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208 Cards in this Set
- Front
- Back
Define Sterilization
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Devoid of all live; the destruction of ALL forms of microbial life including endospores.
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Sterilization is usually reserved for_________. Why is this?
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inanimate objects. Sterilizing parts of the human body would call for such harsh treatment that it would be highly dangerous and impractical.
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Define Sepsis
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without microbial activity. in living tissues and blood.
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Define Antisepsis
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a procedure to control growth and replication of microbes on living tissues
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Give an example of an antiseptic technique
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-Using rubbing alcohol on the skin before getting a shot
-Using mouthwash after brushing to prevent microbial growth |
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Define Disinfection
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a physical procedure used to kill vegetative cells on inanimate objects
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Define Sanitation
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A chemical process used to reduce microbial activity to safe levels in non-clinical settings. Sanitizer, non-toxic to people
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Define: -cide, -cidal
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lethal to microbes (fungicide, bactericide, sporicidal, etc)
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Define: -stais, -static
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controls as long as the agent is present, but does not kill the bacteria (bacteriostatic, fungistatic)
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Give an example of a -static technique
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maintaining the pH balance of your pool
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List 6 factors that affect the activity of antimicrobial agents or procedures
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-time (longer the disinfectant, the better chance of disinfection)
-microbial load (how many) -spore formers -interfering matters -pH -heat |
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List 4 modes of action antimicrobial agents utilize
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-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) |
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Give an example of sepsis
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infected wounds, blood infection
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Give an example of asepsis
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cleansing the skin with iodine prior to surgery using sterile needles
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Give an example of an antiseptic
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antibacterial soap, chlorhexidine
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Give an example of disinfection
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5% bleach, boiling water
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Give an example of sanitation
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dishwashing, laundering clothes
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Give an example of sterilization
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autoclaving, ionizing radiation
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List two methods of Dry Heat disinfection
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sterilization and incineration (direct exposure to heat)
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Name the minimum require temperature for dry heat. For how many hours?
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160 C or 320 F
2 hours |
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List the 4 methods of moist heat
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Boiling (disinfects)
Pasteurization (does not sterilize) Intermittent (or fractional) Autoclaving (sterilizes) |
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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.
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100 C
30 minutes |
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Explain intermittent (or fractional) sterilization and for how long must be applied to be effective in eliminating most pathogens?
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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 |
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Explain pasteurization
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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.
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List the three temperatures/times required for pasteurization
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62 C/30 min (batch method)
72 C/15 sec (flash method) 82 C/3 sec |
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Explain autoclaving. List the required temp, time, and pressure.
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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 |
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List the characteristics of cold disinfection
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-retards activity of microbes but does not kill it
-preservation (freezing -20 C and refrigeration 4 c) - does not sterilize |
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Explain filtration
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used to prepare liquids that cannot withstand heat.
-removes microbes from air and liquid |
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2 types of filters utilized in filtration
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-HEPA air filters- used to provide a flow of sterile air to hospital rooms and sterile rooms
- Milipore filters-liquids |
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List the three pore sizes used in filtration
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0.45um
0.22 um 0.02 um |
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What is ultrasound used for, in terms of microbes?
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useful for decontamination, preliminary cleaning
*not useful for killing microbes |
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Explain the two types of radiation, and give examples of each.
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-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 |
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What is irradiation?
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bombardment with radiation
*kills harmful substances in foods |
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What is non-ionizing radiation most widely used for? why? what is the source of uv radiation?
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surface sterilization bc it does not penetrate, air disinfection, water purification.
-germicidal lamp |
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Which type of radiation disrupts the DNA sequence?
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ionizing
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What is ionizing radiation most widely used for? Is it deep penetrating?
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used in sterilization of foods, medical supplies, packaged plastic devices and in bone and skin grafts
deeply-penetrating |
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What is the fundamental principle of the electromagnetic spectrum?
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energy content is inversely proportional to wavelength
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List the 4 halogens
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bromine
flourine chlorine iodine |
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Why are halogens the active ingredient in so many antimicrobial agents?
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They are microbicidal and not just microbistastic, and sporicidial with longer exposure
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What is the role of halogens as a disinfectant?
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they oxidize and halogenate proteins (denaturing)
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List the three types of chlorines used in disinfection and their function.
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chlorine, hypochlorites, chloramines
they are sanitizers and disinfectants, and are weakly sporicidial |
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List the 2 types of iodines (halogen)
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iodophors
iodine tinctures |
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What are idiophors? List the two types of idophors. Which are antiseptics/disinfectants?
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iodine + detergent
betadine (antiseptic) and wescodyne (disinfectant) |
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Explain what a tincture does. What is its percentage?
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antiseptic, 2-3% in alcohol
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Phenols consist of _______
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one or more aromatic carbon rings with added functional groups
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What are the functions of phenol and phenolics? sporicidal or non-sporicidal?
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membrane active agents causing lysis and disrupting transport
not sporcidal |
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List the three types of phenols and phenolics.
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-triclosan: additive in microbial soaps
-chlorophene: disinfectant -bisophenol: hexachlorophene- restricted for use against staph |
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Chlorhexidine is an antiseptic. List its characteristics.
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-effective on both gram positive and gram negative bacteria ("broad spectrum")
-low toxicity and persists longer |
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List the compound of chlorhexidine that is used as a surgical scrub and a wound cleanser
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hibiclens
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Ethanol and Propanol are most effective at what concentration?
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70%
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Characteristics of alcohols
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-membrane-active agents, dissolving lipids and denaturing proteins
-bacteriocidal and fungicial, NOT sporicidal |
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Alcohols do not inactivate some viruses. Name two in particular.
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hepatitis A
polio |
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Define soaps
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long chain salts of fatty acids, some with microbial additives
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Hydrogen peroxide is bacteriocidal at ____ and is sporicidal at _____
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3%
6-35% |
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What are anionic detergents? List an example.
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a detergent with its active portion negatively charged. (so it attracts to + charges) not highly active
sodium lauryl sulfate |
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What are cationic detergents?
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detergents whose active portion is positively charged (attracts neg. charged bacteria_
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List two types of cationic detergents and their features
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Quats- antiseptic benzalkonium chloride
Roccal- disinfectant that is wide spectrum but inactivated by organics |
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What are the roles of aldehydes? sporcidal or non?
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they react with functional groups of proteins and nucleic acids
sporicidal |
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List the properties of formaldehydes
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sporicidal, corrosive, allergenic
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List the properties of glutaraldehyde. Name two specifically used for clinical setting spores.
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sporicidal in 3-10 hours
Cidex and Sporicidin |
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What is ethylene oxidine?
sporicidal or non? |
slow acting, highly penetrable gas
sporcidal |
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What is ethylene oxidine used for?
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sterilization of complex equipment (as in surgical settings)
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What is the role of heavy metals?
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modification of proteins, precipitate proteins from fluids.
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What are the three given heavy metals?
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silver nitrate
mercurials copper sulfate |
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What is silver nitrate used for?
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a bacteriocidal, prophylactic use in eyes of newborns (now replace by erythromycin)
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Mercury is bacteriostatic. List the three types of mercurials and its uses
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-metaphen and merthiolate: most recently replaced by idophors
-thimerisol: preservative in vaccines that is blamed for autism |
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What is copper sulfate used for?
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an algicide (antimicrobial against algae)
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What is the role of acids? Name two types.
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denatures proteins
lactic acid and acetic acid (vinegar) |
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What is the role of alkalis? Name two types.
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denature proteins
sanitizers- lye and lime |
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What is the role of oxidizing agents? Name three types.
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oxidize
hydrogen peroxide peracetic acid ozone (03) |
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Name the basic dye. What is it used for?
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gentian violet. used on fungi and gram POSITIVE bacteria
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Name the acidic dye. What is it used for?
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acridine orange. used to alter nucleic acid synthesis.
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Antibotics are __________.
How do they differ from disinfectants and antiseptics? |
naturally-occurring
they control microbes once they get inside of us |
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What are semisynthetics? What do they do?
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modified antibotics
increase spectrum of activity |
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What are synthetics?
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man-made chemotheraputic agents
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What are antimicrobics?
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refers to ALL antimicrobical drugs regardless of origin.
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Define Therapeutic
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treatment
ex. trying to cure infection |
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Define Prophylaxis. Give an example of an prophylactic procedure.
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prevention
ex. being exposed to someone who has TB. Getting treatment to reduce risk of contraction. |
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List the 4 desirable characteristics of antimicrobial drugs
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-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 |
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List 5 mechanisms of action antimicrobial drugs utilize.
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-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) |
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Name the two antimetabolites that garner a synergistic effect on bacteria
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sulfonamides
trimethoprim |
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Penicillins are distinguishable by their ___ _____ ring
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beta-lactam
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What is the spectrum of general penicillins?
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narrow: gram positives and neisseria
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Name the two forms of penicillin
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-penicillin V (oral and acid resistant)
-penicillin G (potent) |
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Name limitations of penicillin
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-narrow spectrum
-destroyed by pencilinase (beta-lactamase produced by bacteria) -allergenic Semisynthetic penicillins combat all these problems |
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Explain cephalosporons
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-alternatives to penicillin
-cell wall synthesis inhibitors -broader spectrum -concentrate in urine |
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Explain aminoglycosides
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-inhibit protein synthesis
-mostly broad spectrum |
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What is streptomyocin?
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the large spectrum aminoglycoside
gram negatives and mycobacterium (causes TB) |
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What is neomyocin?
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a topical aminoglycoside used in neosporin
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What are some limitations of aminoglycosides?
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-otooxicity and nephrotoxicity
-one step resistance |
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Explain the effects of chloramphenicol
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-protein synthesis inhibitor
-reserved for severe infections (rock mountain syndrome, typhoid, meningitis) *can cross blood-brain barrier |
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List some side effects of chloramphenicol
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-aplastic anemia (removes stem cells in bone marrow)
-gray syndrome in children |
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List the characteristics of tetracycline
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-inhibits protein synthesis
-broad spectrum -used on rickettsiae, chlamydia, mycoplasma, and as acne treatment |
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List some drawbacks of tetracycline
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-superinfections (clodistrum dificile and candida albicans)
-tooth discoloration -sensitivity to sunlight |
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List the characterestics of macroclides
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-inhibits protein synthesis
-erythromyocin |
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What is a nosocomial infection?
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an infection acquired in the hospital
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What is vancomycin? List two types of strains resistant to vancomyocin
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a cell wall synthesis inhibitor
VRE VRSA |
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What does rifampin do? Name one use.
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--inhibits RNA synthesis
used on Mycobacterium TB |
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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.
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-competitive enzyme inhibitors (blocks synthesis of folic acid made by bacteria)
-broad spectrum -trimethroprim |
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Name the drug lethal to growing TB, used as a prophylactic.
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Isoniazid (INH)
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Why are anitfungal and antiviral agents so limited in their effectiveness?
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they are limited due to toxicity to eucaryotes
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List some important considerations for all levels of defense
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-genetic determinants (immune response gene)
-dietary factors (proteins, vitamins, etc) |
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List five actors in the "1st line of defense".
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-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) |
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List 4 mechanisms of resistance
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-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 |
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List 3 ways in which resistance develops
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-mutations
-transfer of genes via plasmids (R/resistance factors) through conjugation, transduction or transformation - antibiotics select for resistant microbes |
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Gram ______ bacteria are inherently resistant to some penicillins. Why?
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negative
they have naturally-occuring beta lactamases |
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Give another term and explain the procedure for the disk dilution assay.
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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 |
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What is the tube dilution assay used for?
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to determine dosage of a drug
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Explain the MIC
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minimum inhibitory concentration
smallest concentration (highest dilution) of a drug that visibly inhibits growth. smallest effective dosage. |
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What is the MLC? MBC?
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minimum lethal concentration
minimum bacteriocidal concentration |
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List the two major divisions of leukocytes
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granulocytes (lobbed nucleus)
agranulocytes |
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Function of neutrophils? What is their make up?
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important for phagocytosis
55-90% |
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Function of basophils? What is their make up?
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mast cells that recruit other inflammatory cells and responsible for histamine and allergenic stimulus
0.5% |
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List the three granulocytes
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basophils
eosinophils neutrophils |
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Function of eosinphils? What is their make up?
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attacks large eukaryotic pathogens as well as involved in inflammation and allergic reaction
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List the two types of agranulocytes
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monocytes
lymphocytes |
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Function of monocytes? What is their make up?
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macrophages. largest of all blood cells, cytoplasm contains digestive enzymes
3-7% |
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Functions of lymphocytes? What is their make up?
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B & T cells- cells of the specific immune response
20-35% |
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What do natural killer cells do?
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non-specifically destroy tumor cells and virus infected cells by releasing proteases and phospholipases
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What type of immunity are B cells responsible for? Which important cell bodies are they known for producing?
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humoral response immunity
antibodies |
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What type of immunity are T cells responsible for? What is their role?
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cell-mediated immunity
t-cells modulate immune functions and kills foreign cells directly |
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Calor
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warmth
heat given off by increased blood flow |
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Rubor
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redness
increased circulation and vasodilation in injured tissues |
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Tumor
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swelling
increase fluid escaping into the tissues |
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Dolor
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pain
stimulation of nerve endings |
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In the complement system, how many serum proteins are there?
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20 or more
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4 functions of the complement system
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-enhance phagocytosis (opsonization)
-promote inflammation and edema -promote lysis of foreign cells -promote immune adherence |
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In the complement system, what is the "classic" pathway?
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initiated by antigen-antibody binding
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In the complement system, what is the "alternate" pathway?
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intiated by endotoxin
complement proteins bind to internal cell wall and surface components of microbes |
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What are cytokines?
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regulatory proteins that affect behavior of other cells
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Interfeurons
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antiviral, induce changes in genetic expression
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Interleukins
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stimulate proliferation and activation of various immune cells that induce fever
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Colony stimulating factos (CSFs)
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stimulate growth and differentiation of some leukocytes
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Immunocompetence
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the ability of the body to react with a wide spectrum of foreign substances
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Naturally acquired active immunity
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-antigens induce formation of antibodies
-sensitization of allergens stimulate immune response -you illicit the immune response yourself |
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Naturally acquired passive immunity
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-mother to child
-conferred immunity (transplacental- ass antibodies to child during pregnancy) -colostrum contains secretory antibody from mother (breastmilk) |
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Artificially acquired active immunity
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-vaccination (vaccines illicit the immune response)
-attenuated, killed or subunit vaccines (partial proteins from viruses) |
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Artistically acquired passive immunity
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-passive immunization (immunoprophalyxis)
-preformed antibody (blood from someone who had the cirus) -anitserum, antivenom, etc |
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Antigen
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substance that elicits an immune response
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Mosaic antigen
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complex antigen that may have multiple antigenic sites that evoke unique immune responses
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Autoantigen
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self-antigen
* often mistaken for foreign Ag |
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Alloantigen
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molecules that differ in the same species
*responsible for blood incompatibilities |
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Heterophile Ag
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similar Ag which occurs in unrelated groups of organisms
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Allergen
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Ag which evoke allergic reaction
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Hapten
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small foreign molecules too small to illicit an immune response unless coupled with self proteins
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2 examples of Haptens
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penicillin
urushiols from poison ivy |
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MHC is controlled by genes on chromosome __
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6
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MHC-1
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tissue type antigens, code for markers that display unique characteristics of self and allow for recognition of self molecules
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MHC-II
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involved in immune recognition on surface of immune cells
*code for immune regulatory receptors found in only macrophage, dendritic, and b cells |
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MHC-III
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regulate production of complement proteins in blood
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3 characteristics of T cells
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-cell mediated immune response
-thymus derived -long life span |
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3 characteristics of B cells
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--humoral immune response
-bursa derived -short life span |
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Immunoglobins
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large gylcoprotein molecules that serve as the specific receptors to B cells anf as antibodies
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2 arms on the immunoglobin that bind the antigen. What is the rest of the molecule called?
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antigen-binding fragment/ Fabs
crystallizable fragment (Fc) which binds phagocytic cells and fixes complement |
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Events of the humoral response
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-macrophage ingests and processes Ag
-presentation of Ag to B cells -activation of B cell clone (clonal selection) |
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4 Roles of Immunoglobins
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-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) |
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Primary response
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-1st exposure
-slower response times -lower levels of antibody produced -short-lasting |
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Secondary resonse
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-repeated exposure
-faster response times -higher levels of antibody produced -longer lasting |
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Monoclonal antibody
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MABs, specific antibody produced to a specific antigen in a lab setting
|
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2 uses of monoclonal antibodies
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-diagnostic tests
-delivery of toxic chemicals to specific cells which express specific Ag |
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T cells involve the _____ ______ between macropages and T cells is required for T cell activation
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direct contact
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Helper T cells (CD-4)
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regulates immune reactions to antigens, as well as activate macrophages and increase phagocytosis
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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 |
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perforins
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punches holes in membranes of target cells creating a passageway for granzymes to enter
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granzymes
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perform apoptsis
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anaphalyxis
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common allergy
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Mechanism for anaphalyxis
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-IgE produced on first exposure
-IgE attaches to surface of mast cells leading to the release of histamines |
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Systematic anaphalyxis
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sudden respiratory and circulatory disruption that can be fatal
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Localized anaphalyxis is also called____
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atopy
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Cytotoxic hypersensitivity
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involve complement assisted lysis of cells by antibodies
|
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What two immunglobins mediate cytotoxic hypersensitivity?
|
IgG
IgM |
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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) |
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Anaphalyxis is also called______
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type I or immediate hypersensitivity
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Cytotoxic Hypersensitivity is also called ______
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Type II
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Immune Complex Disease is also called ______
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Type III
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Cellular/Delayed Hypersensitivity is also called ____
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Type IV
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Immune Complex disease
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Ag-Aby complexes deposit in capillary beds causing inflammatory response
|
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Which immunoglobins mediate immune complex disease?
|
IgA, IgM, IgG
|
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3 examples of Immune Complex Disease
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-Rheumatoid arthritis
-Lupus -glomerulonephritis |
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Cellular hypersensitivity
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T cells respond to antigens (cytokines) which attract other cells to the antigen's location
|
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Reexposure of cellular hypersensitivity causes____-
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erythema and induration (redness, itching, inflammation)
|
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Example of cellular hypersensitivity
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contact dermatitis (posion ivy, metal alloys)
|
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B cell deficiency. Give its formal name and characteristics
|
Bruton's agammaglobulinemia
absence of gamma gloubin (the fraction of serum containing Igs) |
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T cell deficiency. Give its formal name and characteristics
|
DiGerorge's syndrome
congenital absence of immaturity of the thymus gland |
|
Severed Combined Immunodeficiency (SCID)
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dysfunction in both systems, absence of lymphocyte stem cell or dysfunction of T and B cells later in life
|
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What is the role of regulatory T cells(CD 25+)?
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dampens immune response so as not to cause overregulation
|
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Explain clonal selection
|
Macrophages (dendritic cells) present Ag to B cell clones
|
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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 |
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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)
|
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IgM
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first antibody produced through clonal selection and contains a pentamer with joining chains of 10 antigen binding sites
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IgG
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-most abundant in serum, -transplacental
-monomer with two antigen binding sites |
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IgA
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-secretory antibody with secretory component (essential on mucosal surfaces)
-monomer or dimer with 2 or 4 antigen binding sites |
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IgD
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receptor on surface of B cells that allows for activation of B cells
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IgE
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responsible for anaphylaxis
|
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B cells produce antibodies while T cells produce_____
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cytokines
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T cell activation
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-requires contact with antigen presenting cells (APC)
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Role of antigen presenting cells (APCs)
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to secrete interleukin-1, thus activating the T cell
|
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Basis of tuberculin test for TB diagnosis
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delayed hypersensitivity T cells
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Role of regulatory cells
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-reduce risk of some immune activities (autoimmunity, transplant rejection, allergy) and suppresses immune functions
|
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What type of T cells specifically target cancer cells?
|
cytotoxic
|
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Cytotoxic cells are said to combat which intracellular pathogens?
|
virus-infected cells
fungal infections and TB parasite infected cells |
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What autoimmune disorder destroys helper (CD4) cells?
|
AIDS
|
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Helper cells work to enhance the activities of immune cells such as ___
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B cells
cytotoxic cells macrophage |
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Helper cells secrete this
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interleukin-2
|
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How are variates of T cells identified?
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by CD antigens on cell surfaces
|
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Hemolysis
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antibodies attack foreign cells in blood transplants causing a major cross reaction
|
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Why is type O considered the universal recipient?
|
there are no antigens on the surface of the cells causing no reactions
|
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Why is type AB considered the universal donor?
|
They do no contain neither A or B antigens
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