes? What is their make up?
macrophages. largest of all blood cells, cytoplasm contains digestive enzymes

3-7%
Functions of lymphocytes? What is their make up?
B & T cells- cells of the specific immune response

20-35%
What do natural killer cells do?
non-specifically destroy tumor cells and virus infected cells by releasing proteases and phospholipases
What type of immunity are B cells responsible for? Which important cell bodies are they known for producing?
humoral response immunity

antibodies
What type of immunity are T cells responsible for? What is their role?
cell-mediated immunity

t-cells modulate immune functions and kills foreign cells directly
Calor
warmth

heat given off by increased blood flow
Rubor
redness

increased circulation and vasodilation in injured tissues
Tumor
swelling

increase fluid escaping into the tissues
Dolor
pain

stimulation of nerve endings
In the complement system, how many serum proteins are there?
20 or more
4 functions of the complement system
-enhance phagocytosis (opsonization)
-promote inflammation and edema
-promote lysis of foreign cells
-promote immune adherence
In the complement system, what is the "classic" pathway?
initiated by antigen-antibody binding
In the complement system, what is the "alternate" pathway?
intiated by endotoxin

complement proteins bind to internal cell wall and surface components of microbes
What are cytokines?
regulatory proteins that affect behavior of other cells
Interfeurons
antiviral, induce changes in genetic expression
Interleukins
stimulate proliferation and activation of various immune cells that induce fever
Colony stimulating factos (CSFs)
stimulate growth and differentiation of some leukocytes
Immunocompetence
the ability of the body to react with a wide spectrum of foreign substances
Naturally acquired active immunity
-antigens induce formation of antibodies
-sensitization of allergens stimulate immune response
-you illicit the immune response yourself
Naturally acquired passive immunity
-mother to child
-conferred immunity (transplacental- ass antibodies to child during pregnancy)
-colostrum contains secretory antibody from mother (breastmilk)
Artificially acquired active immunity
-vaccination (vaccines illicit the immune response)
-attenuated, killed or subunit vaccines (partial proteins from viruses)
Artistically acquired passive immunity
-passive immunization (immunoprophalyxis)

-preformed antibody (blood from someone who had the cirus)

-anitserum, antivenom, etc
Antigen
substance that elicits an immune response
Mosaic antigen
complex antigen that may have multiple antigenic sites that evoke unique immune responses
Autoantigen
self-antigen

* often mistaken for foreign Ag
Alloantigen
molecules that differ in the same species

*responsible for blood incompatibilities
Heterophile Ag
similar Ag which occurs in unrelated groups of organisms
Allergen
Ag which evoke allergic reaction
Hapten
small foreign molecules too small to illicit an immune response unless coupled with self proteins
2 examples of Haptens
penicillin
urushiols from poison ivy
MHC is controlled by genes on chromosome __
6
MHC-1
tissue type antigens, code for markers that display unique characteristics of self and allow for recognition of self molecules
MHC-II
involved in immune recognition on surface of immune cells

*code for immune regulatory receptors found in only macrophage, dendritic, and b cells
MHC-III
regulate production of complement proteins in blood
3 characteristics of T cells
-cell mediated immune response
-thymus derived
-long life span
3 characteristics of B cells
--humoral immune response
-bursa derived
-short life span
Immunoglobins
large gylcoprotein molecules that serve as the specific receptors to B cells anf as antibodies
2 arms on the immunoglobin that bind the antigen. What is the rest of the molecule called?
antigen-binding fragment/ Fabs

crystallizable fragment (Fc) which binds phagocytic cells and fixes complement
Events of the humoral response
-macrophage ingests and processes Ag
-presentation of Ag to B cells
-activation of B cell clone (clonal selection)
4 Roles of Immunoglobins
-opsonins (enhance phagocytosis)

-agglutinate particulate Ag (such as bacterial cells, clumping them together so that they become immobile)

-complement fixation (promotes lysis of cells)

-neutralize viruses and toxins (antibodies fill the surface receptors on the virus preventing them from attaching to the target)
Primary response
-1st exposure
-slower response times
-lower levels of antibody produced
-short-lasting
Secondary resonse
-repeated exposure
-faster response times
-higher levels of antibody produced
-longer lasting
Monoclonal antibody
MABs, specific antibody produced to a specific antigen in a lab setting
2 uses of monoclonal antibodies
-diagnostic tests
-delivery of toxic chemicals to specific cells which express specific Ag
T cells involve the _____ ______ between macropages and T cells is required for T cell activation
direct contact
Helper T cells (CD-4)
regulates immune reactions to antigens, as well as activate macrophages and increase phagocytosis
Cytotoxic cells are also known by what name? What is their role?
killer cells
the capacity of certain T cells to kill a specific target cells by secreting perforins and granzymes
perforins
punches holes in membranes of target cells creating a passageway for granzymes to enter
granzymes
perform apoptsis
anaphalyxis
common allergy
Mechanism for anaphalyxis
-IgE produced on first exposure
-IgE attaches to surface of mast cells leading to the release of histamines
Systematic anaphalyxis
sudden respiratory and circulatory disruption that can be fatal
Localized anaphalyxis is also called____
atopy
Cytotoxic hypersensitivity
involve complement assisted lysis of cells by antibodies
What two immunglobins mediate cytotoxic hypersensitivity?
IgG
IgM
3 examples of cytotoxic hypersensitivity
-automimmune disorders
-transfusion reactions
-erythroblastosis fetalis (Rh disease- mother has Rh- and child has Rh+ causing mom's antibodies to release erythroblasts causing massive destruction of child's cells. mother builds up an immunity after the first child, there second child is most aptly harmed)
Anaphalyxis is also called______
type I or immediate hypersensitivity
Cytotoxic Hypersensitivity is also called ______
Type II
Immune Complex Disease is also called ______
Type III
Cellular/Delayed Hypersensitivity is also called ____
Type IV
Immune Complex disease
Ag-Aby complexes deposit in capillary beds causing inflammatory response
Which immunoglobins mediate immune complex disease?
IgA, IgM, IgG
3 examples of Immune Complex Disease
-Rheumatoid arthritis
-Lupus
-glomerulonephritis
Cellular hypersensitivity
T cells respond to antigens (cytokines) which attract other cells to the antigen's location
Reexposure of cellular hypersensitivity causes____-
erythema and induration (redness, itching, inflammation)
Example of cellular hypersensitivity
contact dermatitis (posion ivy, metal alloys)
B cell deficiency. Give its formal name and characteristics
Bruton's agammaglobulinemia

absence of gamma gloubin (the fraction of serum containing Igs)
T cell deficiency. Give its formal name and characteristics
DiGerorge's syndrome

congenital absence of immaturity of the thymus gland
Severed Combined Immunodeficiency (SCID)
dysfunction in both systems, absence of lymphocyte stem cell or dysfunction of T and B cells later in life
What is the role of regulatory T cells(CD 25+)?
dampens immune response so as not to cause overregulation
Explain clonal selection
Macrophages (dendritic cells) present Ag to B cell clones
Explain t-independent/dependent cell participation in clonal selection
-t dependent Ag requires T cell participation

-t independent Ag foes not require T cell participation
Explain the process of clonal expansion
after clonal selection, mitosis occurs inducing clonal expansion- plasma cells secrete Aby and and memory cells (for anamnestic response)
IgM
first antibody produced through clonal selection and contains a pentamer with joining chains of 10 antigen binding sites
IgG
-most abundant in serum, -transplacental
-monomer with two antigen binding sites
IgA
-secretory antibody with secretory component (essential on mucosal surfaces)
-monomer or dimer with 2 or 4 antigen binding sites
IgD
receptor on surface of B cells that allows for activation of B cells
IgE
responsible for anaphylaxis
B cells produce antibodies while T cells produce_____
cytokines
T cell activation
-requires contact with antigen presenting cells (APC)
Role of antigen presenting cells (APCs)
to secrete interleukin-1, thus activating the T cell
Basis of tuberculin test for TB diagnosis
delayed hypersensitivity T cells
Role of regulatory cells
-reduce risk of some immune activities (autoimmunity, transplant rejection, allergy) and suppresses immune functions
What type of T cells specifically target cancer cells?
cytotoxic
Cytotoxic cells are said to combat which intracellular pathogens?
virus-infected cells
fungal infections and TB
parasite infected cells
What autoimmune disorder destroys helper (CD4) cells?
AIDS
Helper cells work to enhance the activities of immune cells such as ___
B cells
cytotoxic cells
macrophage
Helper cells secrete this
interleukin-2
How are variates of T cells identified?
by CD antigens on cell surfaces
Hemolysis
antibodies attack foreign cells in blood transplants causing a major cross reaction
Why is type O considered the universal recipient?
there are no antigens on the surface of the cells causing no reactions
Why is type AB considered the universal donor?
They do no contain neither A or B antigens