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36 Cards in this Set

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What are the components of Acute Phase Response?
Thermoregulatory, Anti-infective, Anti-inflammatory, Metabolic, Pro-coagulant
What is a fever temperature?
36.6C
What neuropeptides have antipyretic properties?
ACTH and Melanocyte Stimulating Hormone
What cytokines are anti-inflammatory?
IL-4, IL-10 (proteins like ACTH, haptoglobin and IL-1 receptor antagonist are also anti-inflammatory)
What are Etiological considerations for FUO?
Infection, Neoplasia, Collagen vascular disease, Misc
What are sources of IL-1?
Mononuclear phagocytes, Myelomonocytic leukemia cells, Renal cell carcinoma cells, Langerhans cells, Keratinocytes (lymphocytes do not make IL-1, nor do eosinophils or basophils)
Beneficial Effects of Fever?
Increased Ig synthesis, T-cell activation, increased cytokine production, increased NK cell activity, suppression of microbial growth, reduced virus replication
Why are techoic acids important?
They affect the ability of a cell to take up DNA, or its competence. They also are involved in adhesion, which is required for virulence, and as a cause of Gram positive sepsis.
What is Braun's lipoprotein?
Found only in Gram negative bacteria, in which it anchors the outer membrane to the cell wall.
Sepsis from Gram negative is due to what? Sepsis from Gram positive is due to what?
G-negative: Lipid A of LPS;
G-positive: Techoic Acid
Clinical significance of LPS?
Activates alternative complement pathway, acts as pyogen, causes Gram-negative sepsis, DIC, and shock. Causes host cells to produce abnormal amounts of molecules that regulate vascular permeability, blood pressure, coagulation, and immune responses.
Intracellular parasites include:
Salmonella, Mycobacteria, Legionella, Chlamydiae
Bacteria that use A-B toxin:
Cholera, Diphtheria, Botulism, Tetanus, Anthrax
Where does diphtheria toxin come from?
Corynebacterium diphtheriae

Interferes with host cell protein synthesis and causes cell death.

Heart, nerve tissue, kidney cells
Plasmid encoded exotoxins
Anthrax
E. coli
Tetanus
Phage encoded exotoxins
Botulism
Diphtheria
Shigga-like
Chromosomally encoded exotoxins
Bordetella AC toxin
Cholera
Pertussis
Exotoxin A
Shiga
Growth on chocolate agar is particularly useful for identifying which bacteria?
Haemophilus
Are Enterobacteriacae, Oxidase Positive or Negative?
Oxidase-negative
Are Campylybacter Oxidase Positive or Negative?
Oxidase-Positive
Are Neisseria, Oxidase Positive or Negative?
Oxidase-Positive
Are Gram-negative Bacilli typical etiologic agents in endocarditis?
Rarely in drug addicts
Peripheral manifestations of endocarditis include:
conjunctival petecchiae, splinter hemorrhages, Osler's nodes, Janeway lesions, Roth's spots
Treatment principles for Bacterial Endocarditis:
High dose, prolonged, intravenous, bactericidal antibiotics.

2-4 wks Viridians
4-6 wks Enterococci

Combination therapy with aminoglycosides is often used for synergy.
Infective endocarditis bacterial adherence include:
Surface glycoproteins
High molecular weight dextrans
Lipoteichoic acid
Slime: coagulase negative staph epidermitis
Causes of SBE
Viridans strept
group D strept
enterococci
S. bovis **colon cancer!
Causes of ABE
S. aureus
Gram-neg bacilli (drug addicts)
Enterococci (GI/GU manipulation)
Clinical Manifestations and Diagnosis of Endocarditis
Heart Murmur
CHF
Clubbing (hypertrophic osteoarthropathy)
Splenomegaly

Leukocytosis, anemia, hematuria common

Blood cultures
Transthoracic echo
Transesophageal echo
Who has Filamentous hemaggluttinin and what is it?
Bordetella

Blocks neutrophil phagos and helps bind to cilia in respiratory tract.
What are the clinical stages of Pertussis?
Incubation
Catarrhal
Paroysmal
Convalescent
Thumbprint sign on lateral neci radiograph... THINK:
Haemophilus influenza
Widened mediastinum on XRay, THINK:
B. anthrax
Who are the Gram Positive Rods?
Bacillus
Corynebacteria
Listeria
Erysipelthrix
Cardiac toxicity
Neurological toxicity

(clinical manifestations in what?)
Corynebacteria Diptheria
Loves the Placenta and CNS (meningitis)
Listeria
Granulomatosis Infantiseptica
Immediate abortion of fetus if infection occurs in utero.

Listeria!

Listerosis- pregancy increases risk of developing Listeria due to major decline in T-cell function at 30-weeks as a protective measure that mother doesn't attack fetus.