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99 Cards in this Set
- Front
- Back
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Dysentary
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++Blood, ++WBC, little water, Tissue Invasion, Shigella and EVEC
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Secretory Diarhea
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Lots of Water/volume, no WBC or blood, no tissue invasion, ETEC, Vibrio cholerae
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Watery Diahrea
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Moderate Volume, +WBC, +blood, Tissue Invasion, Salmonella, campylobacter, Yersinia
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Hemmorrhagic Diahrea
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++Blood, No WBC, No Tissue Invasion, EHEC
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ETEC
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Traveller's Diahrea, self-limiting1-3 days, eating uncooked or bad water, heat labile enterotoxin
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EVEC
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Dysentary, similar to Shigella
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EHEC
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O157, mostly bloody diahrea with sudden onset, sytemic toxicity: hemolytic uremic syndrom, especially in children (Renal Failure, Shiga like toxin-inhibit protein synthesis by cleacing ribosome, associated with undercooked beef
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Escherichia coli general
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Major: GI, Minor: Unirnary tract, sepsis, neonatal meningitis
Virulence: pili attatch to mucosa, antiphagocytic capsule, endotoxin, 2 enterotoxins: heat labile stimulates adneylate cyclase by ADP ribosylation increased cAMP, heat stabile: stimulates guanylate cyclase -broad spectrum penicillins |
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Salmonella typhi
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typhoid fever, fever, delirum, rose spots, tender abdomen, large spleen,fecal oral transmission, human only, growth in macrophages, chart in handout, Quinolones and 3 types of vaccine
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Salmonella enteriditis/cholerasuis
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Gastroenteritis: colon infection, diahrea, pain, fever, 2-5 days self-limited,
Septicemia: prolonged constant fever, chills, anorexia, anemia. 2ndary osteomylitis, pneumonia, pulmonary abscess Enteric Fever: similar to Typhoid Fever but milder transmitted by chickens, eggs, and reptiles, fecal oral, endotoxin, invades mucosa of intestines, gastric acid important in defense, |
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Edwarsiella
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Similar to slamonella, mostly acute gastroenteritis
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Arizona
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GNR, slow lactose fermenters, similar to salmonella, entercolitis,
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Shigella
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Dysentary, fecal oral, invades mucosa but does not penetrate, rare septicemia, shigga toxin- A subunit binds to 60s portion and inhibits, B binds to mucosa wall
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Vibrio Cholerae
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Cholera, No blooed or WBC, raid dehydration and electrolyte abnormalities, fecal oral, human only, subunit B binds to cell membrane, A has ADP ribosylating effect increasing cAMP, outflow or water and CL-, mucinase dissovles glycoprotein coat of epithelium, antibiotics, vaccine 50% effective,
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Campylobacter jejunem
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Enterocolitis, watery diahrea, followed by fevera nd pain, fecal oral animals may transmit, may invade tissue, but not penetrate, no enterotoxin, erythromycin, quinolone, no vaccine
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Vibrio paraheamolyticus
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Gastroenteritis related to eating raw or poorly cooked seafood,
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Helicobacter pylori
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Gastritis and gastric ulcers, invade gastric mucosa and produce urease, spiral shaped, motile, antibiotics prevent relapse
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Aeromonas
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Freshwater and occasionally infecting snakes, frogs, and fish, motile, oxidase +, variety of toxins one similar to shiga and one similar to V. cholerae, diahrea and fresh water wound infection
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Plesiomonas
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Fresh water fish and animals especially in tropics, tropical diahreal illness
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Proteus mirabilis and vulgaris
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Urinary tract infection, live in human colon,soil and water, ascend urethra to cause UTI, endotoxin, urease degrades urea to NH4 raising pH leading to stones, motile, ampicillin sensitivity
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Morganella
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Similar to Proteus causes UTI, urease, stone formation
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Providencia
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normal flora of intestine, cause UTI and antibiotic resistant
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Haemophilus influenzae
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Upper respiratory tract infections, Otis media, sinusitism epiglottitis-almost exclusively, pneumonia in older adults, meningitis, respiratory droplets, polysacharide capsule, IgA protease, endotoxin, ceftriaxone for meningitis, some ampicillin resistance, rifampin to household contacts
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Haemophilus ducreyi
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chancroid STD, common in tropical regions not US, painful ulcers on gentialia, enlarged inguinal lymph nodes, oral erythromycin
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Legionella
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Pontiac fever more mild dlu-like, legionaire's disease "atypical pneumonia" to multi-lobar pneumonia, Lives in enviromental water sources, associated with traveling, transmitted by aerosol from person to person, grows within macrophages, endotoxin, produces proteases, lipases, hemolysins, cytotoxins, do not stain well, erythromycin, no vaccine
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Bordetella pertussis
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Whooping cough, primarily in infants and young children, acute tracheobronchitis, 1-4 weeks, does not spread beyond respiratory tract, can be in adults after immunity has waned, human only, attatches to cilia, no invasion, transmitted via highly contagious respiratory droplets, polysaccharide capsule, pertussis toxin-AB toxin B binds and A ADP ribosylates inhibiting a coupling protien, extracellular adenylate cyclase inhibits macrophage killing, attatchment to epithelium via pili vaccinec against pili protects, erythromycin, vaccine in tetanus boosters
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Klebsiella pneumoniae
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Pneumonia with thick sputum due to large polysacharid capsule, common in people with an underlying illness, UTI involving catheters, Sepsis, upper respiratory tract and colon, migrate up UTI, endotoxin and large antiphagocytic capsule, cephalosporins, no vaccine
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Enterobacter
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inhabit soil and water, aerogenes is most common, inhabit any tissue, most frequently UTI, more common in chonically ill patients, ampicillin and cepholosporin resistant
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Serratia
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Oppurtunistic pathogen in hospitalized patients, sepsis, wound infection, pneumonia, and UTI, colonize on instruments, produce red or pink pigment, often multi antibiotic resistant, ill patients
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Brucella abortus, suis, and melitensis
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placental and fetal membranes of cattle, swine, and goats, undulant fever, flu-like sypmtoms with undulating fever pattern, weakness fatigue, enlarged liver and spleen,osteomylytis is frequent complication, rare in US due to pasteurization, can survive in macrophages producing granulomatous repsonse in host
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Francisella tularensis
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Tularemia, ulceroglandular-ulcer at site of infection, regional lymph nodes swell, occuloglandular-conjuntivis of eye infected, typhoid-dissemenated infection, gastrointestinal, pulmonary, spread by many animals and ticks, aerosols, contact or tick bit, or ingestion, granulomatous inflamation in lymph nodes, streptomycin, vaccine for at risk people
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Yersinia pestis
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Plague, spread by flea, regional lymph nodes swell and become tender, fever, myalgias, sceptic shock and pneumonia, bubonic and pneumonic varieties, pneumonic is 100% mortality spread from aerosol of ill patients, wild rodents in western US, endotoxin, exotoxin, V and W antigens, F1 antigen protects against phagosytosis, small GNB, safety pin appearance, streptomycin, tetracycline for contacts, quarentine, vaccine for high risk patients
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Pasturella multocida
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wound infection of dog and cat bites, occasional osteomylitis in deep woulnds, bites especially cats, endotoxin, ampicillin
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Mycoplasma pneumoniae
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tracheobronchitis, atypical walking pneumonia, 2-3 week incubation, gradual onset of fever, malaise, headache, and cough, can last up to 3 weeks without treatment, common in groups in winter(families), resporatory droplets, inhibits cilliary motion in respiratory tract, causes necrosis with cytolytic enzymes and hydrogen peroxide, very small, slow growth, quinolones, tetracyclines, no vaccine
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Chlamydia trachomatis
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Trachoma-chronic eye infection, eye to eye transmission of infected droplets on hands/clothing, infiltration of neutrophils leas to fibrosis and scaring, blindness
Genitourinary infections-STD chronic cervicitis and urethritis in women, scarring of fallopian tubes causes sterility, can give newborns conjunctivitis or pneumonia Lymphogranuloma venereum- STD rare in US, initial small mucosal legion overlooked leading to enlarged matted inguinal lymph nodes, giemsa or fluorescent staining, erythromycin or tetracycline |
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Chlamydia pneumoniae
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atypical pneumonia syndrome, respiratory droplets, sore throat, low grade fever, cough, more frequent in older adults, serologic tests, tetracycline
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Chlamydia psittaci
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bird infection transmitted to humans, pneumonia, fver, malaise, myalgia, headache, cough, xray shows pneumonia, aersolization of bird feces, spreads to blood and reticuloendothelial organs, necrosis of liver, spleen, and invades lungs, no toxins, serologic diagnosis, tetracycline
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Burkholderia pseudomallei
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common in SE asian soil, inhaled when soil is disturbed, Vietnam, septicemia with abscess, or slow progressing pulmonary disease, may reactivate later
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Burkholderia mallei
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disease in horses and mules, USSR weaponized it, wound infections and pneumonia and sepsis when aerosolized
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Pseudomonas aeruginosa
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nosocomial infection, surgical wounds, UTI, pneumonia and sepsis, BURN INFECTIONS, respiratory tract in those with CF, lives in enviromental water sources, solonizes skin, RT, and colon of 10%, aerosols, fecal oral, contaminated equipment, oppurtunistic, Endotoxin, Exotoxin A-ADP ribosylater, pili mediate attatchment, capsule, produse blue and yellow pigment, antibiotic resistant
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Bacteroides fragilis
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common cause of serious Anearobic infections, predominant anearobe in colon, may be foundin oral cavity as well, infections arise from a break in mucosal surface (ruptured appendix, penetrating trauma), antiphagocytic capsule, chemically different endotoxin, GNB, gas chromatography,
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Rickettsia akari
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rickettsia pox, somewhat resembles varicella, black eschar at site of mite bite, associated with mice
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Rickettsia rickettsii
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Rocky Mntn Spotted Fever, 1 week incubation, fever, headache, myalgias, typical rash on hands and feet spreading to trunck, Dissemenated Intravascular coagulation (clotting in vessels) circulatory collapse, tick bite, serologic tests, remove ticks, tetracycline, only suppresses growth recovery depends on imune responses
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Rickettsia prowazekii
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Epidemic typhus, Louse bite with sudden onset of symptoms, fever, headache, malasie, skin rash from trunck to extremities, enlarges liver and spleen, meningocephalitis, delirium and coma, can reoccur as Brill-Zinsser disease, limited to human louse, transmitted by fecal excretion of louse, resevoirin flying squirrel, tetracyclin
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Rickettsia typhi
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similar to epidemic typhus/prowazekii, but more mild
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Orientia tsutsugamushi
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resembles epidemic typhus, typically an eschar, generalized lymphadenopathy and lymphocytosis, cardiac and cerebral involvement may be severe, mites in scrub of jungle, Burma Japan Taiwan
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Coxiella Burnetii
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Q-fever, resembles influenza rather than thyphus, no rash or local lesion, fever, headache, myalgias, pneumonia in 50%, hepatitis is frequent-combo of hepatitis and pneumonia=coxiella, inhalation of aerosols of urine, milk, feces, or slaughterhouse, serologic tests, tetracycline, vaccine for high risk
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Ehrlichia
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Two forms
Human Monocytic Ehrilchiosis and Human Granulocytic Ehrilichiosis, slightly different regions and cells infected are different, flu-like illness, HME may have rash but only 1/3 rare in HGE, tetracycline and serologic tests |
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Bartonella quintana
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Trench fever-headache exhaustion, diaphoreseis, fever with roseolar rash, armies in WWI
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Bartonella henselae
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Primary pathogen, Cat-scratch fever, self-limiting, fever and lymphadenopathy develoing after 2 weeks, skin lesion after 3-10 days, regional lynph enlargement,
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Bartonella bacilliformis
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2 stage infection, Oroya fever is a serious infectious anemia, due to detrsuction blood organism grows in blood vessels, followed by verruga peruna skin lesions 2-8 weeks later, limited to mountainous regions in south america, sandflies
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B cells General
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-Variable fomains of Light and Heavy Chains form critical areas of antigen binding site
-antibody recoginzes souble antigen in 3D conformation -Antigendriven differentiation results in antibody production and memory B cell production |
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Affinity
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strength of a monovalent antigen-antibody binding site interaction
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Avidity
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the strength with which a multivalent antibody binds to a multivalent antigen, depends on the affinity of individual combining sites for the determinants of the antigen
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Cross-reactivity
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May occur when distinct antigens share similar overall configurations, affinity and avidity may vary depending on the degree of similarity of the antigens
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T-cells General
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-Variable domains of the alpha and beta (or gamma and delta) form critical area of the anitgen binding site
-TCR-2 recognizes antigen bound to MHC molecules -Antigen driven activation leads o the production of cytokines and memory Tcell production, or to the development of cells that are cytotoxic |
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CD4+ T cell Activation
-Constitutive |
Interact with APC
-dendritic cells use Toll like Receptors(TLR) to recognize microbes, phagocytize and present MHC II receptors to CD4+ Tcells |
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CD4+ T cell Activation
-Inducible |
Macrophages, B-lymphocytes...phagocytic cells have TLR. B cells are major APC in secondary immune respnse, phagocytize and present microbial proteins with MHC II
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T Cell receptor
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Recognizes peptides lodged in peptide binding grovve of MHC class II molecules
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CD4
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Binds invariant region of MHC II
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Costimulatory Pairs
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Paired interactions that contribute to the formation of immunological synapse
Cd40-CD154 B7-CD 28-results in prolonged half-life of IL2 mRNA-more IL2 |
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Interaction of TH0 with APC
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-causes p55 chain of IL2 receptor to combine with p75 chain to form a high affinity IL2 receptor
-transient production of IL2 and IL4 -interaction of IL2 and IL2 receptor is stimulus for T cell activation and growth |
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T cell proliferation
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APC binds to tcell and IL2 interaction causes secretion of cytokines and differentiation into memory cells
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TH1 differentiation
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Develop from IL-2, ING-gamma, and IL12, these cytokines are produced by macrophages and NK cells, TH1's make IL-2, INF-gamma, and TNF-beta, activates cell mediated imunnity-CD8+ Tcells, NK, and macrophages
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TH2 Differentiation
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Develops form IL4, IL4 produced by mast cells and CD4+ tcells, makes IL4, IL5, IL10, IL13 and trigger B cell class shift and activation of eosinophils
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INF gamma and IL4 and amounts of antigen
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INF gamma inhibits TH2 production, IL4 inhibits TH1 production, Lare amounts of antigen faveo TH1 and small amounts favor TH2
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B cell interactions with Tcells
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B cell presents antigen to acitive T cell, interaction uses CD40 and CD154 reaction to upregulate B7 which is needed for B cell switching, also TH interaction with B cell releases cytokines that aid in B cell differentiation to memory cells and plasma cells
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Secondary Immune response
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Memory T and B cells, Memory T cells can effectivley activate B cells and produce cytokines more rapidly and in larger quantities, Memory B cells make IgG earlier and hiave higher afinities fir antigen receptors
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T independent Antigens
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Do not rquire T helper cells to activate B cells, can bind multiple antigens, produce only IgM, a quick response, but limited variation, n o immunity formed
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Interleukins
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cytokines that mediate signals btwn leukocytes, have important effects on cells outside imune system-osteoclast, fibroblast
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Lymphokines
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Cytokines produced by lymphocytes
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monokines
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cytoines produced by moncytes
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chemokines
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cytokines involved in chemotactic activity, IL8
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Cytokines-general properties
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-act on many cell types
-functionally redundant-several have simialr effects -effective at low concentratuons -short lived -may act in autocrine, paracrine, and endocrine fashion -bind to receptors on target cells -they are glycoproteins -synthesized rapidly and secreted in response to stimulus, no storage -a given cell may make several varieties -small half-life |
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Toxic Shock Syndrome
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Staph and Strep super antigens bind to variable region of TCR and MHC II molecules causing massive release of cytokines inducing a systematic reaction
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Bacterial Sceptic schock
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endotoxins stimulate macrophages to overproduce IL1 and THN-alpha causing bacterial sceptic shock
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Basic Immunoglobulin Structure
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Variable carb portion, one region is concerned with binding aintigen while the othet mediates binding to cells or complements, consists of two light and two heavy chains connected by disulfide bonds
The n terminal ends are variable ends, both constant and variable domains are globular and a hinge region is present at the center to provide flexibility |
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Immunoglobulin G-IgG
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-Most abundant(70-75%), especially extravscular where it combats microorganisms,
-monomeric with 4 subtypes -Half life=21 days for 1,2,4 and 7 days for 3, has longest Ig half-life due to a protection receptor -functions-placental transfer, opsinozation, antibody dependent cell mediated immunity, activation of compliment, neutralization of toxin, immobilization of bacteria, virus neutralization |
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Immunoglobulin M-IgM
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-Effective first line defense, produced early in immune response, pentamer form, mu and J chains (Jstabilizes), 10% of pool, 5 day half-life, produced at 5 months, elevated levels indicate a recent exposure, efficient agglutinating antibody, anitbody against ABO blood type, activates compliment
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Immunoglobulin A- IgA
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Found in Serous-mucous where it defends external body surfaces, 2 forms, 2 being a dimer, 12-20% of pool, 6 day half-life, dimeric form is secretory component and held by a J chain
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Isotype variation
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Genes for isotypic varients are present in all healthy people, differences among general immunoglobulin forms-IgG, IgA, IgM...
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Allotypic Variation
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Different alleles at a given locus, differences btwn people, usually an amino acid difference
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Idiotypic variation
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Variation in th evariable domain, specific for individual antibody, variable domain differences
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Pro-B cell
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Earliest distinguishable B cell stage
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Pre-B cell
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undergone heavy chain recombination and the heavy chain is associated with surrogate light chains
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Immature B
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Only produce monomeric IgM, interacton with self antigens leads to apoptosis or inactivation
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Mature B cells
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are IgM and IgD positivem antigen interaction results in activation to either B memory cell(isotype switch) or plasma cell(Ig secretion)
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Plasma Cells
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Antibody producers, migrate to a variety of tissues and secrets thousands of antibody per second
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Memory B cells
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Rapid response to very small antigenic stimulus, live for years and have multiple types of Ig on surface, but usually IgG
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Light Chain Recombination
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2 sequences combine, V and J segments are chosen and combined with the constant chainsection
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Heavy Chain Recombination
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Contains three sequences, V D and J segments that add variability to the heavy chain, join with constant sequence
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Somatic Mutations
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Add variability to anitbodies, variable region is highly susceptable to mutation resulting in slightly varied forms of B cells, the ones with the greatest affinity go on to produce more B cells and so the affinity of B cells increases
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T cell receptor diversity
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Similar to the diversity found in antibodies, alpha and beta chains, alpha chain is VJ recombination, and Beta is VDJ typically, no somatic mutations,
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TCR-2 CD8+ T cells
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Cytotoxic T lymphocytes, kill virally infected, tumor, or allograph cells, kill by release of perforins or induce apoptosis, 35% of T cells
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TCR-2 CD4+
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T helper lymphocytes, divided into type 1 and 2, one mediates cell cytotoxic response and type 2 mediated antibody response
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TCR-2 Education
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2 Stages,
1. recognize antigen only in association with self MHC molecules-cells must require MHC 2. Do not respond to self antigens-will not attck self antigens only viral |
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Major Histone Compatability Complex
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Responsible for rejection of grafts btwn individuals, function in signaling btwn lymphocytes and cells expressing antigen
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MHC class I
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Present peptides derived from endogenous (internal) proteins antigens to the CD8+ T cells
-coexpressed, large # of variations, polymorphic occurence, 2 types of each class I -short alpha chain with long beta chain with CD 8 reconizing site |
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MHC class II
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Present exogenous(external) peptides to CD4+ T cells
-At least 6 class II olecules or moe, some cell can inducivly express, some sometimes present -Equal alpha and Beta chains with CD4 binding site |
