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827 Cards in this Set
- Front
- Back
3 main roles of Ig binding to bacteria
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- opsonization - neutralization - complement activation
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A defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes is indicative of what immune deficiency disease?
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Chronic granulomatous disease, which presents with marked susceptibility to S. aureus, E.coli, Aspergillus. Diagnosis confirmed with neg nitroblue tetrazolium dye reduction test.
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After exposure to what 4 things are preformed (passive) antibodies given?
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Tetanus toxin, Botulinum toxin, HBV, or Rabies.
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All nucleated cells have what class of MHC proteins?
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class I MHC proteins
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Anaphylaxis, asthma, hives, or local wheal and flare are possible manifestations of which type of hypersensitivity?
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Type I
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Anti-gliadin autoantibodies are associated with what disease?
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Celiac disease
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Anti-inflammatory cytokines
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IL-10&TGF-b
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Anti-Scl-70 autoantibodies are associated with what disease?
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diffuse Scleroderma
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Ataxia-telangiectasia
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AR, df. in DNA repair. hypersensitivity to ionizing radiation. Manifestations : cerebellar ataxia, oculocutanoeous telangiectasias, repeated sinopulmonary infxn, inc. malignancy
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Autoimmune hemolytic anemia, Rh disease (erythroblastosis fetalis), Goodpasture's syndrome, Rheumatic fever, Graves disease, and bullous pemphigoid are examples of what kind of hypersensitivity reaction?
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type II hypersensitivity
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Class I major histocompatibilty complex consists of 脰
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1 polypeptide, with B2-microglobulin
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Class II major histocompatibilty complex consists of 脰
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2 polypeptides, an alpha and a Beta chain
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Cytotoxic T cells have CD(?), which binds to class (?) MHC on virus-infected cells.
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CD8 binds to class I MHC
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def. in C3
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pyogenic sinus and resp. infxn. in childhood, esp H.inf
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def. in C6-C9
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Neisseria bacteremia
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Define acute transplant rejection.
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Cell-mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation.
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Define adjuvant.
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Adjuvants are nonspecific stimulators of the immune response but are not immunogenic by themselves.
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Define Anergy?
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Self-reactive T cells become nonreactive without co-stimulatory molecule. Bcells also become anergic but tolerance is less complete than in Tcells
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Define chronic transplant rejection.
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Antibody-mediated vascular damage (fibrinoid necrosis)--irreversible. Occurs months to years after transplantation.
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Define Graft-versus-Host Disease
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grafted immunocompetent Tcells proliferate in the irradiated immunocompromised host and reject cells with foreign proteins, resulting in severe organ dysfunction
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Define hyperacute transplant rejection.
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Antibody-mediated due to the presence of preformed anti-donor antibodies in the transplant recipient. Occurs within minutes after transplantation.
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Define Ig allotype (polymorphism).
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Ig epitope that differs among members of the same species (on light or heavy chain)
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Define Ig idiotype.
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Ig epitope determine by the antigen-binging site (specific for a given antigen-binding site), Hypervariable region is unique
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Define Ig isotype.
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Ig epitope common to a single class of Ig (5 classes, determined by the heavy chain-IgG,IgA,etc.)
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Does IgA fix complement?
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No
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Give 3 examples of possibly causes for SCID?
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(1) failure to synthesize class II MHC antigens (2) defective IL-2 receptors (3) adenosine deaminase deficiency
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Goodpasture's syndrome is associated with what kind of autoantibodies?
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anti-basement membrane antibodies.
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Helper T cells have CD(?) which binds to class (?) MHC on antigen-presenting cells.
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CD4 binds to class II MHC
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How does Bruton's agammaglobulinemia usually present?
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Recurrent bacterial infections in boys after about 6 months of age, when levels of maternal IgG antibody decline
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How is active immunity acquired?
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Active immunity is induced after exposure to foreign antigens. There is a slow onset with long-lasting protection.
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How is passive immunity acquired?
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by receiving preformed antibodies from another host. Antibodies have a short life span, but the immunity has a rapid onset.
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I-cell dz.
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def. in N-Ac-glucosamine phosphotransferase in Golgi apparatus.
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IL-4 promotes the growth of B cells and the synthesis of what 2 immunoglobulins?
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IgE and IgG
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In what immune deficiency is there a failure of gamma-interferron production by helper T cells and neutrophils fail to respond to chemotactic stimuli?
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Job's syndrome
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In what T-cell deficiency do the thymus and parathyroids fail to develop owing to failure of development of the 3rd and 4th pharyngeal pouches?
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Thymic aplasia (DiGeorge syndrome)
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Job's syndrome is associated with high levels of what immunoglobulin?
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IgE
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MHC I Ag loading occurs in __(1?)__ while MHC II Ag loading occurs in __(2?)__?
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(1) in rER (viral antigens) (2) in acidified endosomes.
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Primary biliary cirrhosis has what kind of autoantibodies?
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anti-mitochondrial antibodies
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Role of TH1 cells?
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produce IL-2 (activate Tc cells and further stimulate TH1 cell) and gamma-interferon (activate macrophages)
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Role of TH2 cells?
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produce IL-4 and IL-5 (help B cells make Ab)
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Sensitized T lymphocytes encounter antigen and then release lymphokines which leads to macrophage activation' in what hypersensitivity reaction?
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Type IV
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TB skin test, Transplant rejection, and contact dermatitis are examples of what type of hypersensitivity reaction?
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Type IV
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The 3 kinds of MHC class I genes are脰
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A, B, and C
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The 3 kinds of MHC class II genes are脰
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DP, DQ, DR
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The Fc portion of immunoglobulins are at the __?__ terminal.
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The carboxy terminal
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What 2 cytokines are secreted by macrophages?
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IL-1 and TNF-a
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What 2 kinds of autoantibodies are specific for SLE?
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Anti-dsDNA and anti-Smith
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What 3 cytokines are classified as 'acute phase cytokines'?
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IL-1, IL-6, and TNF-alpha
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What 3 ways do interferons interfere with viral protein synthesis?
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(1) alpha and beta interferons induce production of a second protein that inhibits viral protein synthesis by degrading viral mRNA (2) gamma interferons increase MHC class I expression and antigen presentation in all cells (3) activates NK cells to kill virus-infected cells.
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on Bcells?
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Bcell mobilization and antibody production
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on fat and muscle?
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mobilization of energy reserves to raise body temperature
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on neutrophils?
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Neutrophil mobilization and phagocytosis
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on Tcells?
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Tcell mobilization and cytotoxic response
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on the bone marrow?
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Incr. Production of Colony stim. Factor (CS) which leads to leukocytosis
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on the hypothalamus?
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increase body temperature
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What affect do the acute phase cytokines (IL-1,IL-6,TNF-alpha) have on the liver?
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acute phase proteins (eg C-reactive protein) which activates complement and opsonization
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What antibody isotype can cross the placenta, fix complement, opsonized bacteria, and neutralize bacterial toxins and viruses?
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IgG
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What are 3 types of antigen-presenting cells?
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macrophages, B cells, and dendritic cells
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What are some examples of Immune Complex?
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PAN, immune complex GN, SLE, rheumatoid arthritis
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What are the four steps in Th activation?
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(1)Foreign body is phagocytosed by APC (2)Foreign antigen is presented on MHC II and recognized by TCR on Th cell (3)Co-stimulatory signal is given by interaction of B7 and CD28 (4)Th cell activated to produce IL-2 and gamma-interferon
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What are the main symptoms of serum sickness and at what period of time following Ag exposure?
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fever, urticaria, arthralgias, proteinuria, lymphadenopathy 5-10 days after Ag exposure
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What are the major symptoms of graft-vs.-host disease?
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maculopapular rash, jaundice, hepatosplenomegaly, and diarrhea.
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What are the two steps in Tc activation?
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(1)endogenously synthesized (viral or self) proteins are presented on MHC I and recognized by TCR on Tc cell (2)IL-2 from Th cell activates Tc cell to kill virus-infected cell
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What B- and T- cell deficiency, assoc. with IgA deficiency, presents with cerebellar problems (ataxia) and spider angiomas (telangiectasia)?
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ataxia-telangiectasia
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What causes the tissue damage associated with Serum sickness?
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formation of immune complexes of foreign particles and Abs that deposit in membranes where they fix complement (leads to tissue damage)
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What cell secretes gamma-interferon and what does it stimulate?
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Secreted by helper Tcells, stimulates macrophages
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What cell secretes IL-1 and what does it stimulate?
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Secreted by macrophages, stimulates Tcell, Bcells, neutrophils, fibroblasts, and epithelial cells to grow, differentiate, or synthesize specific products. IL-1 is an endogenous pyrogen
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What cell secretes IL-2 and what does it stimulate?
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Secreted by helper Tcells, stimulates the growth of helper and cytotoxic Tcells
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What cell secretes IL-3 and what does it stimulate?
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Secreted by activated Tcells, stimulates bone marrow (similar function to GM-CSF)
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What cell secretes IL-4 and what does it stimulate?
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Secreted by helper Tcells, stimulates growth of Bcells and enhances IgE and IgG production
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What cell secretes IL-5 and what does it stimulate?
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Secreted by helper Tcells, stimulates synthesis of IgA and production and activation of eosinophils
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What cell secretes TNF-alpha and what does it stimulate?
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Secreted by macrophages, stimulates IL-2 receptor synthesis by helper Tcells and inc Bcell proliferation, attracts and activates neutrophils
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What cell secretes TNF-beta and what does it stimulate?
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Secreted by activated T lymphocytes, function similar to TNF-alpha
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What cell surface proteins do all cells (except mature red cells) have?
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MHC I
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What cell surface proteins do Bcells have?
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IgM,B7,CD19,CD20
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What cell surface proteins do Cytotoxic Tcells have?
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CD8,TCR,CD3
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What cell surface proteins do Helper Tcells have?
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CD4,TCR,CD3,CD28
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What cell surface proteins do Macrophages have?
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MHCII,CD14
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What cell surface proteins do NK cells have?
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Receptors for MHC I,CD16 CD56
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What class of MHC proteins are the main determinants of organ rejection?
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class II MHC
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What complement component can cause opsonization?
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C3b
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What complement components can cause anaphylaxis?
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C3a and C5a
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What complement components can cause viral neutralization?
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C1,C2,C3,C4
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What components of the alternative complement pathway make the C3 convertase?
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C3b, Bb
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What components of the alternative complement pathway make the C5 convertase?
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C3b, Bb, and C3b+C3a
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What components of the classic complement pathway make the C3 convertase?
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C4b, C2b
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What components of the classic complement pathway make the C5 convertase?
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C3a+C4b, 2b, and 3b
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What components of the complement pathway are deficient in Neisseria sepsis?
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The MAC complex--(C5b, C6, C7, C8, C9)
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What condition presents with disseminated mycobacterial infections?
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IL-12 receptor deficiency
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What cytokines attract and activate neutrophils?
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TNF-alpha and TNF-beta
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What disease is associated with a X-linked defect in a tyrosine-kinase gene associated with low levels of all classes of immunoglobulins?
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Bruton's agammaglobulinemia
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What disease is associated with anti-epithelial cell autoantibodies?
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Pemphigus vulgaris
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What disease is associated with anti-microsomal autoantibodies?
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Hashimoto's thyroiditis
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What does a deficiency of C6-C8 cause (in the complement cascade)?
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Neisseria bacteremia
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What does a deficiency of C1 esterase inhibitor cause (in the complement cascade)?
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hereditary angioedema because of overactive complement
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What does a deficiency of C3 cause (in the complement cascade)?
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can lead to severe, recurrent pyogenic sinus and respiratory tract infections.
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What does deficiency of decay-accelerating factor (DAF) in the complement cascade cause?
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leads to paroxysmal nocturnal hemoglobinuria (PNH)
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What does IL-8 do?
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major chemotactic factor for neutrophils
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What does Job's syndrome classically present with?
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recurrent 'cold' (noninflamed) staphylococcal abscesses, eczema, and high levels of IgE
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What does TNF-alpha stimulate dendritic cells to do during the acute phase response?
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TNF-alpha stimulates their migration to lymph nodes and their maturation for the initiation of the adaptive immune response.
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What elements of the complement cascade make the Membrane Attack Complex (MAC)?
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C5b, C6, C7, C8, and C9
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What Ig is found in secretions as a monomer or a dimer?
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IgA
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What Ig is found in secretions as a monomer or a pentamer?
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IgM
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What Ig levels do you see with Hyper-IgM Syndrome?
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High levels: IgM- Very Low levels: IgG,IgA,IgE
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What immune deficiency disease has an autosomal-recessive defect in phagocytosis that results from microtubular and lysosomal defects of phagocytic cells?
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Chediak-Higashi disease, which presents with recurrent pyogenic infections of staph and strep
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What immune deficiency is associated with elevated IgA levels, normal IgE levels, and low IgM levels?
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Wiskott-Aldrich syndrome
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What immune deficiency presents with tetany owing to hypocalcemia, congenital defects of the heart and great vessels, and recurrent viral, fungal, and protozoal infections?
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Thymic aplasia (DiGeorge syndrome), a T-cell deficiency syndrome
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What immunoglobulin fixes complement but does not cross the placenta and has an antigen receptor on the surface of Bcells?
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IgM
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What immunoglobulin isotype has the lowest concentration in serum?
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IgE
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What immunoglobulin isotype is involved in type-I hypersensitivity reactions by inducing the release of mediators from mast cells and basophils when exposed to allergen?
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IgE
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What immunoglobulin isotype is produced in the primary response to an antigen and is on the surface of B cells?
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IgM
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What immunoglobulin isotype mediates immunity to worms?
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IgE
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What immunoglobulin isotype prevents the attachment of bacteria and viruses to mucous membranes?
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IgA
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What immunoglobulins bind and activate the classic complement pathway?
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IgG and IgM (the Fc portion)
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What interleukin induces naive helper T-cells to become TH1 cells?
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IL-12
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What interleukin induces naive helper T-cells to become TH2 cells?
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IL-4
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What interleukin stimulates the growth of both helper and cytotoxic T-cells?
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IL-2
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What is an example of Arthus Reaction?
|
hypersensitivity pneumonitis caused by thermophilic actinomycetes
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What is an Immune Complex?
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Antigen-antibody complexes that activate complement, which attracts neutrophils (3 things stuck together antigen-antibody-complement)
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What is Chronic Mucocutaneous Candidiasis?
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T-cell dysfunction specifically against Candida albicans presenting with skin and mucous membrane Candida infections.
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What is important about the CD3 complex?
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It is a cluster of polypeptides associated with a T-cell receptor and is important in signal transduction.
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What is the cellular process that causes type I hypersensitivity?
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Ag cross-links IgE on presensitized mast cells and basophils, triggering the release of vasoactive amines (histamine). Reaction occurs rapidly after antigen exposure to preformed antibody.
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What is the cellular process that causes type II hypersensitivity?
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IgM, IgG bind to Ag on 'enemy' cell, leading to lysis (by complement) or phagocytosis (its cytotoxic).
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What is the main antibody in the secondary immune response?
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IgG
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What is the most abundant immunoglobulin isotype?
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IgG
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What is the most common selective immunoglobulin deficiency?
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Selective IgA deficiency that presents with sinus and lung infections
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What is the rise in temperature during the acute phase response help do (3 things?)
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(1) increase specific immune response (2) increase antigen processing (3) decrease viral and bacterial replication
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What is the triad of symptoms seen with Wiskott-Aldrich syndrome?
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recurrent pyogenic infections, eczema, and Thrombocytopenic Purpura
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What kind of autoantibodies are associated with CREST/Scleroderma?
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anti-centromere antibodies
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What kind of autoantibodies are associated with Vasculitis?
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anti-neutrophil antibodies
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What kind of autoantibodies are known as rheumatoid factor?
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anti-IgG antibodies
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What kind of immunity (antibody-mediated or cell mediated) is involved in allergies?
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both: antibody-mediated immunity (B cells)-hay fever, cell mediated immunity (T cells)-poison oak
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What kind of immunity (antibody-mediated or cell mediated) is involved in autoimmunity?
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antibody-mediated immunity (B cells)
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What kind of immunity (antibody-mediated or cell mediated) is involved in graft and tumor rejection?
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cell mediated immunity (T cells)
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What kind of immunity (antibody-mediated or cell mediated) is involved in host defense against infection (opsonize bacteria, neutralize toxins and viruses)?
|
antibody-mediated immunity (B cells)
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What kind of immunity (antibody-mediated or cell mediated) is involved in host defense against infection (TB, virus-infected cells, and fungi)?
|
cell mediated immunity (T cells)
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What kind of immunity (antibody-mediated or cell mediated) is involved in regulation of antibody response (help and suppression)?
|
cell mediated immunity (T cells)
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What kind of transplant rejection is reversible with immunosuppressants such as cyclosporin and OKT3?
|
acute transplant rejection
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What kinds of adjuvants are included in human vaccines?
|
aluminum hydroxide or lipid adjuvants
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What kinds of cells have class II MHC proteins?
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antigen-presenting cells (e.g. macrophages, Bcells, and dendritic cells)
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What symptoms characterize the Arthus reaction and what causes them?
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edema, necrosis, and activation of complement due to the Ag-Ab complexes that form in the skin following intradermal injection of Ag.
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What syndrome has a defect in CD40 ligand on CD4 T helper cells that leads to inability to class switch, presents early in life with severe pyogenic infections?
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Hyper-IgM Syndrome
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What syndrome has a defect in LFA-1 adhesion proteins on phagocytes and presents early in life with severe pyogenic infections?
|
Leukocyte Adhesion Deficiency Syndrome
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What type of cell secretes IL-3?
|
activated T-cells
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What type of cells does gamma interferon stimulate?
|
macrophages
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What type of Hypersensitivity is Type I?
|
Anaphylactic and Atopic
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What type of Hypersensitivity is Type II?
|
Cytotoxic
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What type of Hypersensitivity is Type III?
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Immune Complex, Serum Sickness, Arthus Reaction
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What type of Hypersensitivity is Type IV?
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Delayed (cell-mediated) Type
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What type of hypersensitivity reaction is the Arthus reaction?
|
type III
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What usually causes Serum Sickness
|
Drugs
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Where does the alternative complement pathway occur?
|
On microbial surfaces (nonspecific activators eg. endotoxin)
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Where does the classic complement pathway occur?
|
antigen-antibody complexes (IgG,IgM)
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Where is the defect in SCID?
|
the defect is in early stem-cell differentiation, leading to B- and T-cell deficiency
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Which immunoglobulin has an unknown function and is found on the surface of many Bcells and in serum?
|
IgD
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Which interleukin causes fever?
|
IL-1
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Which interleukin enhances the synthesis of IgA?
|
IL-5
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Which interleukin stimulates the production and activation of eosinophils?
|
IL-5
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Which interleukin supports the growth and differentiation of bone marrow stem cells?
|
IL-3
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Which is the only type of cell-mediated hypersensitivity reaction, and thus not transferable by serum?
|
Type IV
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Wiskott-Aldrich syndrome is a defect in the ability to mount what immune response?
|
an IgM response to capsular polysaccharides of bacteria.
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With what disease are anti-histone autoantibodies associated?
|
drug-induced lupus
|
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With what disease are anti-nuclear antibodies associated?
|
systemic lupus (SLE)
|
|
Name 5 species of bacteria that are transmitted to humans from animals.(Acronym: BBugs From Your Pet.)
|
Borrelia burgdorferi - Brucella spp. - Francisella tularensis - Yersinia pestis - Pasteurella multocida
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(T/F) The outer membrane for G+ and the cell membrane for G- act as major surface antigens.
|
FALSE: they DO act a major surface antigens BUT the outer mb for G- and the cell membrane for G+
|
|
All Rickettsiae (except one genus) are transmitted by what type of vector?
|
arthropod (Coxiella is atypical: transmitted by aerosol and causes pneumonia)
|
|
Are endotoxins heat stable?
|
yes, stable at 100C for 1 hr.
|
|
Are endotoxins secreted from cells?
|
NO
|
|
Are endotoxins used as antigens in vaccines?
|
no, they don't produce protective immune response
|
|
Are exotoxins heat stable?
|
no, destroyed rapidly at 60C (exception: Staphylococcal enterotoxin)
|
|
Are exotoxins secreted from cells?
|
YES
|
|
Are exotoxins used as antigens in vaccines?
|
Yes, TOXOIDS are used as vaccines
|
|
Are G(-) bugs resistant to Pen G? to ampicillin? to vancomycin?
|
G- bugs are resistant to PenG but may be susceptible to pen. derivative like ampicillin. The G- outer mb inhibits entry of PenG and vancomycin.
|
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Are Strep. pneumoniae sensitve to optochin? Are Viridans strep.?
|
Strep. pneumoniae is optochin-Sensitive - Viridans streptococci is optochin-Resistant
|
|
Are Strep. pyogenes Bacitracin-sensitive?>
|
YES.
|
|
Are Viridans strep. alpha, beta, or non-hemolytic?
|
alpha
|
|
Bartonella henselae
|
cat-scratch dz. & bacillary angiomatosis(aids pt.), endocarditis
|
|
Because of drug resistance, what in an alternate treatment combination for leprosy?
|
rifampin with dapsone and clofazimine
|
|
Besides the rash, what other body systems are affected by Lyme disease? (3)
|
joints -CNS -heart
|
|
C.diffficile toxin
|
"toxin A: enterotoxin(mucosal inflammation, loss of water, mucosal death)
|
|
Describe lab-findings for Pseudomonas aeruginosa.
|
Aerobic, G(-) rod. - Non-lactose fermenting - Oxidase positive - Produces pyocyanin (blue-green pigment)
|
|
Describe the chemical composition of peptidoglycan.
|
Sugar backbone with cross-linked peptide side chains.
|
|
Describe the disease associated with M. avium-intracellulare.
|
often resistant to multiple drugs; causes disseminated disease in AIDS.
|
|
Describe the H. flu vaccine. When is it given?
|
contains type b capsulare polysaccharide conjugated to diphtheria toxoid or other protein. -Given b/t 2m and 18m.
|
|
Describe the major components of a G- cell wall.
|
inner and outer lipid bilayer membranes- thin layer of peptidoglycan- periplasmic space- contains lipopolysaccharide, lipoprotein and phospholipid
|
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Describe the major components of a G+ cell wall.
|
one lipid bilayer membrane- thick layer of peptidoglycan- contains teichoic acid
|
|
Describe the process of conjugation.
|
DNA transfer from one bacterium to another.
|
|
Describe the process of transduction.
|
DNA transfer by a virus from one cell to another
|
|
Describe the process of transformation.
|
purified DNA is taken up by a cell
|
|
Describe the typical findings with diarrhea caused by enterotoxigenic E. coli. (3)
|
1) Ferments lactose 2) watery diarrhea 3) no fever/leukocytosis
|
|
Describe the typical findings with Vibro cholerae. (3)
|
1) Comma-shaped organisms 2) rice-water stools 3) no fever/leukocytosis
|
|
Do Streptococcus pneumonia have catalase? Do Viridans Strep. have catalase?
|
No. both are catalase neg.
|
|
Does endotoxin induce an antigenic response?
|
no, not well
|
|
Does exotoxin induce and antigenic response?
|
Yes, induces high-titer antibodies called antitoxins
|
|
ecthyma gangrenosum
|
Pseudomonas in i.comprimised pt.
|
|
Enterococci are hardier than nonenterococcal group D bacteria. What lab conditions can they grow in?
|
6.5% NaCl (used as lab test)
|
|
Following primary infection with TB, if preallergic lymphatic or hematogenous dissemination occurs, what follows?
|
#NAME?
|
|
Following primary infection with TB, if severe bacteremia occurs, what follows?
|
Miliary tuberculosis and possibly death
|
|
Following primary infection with TB, if the lesion heals by fibrosis, what is the result?
|
Immunity and hypersensitivity---> tuberculin positive
|
|
Following primary infection with TB, under what conditions would the lesion likely progress to lung disease?
|
HIV, malnutrition. This progressive lung disease can rarely lead to death.
|
|
Following primary infection with TB, what are 4 possible courses the disease could take?
|
1) Heals by fibrosis 2) Progressive lung disease 3) Severe bacteremia 4) Preallergic lymphatic or hematogenous dissemination
|
|
Give 3 classic examples of bacteria with antigen variation.
|
(1) Salmonella (2 flagellar variants) (2) Borrelia (relapsing fever) (3) Neisseria gonorrhoeae (pilus protein)
|
|
Give 3 examples of obligate anaerobes.
|
Clostridium - Bacteroides - Actinomyces
|
|
Give 3 types of infection Pseudomonas aeruginosa is commonly responsible for.
|
1) burn wound infection 2) nosocomial pneumonia 3) pneumonia with cystic fibrosis
|
|
Give 4 examples of encapsulated bacteria.
|
1) Strep. pneumoniae (Pneumococcus 2) Haemophilus influenza (especially b) 3) Neisseria memingitidis 4) Klebsiella pneumoniae
|
|
Give two general functions of peptidoglycan
|
Gives rigid support- protects against osmotic pressure
|
|
H. flu causes what? (4)
|
Epiglottitis -Meningitis -Otitis media -Pneumonia (haEMOPhilus)
|
|
How are Borrelia visualized?
|
using aniline dyes (Wright's or Giemsa stain) in light microscopy
|
|
How are Group A and Group B Strep primarily differentiated?
|
Group A are Bacitracin sensitive- Group B are Bacitracin resistant
|
|
How are Mycobacteria visualized in the lab?
|
all Mycobacterium are acid-fast, stain =Ziehl-Neelson
|
|
How are the pathogenic Neisseria species differentiated?
|
on the basis of sugar fermentation
|
|
How are the species of Streptococcus primarily differentiated?
|
on the basis of their HEMOLYTIC capabilities
|
|
How are Treponema visualized?
|
by dark-field microscopy
|
|
How can secondary tuberculosis in the lung occur?(2)
|
1) Reinfection of partially immune hypersensitized hosts (usu. adults) =exogenous source 2) Reactivation of dormant tubercle bacilli in immunocompromised or debilitated hosts =endogenous source
|
|
How can you remember that Viridans strep are resistant to optochin?
|
they live in the mouth and are not afraid of the (opto-)CHIN
|
|
How does primary syphilis present?
|
with a painless chancre (localized disease; 2-10 wks).
|
|
How does secondary syphilis present?
|
disseminated disease (1-3m later) with constitutional symptoms, maculopapular rash, condylomata lata (genital lesions)
|
|
How does tertiary syphilis present?
|
gummas (granulomas), aortitis, neurosyphilis (tabes dorsalis), Argyll-Robertson pupil
|
|
How does the rash with typhus differ from the rash with RMSF?
|
typhus: maculopapillary rash BEGINS ON TRUNCK, moves peripherally -RMSF: macules progressing to petichiae BEGIN ON HANDS &FFET and move inward.
|
|
How is Brucellosis/Undulant fever transmitted?
|
dairy products, contact with animals
|
|
How is Cellulitis transmitted?
|
Animal bite; cats, dogs
|
|
How is H. flu transmitted?
|
aerosol
|
|
How is Legionnaires' disease diagnosed in lab?
|
Gram neg rod. Use silver stain (doesn't Gram stain well) -culture with charcoal yeast extract with iron and cysteine.
|
|
How is Legionnaires' disease transmitted?
|
aeresol transmission from envirnomental water source habitat (NO human-to-human transmission).
|
|
How is Lyme disease transmitted?
|
Tick bite; Ixodes ticks that live of deer and mice
|
|
How is Shigella spread?
|
food, fingers, feces, and flies'
|
|
How is the Plague transmitted?
|
Flea bite; rodents, especially prairie dogs
|
|
How is Tuleremia transmitted?
|
Tick bite; rabbits, deer
|
|
Is Bacillus anthracis G+ or G-? What is its morphology?
|
It is a G+, spore-forming rod
|
|
Is there an animal reservoir for leprosy?
|
Yes, armadillos in the US
|
|
List 5 findings associated with rheumatic fever. (Hint: PECCS)
|
Polyarthritis - Erythema marginatum -Chorea - Carditis - Subcutaneous nodules
|
|
List the 'ABCDEFG' of diphtheria.
|
ADP ribosylation -Beta-prophage -Corynebacterium - Diphtheria - Elongation Factor 2 - Granules
|
|
List the four phases of the bacterial growth curve.
|
Lag phase- log (exponential) phase- stationary phase- death phase
|
|
Name 2 alpha-hemolytic bacteria.
|
Strep. pneumoniae - Viridans streptococci
|
|
Name 2 bugs that cause diarrhea but NOT fever and leukocytosis?
|
E. coli and Vibro cholerae
|
|
Name 2 disease processes that can be caused by enterococci.
|
1) UTI 2) subacute endocarditis
|
|
Name 2 G- rods that are considered slow lactose fermenters.
|
Citrobacter and Serratia
|
|
Name 2 species of enterococci.
|
Enterococcus faecalis -Enterococcus faecium
|
|
Name 2 symptoms of diphtheria.
|
pseudomembraneous pharyngitis (grayish white membrane)- lymphadenopathy
|
|
Name 3 G- rods that are considered fast lactose fermenters.
|
1) Klebsiella 2) E. coli 3) Enterobacter
|
|
Name 3 G- rods which are lactose nonfermenters and Oxidase(-)?
|
Shigella, Salmonella, Proteus
|
|
Name 3 spore forming bacteria.
|
Bacillus anthracis - Clostridium perfringens - C. tetani
|
|
Name 4 bacteria that use IgA protease to colonize mucosal surfaces.
|
1) Strep. pneumoniae 2) Neisseria meningitidis 3) Neisseria gonorrhea 4) H. flu
|
|
Name 4 beta-hemolytic bacteria.
|
1) Staph. aureus 2) Strep. pyogenes (GAS) 3) Strep. agalactiae (GBS) 4) Listeria monocytogenes
|
|
Name 4 genus of bacteria that are G- 'coccoid' rods.
|
1) H. flu 2) Pasteruella 3) Brucella 4) Bordetella pertussis
|
|
Name 4 lactose-fermenting enteric bacteria.
|
E. coli -Klebsiella -Enterobacter Citrobacter (think Lactose is EKE for first three listed)
|
|
Name 5 bugs that cause watery diarrhea.
|
1) Vibrio cholerae 2) enterotoxigenic E. coli 3) viruses (rotavirus) 4) protozoa (Cryptosporidium and (5) Giardia)
|
|
Name 6 bacteria that don't Gram's stain well?
|
Treponema - Rickettsia - Mycobacteria - Mycoplasma - Legionella pneumophila - Chlamydia
|
|
Name 6 bugs that cause bloody diarrhea.
|
1) Salmonella 2) Shigella 3) Campylobacter jejuni 4) enterohemorrhagic/enteroinvasive E.coli 5) Yersinia enterocilitica 6) Entamoeba histolytica (a protozoan)
|
|
Name 7 facultative intracellular bacteria.
|
1) Mycobacterium 2) Brucella 3) Francisella 4) Listeria 5) Yersinia 6) Legionella 7) Salmonella
|
|
Name four genus of bacteria that are G+ rods.
|
1) Clostridium (an anaerobe) 2) Coynebacterium 3) Listeria 4) Bacillus
|
|
Name seven G+ bacteria species that make exotoxins.
|
1) Corynebacterium diphtheriae 2) Clostridium tetani 3) Clostridium botulinum 4) Clostridium perfringens 5) Bacillus anthracis 6) Staph. aureus 7) Strep. pyogenes
|
|
Name three diseases caused by exotoxins.
|
Tetanus- botulism- diptheria
|
|
Name three G- bacteria species that make exotoxins.
|
1) E. coli 2) Vibrio cholerae 3) Bordetella pertussis
|
|
Name three genera of spirochetes.
|
Borrelia (big size) - Leptospira -Treponema (think: BLT; B is big)
|
|
Name three Lactose-fermenting enterics.
|
Eschericia, Klebsiella, Enterobacter
|
|
Name two diseases caused by endotoxins.
|
Meningococcemia- sepsis by G(-) rods
|
|
Name two lab tests used to detect syphilis?
|
VDRL and FTA-ABS
|
|
Name two non-lactose fermenting bacteria that invade intestinal mucosa and can cause bloody diarrhea.
|
Salmonella and Shigella
|
|
Name two obligate intracellular bacteria.
|
Rickettsia and Chlamydia (Hint: 'stay inside when its Really Cold.')
|
|
Name two type of Strep that exhibit alpha hemolysis?
|
S. pneumoniae - Viridans strep. (e.g. S. mutans)
|
|
Name two types of Strep. that are non-hemolytic (gamma hemolysis).
|
Enterococcus (E. faecalis) and Peptostreptococcus (anaerobe)
|
|
Name two types of Strep. that exhibit beta hemolysis.
|
Group A Strep. (S. pyogenes) and Group B Strep. (S. agalactiae)
|
|
pt. w/ CGD is risk infxn for
|
S.aureus, Pseudomonas, Serratia, Nocardia, Aspergillus
|
|
RMSF is endemic to what part of the US?
|
the East Coast (in spite of the name)
|
|
Spore are formed by certain species of what type of bacteria?
|
Gram+ rods, usually in soil; form spores only when nutrients are limited
|
|
T/F Chlamydia are obligate intracellular parasites that cause mucosal infections.
|
TRUE
|
|
T/F Chlamys means cloak.
|
TRUE (intracellular)
|
|
T/F Enterobacteriaceae are oxidase negative and are glucose fermenters.
|
TRUE
|
|
T/F H. pylori infection is a risk factor for peptic ulcer and gastric carcinoma.
|
TRUE
|
|
T/F Penicillin is not an effective treatment against Mycoplasma pneumoniae.
|
TRUE Mycoplama are naturally resistant b/c they have no cell wall.
|
|
T/F Pseudomonas produces both endotoxin and exotoxin.
|
TRUE: endotoxin---> fever, shock -exotoxin---> inactivates EF-2
|
|
T/F Rickettsiae are obligate intracellular parasites and need CoA and NAD.
|
TRUE
|
|
T/F Some enterococci are resistant to PenG.
|
FALSE: ALL enterococci are naturally resistant to Pen/cephlosporins.
|
|
T/F Spores have no metabolic activity.
|
TRUE
|
|
T/F: S. aureus food poisoning is due to the ingestion of bacteria that rapidly secrete toxin once they enter the GI tract.
|
FALSE: rapid onset of S. aureus food poisoning is due to injestion of PREFORMED toxin
|
|
Teichoic acid induces what two cytokines?
|
TNF and IL-1
|
|
The Weil-Felix reaction usually tests positive for what two diseases? Negative for what? Cross reacts with what?
|
Positive: typhus and RMSF -Negative: Q fever -Cross-reacts: with Proteus antigen
|
|
Think COFFEe for Enterobacteriaceae. What does that stand for?
|
Capsular -O-antigen -Flagellar antigen -Ferment glucose -Enterobacteriaceae
|
|
What's a pneumonic for remembering 4 obligate aerobes?
|
Nagging Pests Must Breath (=Norcardia - Pserudomonas aeruginosa - Mycobacterium tuberculosis - Bacillus
|
|
What (6) infections can Pseudomonas aeruginosa cause?
|
burn-wound infections -Pneumonia (esp. in cystic fibrosis) -Sepsis (black skin lesions) -External Otitis (swimmer's ear) - UTI -hot tub folliculitis
|
|
What 2 bugs can cause bloody diarrhea, fever, and leukocytosis, but do not ferment lactose?
|
Salmonella and Shigella
|
|
What animals carry Lyme disease?
|
The Ixodes tick transmits it. - Deer are required for tick life cycle. - Mice are important reservoirs.
|
|
What anitbody class is necessary for an immune response to encapsulated bacteria?
|
IgG2.
|
|
What are 2 disease processes caused by Viridans strep and what species are responsible?
|
1) dental caries: Strep. mutans 2) subacute bacterial endocarditis: Strep. sanguis
|
|
What are 2 options for triple thearpy treatment of H. pylori?
|
(1) bismuth (Pepto-Bismal), metronidazole, and tetracyclin or amoxicillin. OR (2) metronidazole, omeprazole, and clarithromycin (#2 is more expensive)
|
|
What are 3 advantages/differences between VDRL and FTA-ABS?
|
FTA-ABS is 1) more specific 2) positive earlier in disease 3) remains positive longer than VDRL
|
|
What are 3 disease processes caused by Strep. pyogenes?
|
1) Pyogenic--pharyngitis, cellulitis, skin infection 2) Toxigenic--scarlet fever, TSS 3) Immunologic--rheumatic fever, acute glomerulonephritis
|
|
What are 4 biological false positives for VDRL?
|
1) Viruses (mono, hepatitis) 2) Drugs 3) Rheumatic fever and rheumatic arthritis 4) Lupus and leprosy (=VDRL)
|
|
What are 4 clinical symptoms of 'walking' pneumonia?
|
1) insidious onset 2) headache 3) nonproductive cough 4) diffuse interstitial infiltrate
|
|
What are 4 clinical symptoms of TB?
|
1) fever 2) night sweats 3) weight loss 4) hemoptysis
|
|
What are 5 areas that can be affected by extrapulmonary TB?
|
1) CNS (parenchmal tuberculoma or meningitis) 2) Vertebral body (Pott's disease) 3) Lymphadenitis 4) Renal 5) GI
|
|
What are the culture requirement for H. flu?
|
culture on chocolate agar with factor V (NAD) and X (hematin). [Think: 'Child has 'flu'; mom goes to five (V) and dime (X) store to buy chocolate.']
|
|
What are the effects of erythrogenic toxin?
|
it is a superantigen- it causes rash of Scarlet fever
|
|
What are the effects of streptolysin O?
|
it is a hemolysin- it is the antigen for ASO-antibody found in rheumatic fever
|
|
What are the effects of the exotoxin secreted by Bacillus anthracis? (1)
|
one toxin in the toxin complex is an adenylate cyclase
|
|
What are the effects of the exotoxin secreted by Bordetella pertussis? (3)
|
Stimulates adenylate cyclase by ADP ribosylation - causes whooping cough- inhibits chemokine receptor, causing lymphocytosis
|
|
What are the effects of the exotoxin secreted by Clostridium botulinum?
|
blocks release of acetylcholine: causes anticholenergic symptoms, CNS paralysis; can cause 'floppy baby'
|
|
What are the effects of the exotoxin secreted by Clostridium perfringens?
|
alpha toxin is a lecithinase- causes gas gangrene- get a double zone of hemolysis on blood agar
|
|
What are the effects of the exotoxin secreted by Clostridium tetani?
|
blocks release of the inhibitory NT glycine; causes 'lockjaw'
|
|
What are the effects of the exotoxin secreted by Corynebacterium diphtheria? (3)
|
1) inactivates EF-2 by ADP ribosylation 2) pharyngitis 3) 'pseudomembrane' in throat
|
|
What are the effects of the exotoxin secreted by E. coli? (2)
|
this heat labile toxin stimulates adenylate cyclase by ADP ribosylation of G protein - causes watery diarrhea
|
|
What are the effects of the exotoxin secreted by Staph. aureus?
|
superantigen; induces IL-1 and IL-2 synthesis in Toxic Shock Syndrome; also causes food poisoning
|
|
What are the effects of the exotoxin secreted by Vibro cholerae? (3)
|
Stimulates adenylate cyclase by ADP ribosylation of G protein - increases pumping of Cl- and H2O into gut - causes voluminous rice-water diarrhea
|
|
What are the general clinical effects of endotoxin?(2)
|
fever, shock
|
|
What are the lab findings with Chlamydia?
|
cytoplasmic inclusions on Giemsa fluorescent or antibody-stained smear
|
|
What are the symptoms of RMSF? (3)
|
1) rash on palms and soles (migrating to wrists, ankles, then trunck) 2) headache 3) fever
|
|
What are the three stages of Lyme disease?
|
1) erythema chronicum migrans, flu-like symptoms 2) neurologic and cardiac manefestations 3) autoimmune migratory polyarthritis
|
|
What are the two forms of chlamydia?
|
1) Elementary body (small, dense): Enters cell via endocytosis 2) Initial or Reticulate body: Replicates in the cell by fission
|
|
What are the two forms of leprosy (or Hansen's disease)?
|
1) lepromatous- failed cell-mediated immunity, worse 2) tuberculoid- self-limited.
|
|
What are three primary/general effects of endotoxin (especially lipid A)?
|
1) Acivates macrophages 2) Activates completment (alt. pathway) 3) Activates Hageman factor
|
|
What are two drugs that could be used to treat 'walking' pneumonia?
|
tetracycline or erythromycin
|
|
What are two drugs that could treat Chlamydia?
|
erythromycin or tetracycline
|
|
What are two exotoxins secreted by Strep. pyogenes?
|
Erythrogenic toxin and streptolysin O
|
|
What are two functions of the pilus/fimbrae?
|
A Glycoprotein that mediates adherence of bacteria to the cell surface- sex pilus forms attachment b/t 2 bacteria during conjugation
|
|
What are two lab findings associated with 'walking' pneumonia?
|
1) X-ray looks worse than patient 2)High titer of cold agglutinins (IgM)
|
|
What are two species of Gram (-) cocci and how are they differentiated?
|
1) Neisseria memingitidis: maltose, glucose fermenter 2) Neisseria gonorrhoeae: glucose fementer (non maltose)
|
|
What are usually associated with pseudomembraneous colitis?
|
Clostridium difficile; it kills enterocytes, usu. is overgrowth secondary to antibiotic use (esp. clindamycin or ampicillin)
|
|
What bacteria are G+, spore-forming, obligate anaerobic bacilli?
|
Clostridia
|
|
What bacteria causes a malignant pustule (painless ulcer); black skin lesions that are vesicular papules covered by a black eschar?
|
Bacillus anthracis
|
|
What bacteria exhibits a 'tumbling' motility, is found in unpasteurized milk, and causes meningitis in newborns?
|
Listeria monocytogenes
|
|
What bacteria is catalase(-) and bacitracin-resistant?
|
Strep. agalactiae
|
|
What bacteria is catalase(-) and bacitracin-sensitive?
|
Strep. pyogenes
|
|
What bacteria is catalase+ and coagulase+?
|
Staph. aureus
|
|
What bacteria produces a blue-green pigment?
|
Pseudomonas aeruginosa
|
|
What bacteria produces a red pigment?
|
Serratia marcescens ('maraschino cherries are red')
|
|
What bacteria produces a yellow pigment?
|
Staph. aureus (Aureus= gold in Latin)
|
|
What bacteria produces alpha-toxin, a hemolytic lecithinase that causes myonecrosis or gas gangrene?
|
Clostridium perfringens
|
|
What bacterium causes Cellulitis?
|
Pasteurella multocida
|
|
What bacterium causes leprosy?
|
Mycobacterium leprae
|
|
What bacterium causes Lyme disease?
|
Borrelia burgdorferi
|
|
What bacterium causes the Plague?
|
Yersinia pestis
|
|
What bacterium causes Tularemia?
|
Francisella tularensis
|
|
What bacterium causes Undulant fever?
|
Brucella spp. (a.k.a. Brucellosis)
|
|
What bug causes atypical 'walking' pneumonia?
|
Mycoplasma pneumoniae
|
|
What bug causes gastroenteritis and up to 90% of duodenal ulcers?
|
Helicobacter pylori
|
|
What bug causes Legionnaire's disease?
|
Legionella pneumophila
|
|
What bug is associated with burn wound infections?
|
Pseudomonas aeruginosa
|
|
What bug is comma- or S-shaped and grows at 42C, and causes bloody diarrhea with fever and leukocytosis?
|
Campylobacter jejuni
|
|
What bug that causes diarrhea is usually transmitted from pet feces (e.g. puppies)?
|
Yersinia enterocolitica
|
|
What causes tetanus? (give bacteria and disease process)
|
Clostridium tetani: exotoxin produced blocks glycine release (inhibitory NT) from Renshaw cells in spinal cord
|
|
What causes the flu?
|
NOT H. flu -it is caused by influenza virus
|
|
What chemical is found in the core of spores?
|
dipicolinic acid
|
|
What coccobacillus causes vaginosis: greenish vaginal discharge with a fishy smell; nonpainful?
|
Gardnerella vaginalis
|
|
What culture requirements do Fungi have?
|
Sabouraud's agar
|
|
What culture requirements do Lactose-fermenting enterics have?
|
MacConkey's agar (make pink colonies)
|
|
What culture requirements does B. pertussis have?
|
Bordet-Gengou (potato) agar
|
|
What culture requirements does C. diphtheriae have?
|
Tellurite agar
|
|
What culture requirements does H. flu have?
|
chocolate agar with factors V (NAD) and X (hematin)
|
|
What culture requirements does Legionella pneumophia have?
|
Charcol yeast extract agar buffered with increased iron and cysteine
|
|
What culture requirements does N. gonorrhea have?
|
Thayer-Martin (VCN) media
|
|
What disease does Bordetella perussis cause? How?
|
Whooping cough: toxin permanently disables Gi-protein in respiratory mucosa (turns the 'off' off);ciliated epithelial cells are killed; mucosal cells are overactive.
|
|
What disease does Vibrio cholerae cause? How?
|
Cholera: toxin permanently activates Gs-protein in intestinal mucosa (turns the 'on' on) causing rice-water diarrhea
|
|
What disease is caused by Borrelia?
|
Lyme Disease
|
|
What disease is caused by Clostridium botulinum? What pathophys. does it cause?
|
Botulism: associated with contaminated canned food and honey, produces a preformed, heat-labile toxin that inhibits ACh release---> flaccid paralysis.
|
|
What diseases (2) are caused by Treponema?
|
Syphilis (T. pallidum) -yaws (T. pertenue; not an STD)
|
|
What diseases can be caused by Staph. aureus?
|
Inflammatory disease: skin infections, organ abcess, pneumonia - Toxin-mediated disease: Toxic Shock Syn., scalded skin syndrome (exfoliative toxin), rapid onset food poisoning (enterotoxins)
|
|
What do Chlamydia trachomatis serotypes A, B, and C cause?
|
chronic infection, cause blindness in Africa (ABC= Africa / Blindness / Chronic
|
|
What do Chlamydia trachomatis serotypes D-K cause? (3)
|
urethritis/ PID - neonatal pneumonia -neonatal conjuctivitis
|
|
What do Chlamydia trachomatis serotypes L1,L2, and L3 cause?
|
lymphogranuloma venereum (acute lymphadentis: positive Frei test)
|
|
What do RMSF, syphilis, and coxsackievirus A infection have in common?
|
rash on palm and sole is seen in each (coxsackievirus A =hand, foot, and mouth disease)
|
|
What does catalase do? Which bacteria have it?
|
it degrades H2O2, an antimicrobial product of PMNs.- Staphlococci make catalase; Strep. do NOT.
|
|
What does the H-antigen represent?
|
H: flagellar antigen, found on motile species
|
|
What does the K-antigen represent?
|
K: capsular, relates to virulence
|
|
What does the O-antigen represent?
|
O-antigen is the polysaccharide of endotoxin (found on all species)
|
|
What does VDRL detect? (It detects non-specific antibody that reacts with what?)
|
detects antibody that reacts with beef cardiolipin
|
|
What drug of choice is used to treat Norcardia? Actinomyces? (Acronym: SNAP)
|
Sulfa for Norcarida, Actinomyces gets Penicillin
|
|
What enteric bacterial infection may be prolonged with antibiotic treatment?
|
Salmonellosis
|
|
What enzyme allows H. pylori to creat an alkaline environment?
|
urease (cleaves urea to ammonia); used in urease breath test
|
|
What family includes E. coli, Salmonella, Klebsiella, Enterobacter, Serratia, and Proteus?
|
Enterobacteriaceae
|
|
What family of bacteria uses the O-, K-, and H-antigen nomenclature?
|
Enterobacteriaceae
|
|
What function does the capsule serve? (2: one for the bacterium, one other)
|
1) antiphagocytic 2) antigen in vaccines (Pneumovax, H. flu b, meningococcal vaccines)
|
|
What G- rod is a lactose nonfermenter and is Oxidase+ ?
|
Pseudomonas
|
|
What G+ anaerobe causes oral/facial abscesses with 'sulfur granules' that may drain through sinus tracts in skin?
|
Acinomyces israelii
|
|
What G+ and also weakly acid fast aorobe found in soil causes pulmonary infections in immunocompromised patients?
|
Norcardia asteroides
|
|
What general type of bacteria are normal flora in GI tract but pathogenic elsewhere?
|
Anaerobes
|
|
What general type of bacteria grow pink colonies on MacConkey's agar?
|
Lactose-fermenting enteric bacteria
|
|
What is a function of the plasma membrane in bacterial cells.
|
site of oxidative and transport enzymes
|
|
What is a Ghon complex and in whom does it occur?
|
Occurs in Primary TB (usually a child) -Ghon complex= draining Hilar nodes and Ghon focus, exudative parenchymal lesion (usu. in LOWER lobes of lung)
|
|
What is a lab diagnosis of diphtheria based on?
|
G+ rods with metachromatic granules; grows on tellurite agar. (Coryne=club shaped)
|
|
What is a major difference between Salmonella and Shigella observable in the lab?
|
Salmonella are motile; Shigella are nonmotile
|
|
What is a positive Quellung reaction?
|
if encapsulated bug is present, capsule SWELLS when specific anticapsular antisera are added.
|
|
What is a toxoid?
|
exotoxin treated with formaldehyde (or acid or heat); retains antigenicity but looses toxicity
|
|
What is an acronym for remembering 6 bacteria that don't Gram's stain well?
|
TRMMLC: These Rascals May Microscopically Lack Color
|
|
What is meant by alpha, beta, and gamma hemolysis?
|
On a Blood agar plate: Beta= complete; clear - alpha= partial; green - gamma= no hemolysis; red
|
|
What is notable about Chlamydia psittaci?
|
has an avian reservoir
|
|
What is one reason M. leparae infects skin and superficial nerves?
|
It likes cool temperatures
|
|
What is the chemical composition of a glycocalix?
|
polysaccharide
|
|
What is the chemical composition of bacterial ribosomes?
|
RNA and protein in 30S and 50S subunits
|
|
What is the chemical composition of endotoxin?
|
Lipopolysaccharide
|
|
What is the chemical composition of exotoxin?
|
polypeptide
|
|
What is the chemical composition of spores?
|
keratin-like coat- dipicolinic acid
|
|
What is the classic symptom of Lyme Disease?
|
erythema chronicum migrans, an expanding 'bull's eys' red rash with central clearing.
|
|
What is the classic triad of symptoms associated with Rickettsiae?
|
1) headache 2) fever 3) rash (vasiculitis)
|
|
What is the common manifestation of secondary TB?
|
Fibrocaseous cavitary lesion usu. in APICIES of lung
|
|
What is the common site of infection for Mycobacterium tuberculosis?
|
the apicies of the lung (which have the highest PO2)
|
|
What is the DOC for treatment of most rickettsial infections?
|
tetracycline
|
|
What is the DOC to treat Lyme Disease?
|
tetracycline
|
|
What is the DOC to treat syphilis?
|
Penicillin G
|
|
What is the drug of choice (D.O.C.) to treat Gardnerella vaginalis?
|
Metronidazole
|
|
What is the drug of choice for H. flu meningitis? What Drug for prophylaxis in close-contacts?
|
Treat meningitis with CEFTRIAXONE; Rifampin for prophylaxis.
|
|
What is the drug of choice for Legionaires' disease?
|
Erythromycin
|
|
What is the funciton and chemical composition of the flagellum?
|
for motility- made of protein
|
|
What is the function of a glycocalix?
|
mediates adherence to surfaces, especially foreign surfaces (i.e. catheters)
|
|
What is the function of spores?
|
provides resistance to dehydration, heat, and chemicals
|
|
What is the major chemical composition of the capsule?
|
Polysaccharide (*except Bacillus anthracis, which contains D-Glutamate)
|
|
What is the major function of the capsule?
|
antiphagocytic
|
|
What is the mode of action of endotoxin?
|
includes TNF and IL-1
|
|
What is the morphology of H. flu?
|
Small G(-) (coccobacillary) rod
|
|
What is the morphology of H. pylori?
|
Gram (-) rod
|
|
What is the nature of the DNA transferred in conjugation?
|
Chromosomal or plasmid
|
|
What is the nature of the DNA transferred in transduction?
|
Any gene in generalized transduction; only certain genes in specialized transduction
|
|
What is the nature of the DNA transferred in transformation?
|
Any DNA
|
|
What is the periplasm? Where is it found?
|
the space between the inner and outer cell membranes found in G(-) bacteria.
|
|
What is the primary drug used to treat leprosy?
|
dapsone (toxicity is hemolysis and methemoglobinemia)
|
|
What is the primary test to subcatergorize G- rods?
|
are they Lactose Fermenters?
|
|
What is the recommended treatment for Pseudomonas aeruginosa infection?
|
aminoglycoside plus extended-spectrum penicillin (e.g. piperacillin or ticarcillin)
|
|
What is the source of endotoxins?
|
cell wall of most G- bacteria (think N-dotoxin=gram Negative)
|
|
What is the source of exotoxins?
|
certain species of some G+ and G- bacteria
|
|
What is the source of infection and the bacterium that causes endemic typhus?
|
R. typhi; from fleas
|
|
What is the source of infection and the bacterium that causes epidemic typhus?
|
R. prowazekii; from human body louse
|
|
What is the source of infection and the bacterium that causes Q fever?
|
Coxiella burnetii; from inhaled aerosols
|
|
What is the source of infection and the bacterium that causes Rocky Mountain Spotted Fever?
|
Rickettsia rickettsii; from tick bite
|
|
What is the toxin responsible for TSS is Staph. aureus?
|
TSST-1; it is a superantigen that binds to class II MHC and T-cell receptors---> polyclonal T-cell activation
|
|
What is the unique chemical component of Gram (-) cell membranes?
|
Lipopolysaccharide
|
|
What is the unique chemical component of Gram + cell membranes?
|
Teichoic acid
|
|
What is the unique component found in Mycoplasma bacterial membranes?
|
cholesterol
|
|
What is the unique feature of Chlamydiae cell walls?
|
its peptidoglycan wall lacks muramic acid
|
|
What is used to stain Legionella?
|
Use silver stain.
|
|
What is woolsorter's disease?
|
inhalation anthrax; can cause life-threatening pneumonia
|
|
What lab test assays for antirickettsial antibodies?
|
Weil-Felix reaction
|
|
What Lancefield Antigen Group are enterococci in?
|
Group D
|
|
What Lancefield Antigen Group are Viridans strep in?
|
They are non-typeable. They do not have a C-carbohydrate on their cell wall to be classified by.
|
|
What level of disinfection is required to kill spores?
|
autoclaving; they are highly resistant to destruction by heat and chemicals
|
|
What populations are most likely to get Mycoplasma pneumoniae infection?
|
patients younger than age 30 - military recruits - prisons
|
|
What rickettsial disease is atypical in that it has no rash, no vector, negative Weil-Felix reaction, and its causative organism can survive outside for a long time?
|
Q fever (Coxiella burnetii)
|
|
What species are associated with food poisoning in contaminated seafood?
|
Vibrio parahaemolytica and Virbrio vulnificus
|
|
What species causes diphtheria?
|
Corynebacterium diptheriae
|
|
What species is associated with food poisoning in improperly canned foods (bulging cans)?
|
Clostridium botulinum
|
|
What species is associated with food poisoning in meats, mayonnaise, and custard?
|
Staphylococcus aureus (this food poisoining usu. starts quickly and ends quickly)
|
|
What species is associated with food poisoning in poultry, meat, and eggs?
|
Salmonella
|
|
What species is associated with food poisoning in reheated meat dishes?
|
Clostridium perfringens
|
|
What species is associated with food poisoning in reheated rice?
|
Bacillus cereus ('Food poisoning from reheated rice? Be serious!')
|
|
What species is associated with food poisoning in undercooked meat and unpasteurized juices?
|
E. coli 0157-H7
|
|
What species is Group A Strep?
|
S. pyogenes
|
|
What species is Group B Strep?
|
S. agalactiae
|
|
What species of Mycobacteria causes pulmonary, TB-like symptoms?
|
M. kansasii
|
|
What stain is amyloid and gives an apple-green birefringence in polarized light?
|
Congo red
|
|
What stain is used for acid fast bacteria?
|
Ziehl-Neelsen
|
|
What stain is used for Borrelia, Plasmodium, trypanosomes, and Chlamydia?
|
Giemsa's
|
|
What stain is used for Cryptococcus neoformans?
|
India ink
|
|
What stains gylcogen, mucopolysaccharides and is used to diagnose Whipple's disease?
|
PAS (periodic acid Schiff)
|
|
What strain of Haemophilus influenza causes most invasive disease?
|
capsular type b
|
|
What symptoms are associated with M. scrofulaceum
|
cervical lymphadenitis in kids
|
|
What test differentiates Viridans from S. pneumoniae?
|
Viridans are resistant to optochin; S. pneu. are sensitive to optochin
|
|
What test distinguishes Staph. and Strep?
|
Staph. are Catalase (+) and are in clusters - Strep. are Catalase (-) and are in chains
|
|
What test distinguishes Staph. aureus from Staph. epidermidis and Staph. saprophyticus?
|
S. aureus is Coagulase (+) - S. epidermidis and S. saprophyticus are Coagulase (-)
|
|
What two bugs secrete exotoxins that act via ADP ribosylation of G-proteins, permanently activating adenyl cyclase (resulting in increased cAMP)?
|
Vibrio cholerae - Bordetella pertussis
|
|
What two genera of G+ rods form long branching filaments resembling fungi?
|
Acinomyces and Nocardia
|
|
What two things distinguish S. pneumoniae from Viridans Strep.?
|
S. pneumoniae: have Capsule (+Quellung); Optochin Sensitive - Viridans strep: No capsule; Optochin Resistant
|
|
What type of bacteria are difficult to culture, produce gas in tissue (CO2 and H2), and are generally foul-smelling?
|
Anaerobes
|
|
What type of bacteria is associated with rusty sputum, sepsis in sickle cell, and splenectomy?
|
Pneumococcus
|
|
What type of E. coli are associated with bloody diarrhea?
|
enterohemmoragic/ enteroinvasive E. coli
|
|
What type of enzymes allows certain bacteria to colonize mucosal surfaces?
|
IgA proteases
|
|
What type of immunologic response is elicited by a Salmonella infection?
|
monocyte response
|
|
What types of infection can chlamydia cause? (4)
|
arthritis - conjunctivitis - pneumonia - nongonococcal urethritis
|
|
What virulence factor of Staph. aureus binds Fc-IgG, inhibiting complement fixation and phagocytosis?
|
Protein A
|
|
What virulence factor of Strep. pyogenes also serves as an antigen to which the host makes antibodies?
|
M-protein
|
|
What will likely be visible under the microscope in the case of Gardnerella vaginallis infection?
|
Clue cell, or vaginal epithelial cells covered with bacteria
|
|
When endotoxin activates complement, what are the secondary effects?
|
C3a: hypotension, edema - C5a: neutrophil chemotaxis
|
|
When endotoxin activates Hageman factor, what are the secondary effects?
|
coagulation cascade: DIC
|
|
When endotoxin activates macrophages, what 3 cytokines are released and what are the secondary effects?
|
IL-1--fever - TNF--fever, hemmoragic tissue necrosis - Nitic oxide--hypotension, shock
|
|
Where are the genes for endotoxin located?
|
on the bacterial chromosome
|
|
Where are the genes for exotoxin located?
|
on a plasmid or in a bacteriophage
|
|
Where are the spores of Clostridium botulinum found?
|
canned food- honey
|
|
Where are Viridans strep. found (reservoir)?
|
normal flora of oropharynx
|
|
Where are when is Lyme disease common?
|
common in northeast US in summer months
|
|
Where is LPS found?
|
in the outer membrane of G (-) cell walls
|
|
Which disease/toxin causes lymphocytosis? (Cholera or Pertussis)
|
Pertussis toxin: by inhibiting chemokine receptors
|
|
Which has a higher toxicity: exotoxin or endotoxin?
|
EXOTOXIN: fatal dose is ~1ug! (for endotoxin, fatal dose is hundreds of micrograms)
|
|
Which has an animal reservoir? (Salmonella or Shigella)
|
Salmonella: poultry, meat, eggs
|
|
Which is more specific for syphilis: VDRL or FTA-ABS?
|
FTA-ABS is more specific
|
|
Which is more virulent? (Salmonella or Shigella)
|
Shigella is more virulent (10^1 organisms vs. Salmonella 10^5 organisms)
|
|
Which is motile? (Salmonella or Shigella)
|
Salmonella (think: salmon swim)
|
|
Which species of chlamydia causes an atypical pneumonia? How is it transmitted?
|
C. pneumonia -transmitted via aerosol
|
|
Which species of chlamydia causes urethritis?
|
C. trachomatis
|
|
Which two species of chlamydia infect only humans?
|
C. trachomatis -C. pneumoniae
|
|
Which type of Neisseria ferment Glucose only?
|
Gonococci (Glucose= Gonococci)
|
|
Which type of Neisseria ferment maltose and glucose?
|
Meningococci (MaltoseGlucose= MeninGococci)
|
|
Which types of transfer can eukaryotic cells do?
|
only transformation
|
|
Which types of transfer can prokaryotic cells do?
|
all 3: conjugation, transduction, and transformation
|
|
Why are anaerobes susceptible to oxygen?
|
they lack catalase and/or oxidase and are susceptible to oxidative damage
|
|
Why does TB usually infect the upper lobes of the lung?
|
M.tuberculosis is an aerobe; there is more oxygen at the apicies
|
|
Why don't Mycobacteria Gram's stain well?
|
high lipid content cell wall requires acid-fast stain
|
|
Why don't Mycoplasma Gram's stain well?
|
no cell wall
|
|
Why don't Rickettsia, Chlamydia, and Legionella Gram's stain well?
|
they are intracellular (Legionella is Mainly intracellular)
|
|
Why don't Treponema Gram's stain well?
|
too thin to be visualized (use darkfield microscopy and antibody staining)
|
|
Why must rickettsia and chlamydia always be intracellular?
|
they can't make their own ATP
|
|
Are most fungal spores asexual?
|
yes
|
|
Are most P. Carinii infections symptomatic?
|
no, most of are asymptomatic
|
|
Are the above mentioned systemic mycoses dimorphic?
|
yes, (histoplasmosis, Paracoccidioidomycosis, Blastomycosis) except coccioidomycosis which is a spherule in tissue
|
|
Aspiration pneumonia is usually caused by脰
|
Anaerobes
|
|
Atypical pneumonia is usually caused by脰
|
Mycoplasma Pneumoniae (walking pneumonia), Legionella, Chlamydia pneumoniae
|
|
Bug Hints: Branching rods in oral infection =
|
Actinomyces israelii
|
|
Bug Hints: Currant jelly sputum =
|
Klebsiella
|
|
Bug Hints: Dog or cat bite =
|
Pasteurella multocida
|
|
Bug Hints: Pediatric Infection =
|
H. influenzae (including epiglottitis)
|
|
Bug Hints: Pneumonia in CS, burn infection =
|
P. aeruginosa
|
|
Bug Hints: Pus, Empyema, Abscess =
|
S. aureus
|
|
Bug Hints: Sepsis/Meningitis in Newborn =
|
Group B strep
|
|
Bug Hints: Surgical wound =
|
S. aureus
|
|
Bug Hints: Traumatic open wound =
|
Clostridium perfringens
|
|
How do the S. Schenckii yeast appear in the pus?
|
Cigar-shaped budding yeast
|
|
How do you diagnose cryptosporidium?
|
cysts on acid fast stain
|
|
How do you diagnose giardiasis?
|
Trophozoites or cysts in stool
|
|
How do you get P. Carinii?
|
Inhalation
|
|
How do you treat systemic mycoses (fungus)?
|
fluconazole or ketoconazole for local infection, amphotericin B for systemic infection
|
|
How do you Tx S. Schenckii?
|
Itraconazole or Potassium Iodide
|
|
How does Aspergillus appear microscopically?
|
Mold with septate hyphae that branch at a V-shaped (45 degree angle), rare Fruiting Bodies, they are NOT dimorphic
|
|
How does Mucor species appear microscopically?
|
It is a mold with irregular nonseptate hyphae branching at wide angles>90 degrees
|
|
How does Paracocciodioidomycosis appear histologically?
|
Captain's wheel' appearance (like on a sailboat)
|
|
How is Clonorchis sinensis transmitted and what disease results?
|
undercooked fish; causes inflammation of the biliary tract
|
|
How is Schistosoma transmitted and what disease results?
|
snails are host; cercariae penetrate skin of humans; causes granulomas, fibrosis, and inflammation of the spleen and liver
|
|
How is Ancylostoma Duodenale (Hookworm) transmitted and what disease results?
|
Larvae penetrate skin of feet; intestinal infection can cause anemia
|
|
How is Ascaris Lumbricoides (Giant roundworm) transmitted and what disease results?
|
Eggs are visible in feces; intestinal infection
|
|
How is cryptosporidium transmitted?
|
Cysts in Water
|
|
How is Dracunculus medinensis transmitted and what disease results?
|
In drinking water; sink inflammation and ulceration
|
|
How is E. Histolytica transmitted?
|
Cysts in Water
|
|
How is Echinococcus Granulosis transmitted and what disease results?
|
Eggs in dog feces cause cysts in liver; causes anaphylaxis if echinococcal antigens released from cysts
|
|
How is Enterobius Vermicularis (Pinworm) transmitted and what disease results?
|
food contaminated with eggs; intestinal infections; causes anal pruritus (don't scratch your bum and suck your thumb)
|
|
How is giardia transmitted?
|
Cysts in Water
|
|
How is Loa loa transmitted and what disease results?
|
Transmitted by deer fly; causes swelling the in the skin (can see worm crawling in conjunctiva)
|
|
How is malaria dx?
|
Blood smear
|
|
How is malaria transmitted?
|
mosquito (Anopheles)
|
|
How is Onchocerca volvulus transmitted and what disease results?
|
transmitted by female blackflies; causes river blindness
|
|
How is Paragonimus Westermani transmitted and what disease results?
|
Undercooked crab meat; causes inflammation and secondary bacterial infection of the lung
|
|
How is Sporothrix schenckii appear under the scope?
|
Dimorphic fugus that lives on vegetation
|
|
How is Strongyloides Stercoralis transmitted and what disease results?
|
larvae in soil penetrate the skin; intestinal infection
|
|
How is T. Solium transmitted and what disease results?
|
undercooked pork tapeworm; causes mass lesions in the brain, cysticercosis
|
|
How is T. Vaginalis transmitted?
|
sexually
|
|
How is Toxo transmitted?
|
cysts in meat or cat feces
|
|
How is Toxocara Canis transmitted and what disease results?
|
food contaminated with eggs; causes granulomas (if in retina=blindness)
|
|
How is Trichinella Spiralis transmitted and what disease results?
|
undercooked meat, usually pork; inflammation of muscle, periorbital edema
|
|
How is Wuchereria Bancrofti transmitted and what disease results?
|
female mosquito; causes blockage of lymphatic vessels (elephantiasis)
|
|
In what cells do you find histoplasmosis?
|
macrophages
|
|
Incidence of what cause of mengitis has decreased with a vaccine?
|
Incidence of H. influenze meningitis has decreased greatly with introduction of H. influenzae vaccine in the last 10-15 years
|
|
Is Pneumocystis Carinii (PCP) a yeast?
|
Yes, but originally classified as a Protozoa
|
|
Microscopically how does Candida appear?
|
budding yeast with pseudohyphae, germ tube formation at 37 degrees C)
|
|
Most osteomyelitis occurs in what age group?
|
children
|
|
Name 3 Trematodes (Flukes) .
|
Schistosoma, Clonorchis sinensis, Paragonimus Westermani
|
|
Name 4 opportunistic fungal infections.
|
Candida Albicans, Aspergillus fumigatus, Cryptococcus Neoformans, Mucor and Rhizopus species
|
|
Name 4 systemic mycoses.
|
Coccidiomycosis, Histoplasmosis, Paracoccidioidomycosis, Blastomycosis
|
|
Name two asexual spores transmitted by inhalation.
|
Histoplasmosis and Coccidiodomycosis
|
|
Name two Cestodes (Tapeworms) .
|
Taenia Solium, and Echinococcus Granulosus
|
|
Neonatal pneumonia is usually caused by脰
|
Group B streptococci, E. coli
|
|
Nosocomial pneumonia is usually caused by脰
|
Staphylococcus, gram-negative rods
|
|
PID includes what disorders in the body?
|
salpingitis, endometritis, hydrosalpinx, tubo-ovarian abscess
|
|
PID is likely caused by what two organisms?What are the characteristics of the disease caused by each organism?
|
#NAME?
|
|
Pneumonia in immunocompromised patients is caused by脰
|
Staphylococcus, gram-negative rods, fungi, viruses, Pnemumocystis carinii (with HIV)
|
|
Pneumonia in the alcoholic/IV drug user is usually caused by脰
|
S. pneumoniae, Klebsiella, Staphylococcus
|
|
Postviral pneumonia is usually caused by脰
|
Staphylococcus, H. influenzae
|
|
Salpingitis is a risk factor for脰
|
#NAME?
|
|
UTIs are found in men in which 2 age groups?
|
Babies with congenital defects and Elderly with enlarged prostates
|
|
UTIs are mostly caused how?
|
by ascending infections
|
|
What's the likely cause of osteomyelitis in a pt where you have no other information?
|
S. aureus
|
|
What 2 pathogens likely cause nosocomial infections associated with urinary catherization?
|
E. coli, Proteus mirabilis
|
|
What 2 pathogens likely cause nosocomial infections in the newborn nursery?
|
CMV, RSV
|
|
What 7 organisms are associated with UTIs?
|
- Serratia marcescens- Staphylococcus saprophyticus- E. coli- Enterobacter cloacae- Klebsiella pneumoniae- Proteus mirabilis- Pseudomonas aeruginosa[HINT: SSEEKS PP]
|
|
What abnormal lab result is often seen in osteomyelitis patients?
|
elevated ESR
|
|
What agar is used to culture for systemic mycoses?
|
Sabouraud's Agar
|
|
What are 4 clinical findings of Pyelonephritis?
|
#NAME?
|
|
What are 4 clinical findings of UTIs?
|
#NAME?
|
|
What are Conidia?
|
asexual fungal spores (ex. Blastoconidia, and arthroconidia)
|
|
What are some common Candida infections?
|
THRUSH in throat of Immunocompromised pts (neonates, patients on steroids, diabetics and AIDS pts) , endocarditis in IV drug users, vaginitis (high pH, Diabetes, post-antibiotic) , diaper rash, disseminated candidiasis (to any organ)
|
|
What are some infections caused by cryptococcus?
|
Cryptococcal meningitis, cryptococcosis
|
|
What are the 2 most common causes of nosocomial infections?
|
E. coli causes UTI- S. aureus causes wound infection
|
|
What are the 3 most common causes of UTI in young ambulatory women?
|
1. E. coli (50-80%)2. Staphylococcus saprophyticus (10-30%)3. Klebsiella (8-10%)
|
|
What are the 4 B's of Blastomycosis?
|
Big, Broad-Based, Budding
|
|
What are the common causes of hospital-acquired UTIs?
|
#NAME?
|
|
What are the common causes of meningitis in 6-60y/o?
|
#NAME?
|
|
What are the common causes of meningitis in 60+ y/o?
|
#NAME?
|
|
What are the common causes of meningitis in children (6mo-6y/o)?
|
#NAME?
|
|
What are the common causes of meningitis in HIV pts?
|
#NAME?
|
|
What are the common causes of meningitis in newborns (0-6mos)?
|
#NAME?
|
|
What are the common causes of osteomyelitis in those with prosthetic replacements?
|
S. aureus and S. epidermidis
|
|
What are the common causes of pneumonia in adults 18-40 y/o?
|
#NAME?
|
|
What are the common causes of pneumonia in adults 40-65 y/o?
|
#NAME?
|
|
What are the common causes of pneumonia in children (6wk-18yrs)?
|
#NAME?
|
|
What are the CSF finings in bacterial meningitis (pressure, cell type, protein and sugar levels)?
|
#NAME?
|
|
What are the CSF finings in fungal/TB meningitis (pressure, cell type, protein and sugar levels)?
|
#NAME?
|
|
What are the CSF finings in viral meningitis (pressure, cell type, protein and sugar levels)?
|
#NAME?
|
|
What are the diseases caused by Cryptosporidium?
|
Severe diarrhea in AIDS, Mild disease (watery diarrhea) in non-HIV
|
|
What are the diseases caused by Toxoplasma?
|
Brain Abscess in HIV and birth defects
|
|
What are the dominant normal florae in the colon?
|
Bacteroides fragilis > E. coli
|
|
What are the dominant normal florae in the vagina?
|
Lactobacillus, colonized by E. coli and group B strep
|
|
What are the infections caused by Aspergillus?
|
Ear fungus, Lung cavity Aspergilloma ('fungus ball') , invasive aspergillosis.
|
|
What are the predisposing factors of UTIs?
|
#NAME?
|
|
What can systemic mycoses mimic?
|
TB (granuloma formation)
|
|
What disease are caused by Entamoeba Histolytica?
|
Amebiasis: bloody diarrhea, dysentery, liver abscess, RUQ pain
|
|
What disease does Mucor species cause?
|
Mucormycosis
|
|
What disease does Pneumocystis carinii cause?
|
Pneumocystis Carinii Pneumonia
|
|
What disease does Sporothrix Schenckii cause?
|
Sporotrichosis
|
|
What disease does Trypanosoma Cruzi cause?
|
Chaga's Disease (heart disease)
|
|
What disease is caused by Giardia Lamblia?
|
Giardiasis: bloating, flatulence, foul-smelling diarrhea
|
|
What disease is caused by Leishmanina donovani?
|
Visceral Leishmaniasis (Kala-azar)
|
|
What disease is caused by P. Carinii?
|
Diffuse interstitial pneumonia in HIV
|
|
What disease is caused by the plasmodium species (vivax, ovale, malariae, falciparum) ?
|
MALARIA: cyclic fever, headache, anemia, splenomegaly
|
|
What disease is caused by Trypanosma Gambiense and Rhodesiense?
|
African Sleeping sickness
|
|
What disesase does Trichomonas Vaginalis cause?
|
Vaginitis: foul-smeilling, greenish discharge; itching and burning
|
|
What do you tx P. Carinii with?
|
TMP-SMZ, pentamidine, dapsone
|
|
What do you use to culture cryptococcus?
|
Sabouraud's Agar
|
|
What do you use to Diagnose E. Histolytica?
|
Serology and/or trophozoites or cysts in stool
|
|
What do you use to stain Cryptococcus?
|
India Ink
|
|
What do you use to tx cryptosporidium?
|
nothing
|
|
What do you use to Tx Giardiasis?
|
Metronidazole
|
|
What do you use to tx T. Vaginalis?
|
Metronidazole
|
|
What do you used to dx P. Carinii?
|
Lung biopsy or lavage, methenamine silver stain
|
|
What do you used to Tx Candida Albicans?
|
Nystatin for superficial infection, Amphotericin B for systemic infection
|
|
What does dimorphic mean?
|
fungi that are mold in the soil (low temp) and yeast in tissue (higher/body temp 37 C)
|
|
What form is cryptococcus and where do you find it?
|
heavily encapsulated yeast (not dimorphic), found in soil and pigeon droppings
|
|
What infections are dangerous in pregnancy?
|
Toxoplasma, Rubella, CMV, HSV/HIV, Syphilis[HINT: ToRCHeS]
|
|
What is chandelier sign?
|
Cervical motion tenderness associated with Pelvic Inflammatory Disease (PID)
|
|
What is diagnositic for L. donovani?
|
Macrophages containg amastigotes
|
|
What is diagnositic of T. Vaginalis?
|
Trophozoites on wet mount
|
|
What is histoplasmosis associated with?
|
bird or bat droppings
|
|
What is the 2nd leading cause of community-acquired UTI in sexually active women?
|
Staphylococcus saprophyticus
|
|
What is the characterisitc of Trichomonas on a slide?
|
motile on wet prep
|
|
What is the common cause of osteomyelitis in IV drug users?
|
Pseudomonas aeruginosa
|
|
What is the common cause of osteomyelitis in most people?
|
S. aureus
|
|
What is the common cause of osteomyelitis in sickle cell pts?
|
Salmonella
|
|
What is the common cause of osteomyelitis in the sexually active?
|
N. gonorrhoeae (rare), septic arthritis more common
|
|
What is the common cause of osteomyelitis in the vertebra?
|
M. tuberculosis
|
|
What is the dominant normal flora contributes to dental plaque?
|
Streptococcus mutans
|
|
What is the dominant normal flora in the nose?
|
S. aureus
|
|
What is the dominant normal flora in the oropharynx?
|
viridans streptococci
|
|
What is the dominant normal flora on the skin?
|
S. epidermidis
|
|
What is the most common STD in the U.S.?
|
Chlamydia trachomatis causes 3-4 million cases per year
|
|
What is the progression of S. Schenckii infection?
|
traumatic introduction into the skin, typically by a thorn ('rose gardner's' disease) , causes local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) . Little systemic illness.
|
|
What is the vector for L. donovani?
|
Sandfly
|
|
What is the vector for T. Cruzi?
|
Reduviid Bug
|
|
What is the vector for T. Gambiense and Rhodesiense?
|
Tstese fly
|
|
What is used to dx African sleeping sickness?
|
Blood smear
|
|
What is used to dx T. Cruzii?
|
blood smear
|
|
What is used to dx toxoplasma?
|
serology and biopsy
|
|
What is used to treat D. Medinensis?
|
Niridazole
|
|
What is used to Treat E. Histolytica?
|
Metronidazole and Iodoquinol
|
|
What is used to tx african sleeping sickness?
|
Suramin for bloodborne disease or melarsoprol for CNS penetration
|
|
What is used to tx Ancylostoma duodenale?
|
Mebendazole/pyrantel pamoate
|
|
What is used to tx Ascaris Lumbricoides?
|
Mebendazole/pyrantel pamoate
|
|
What is used to tx Clonorhis sinensis?
|
Praziquantel
|
|
What is used to tx E. Granulosus?
|
Albendazole
|
|
What is used to tx E. Vermicularis?
|
Mebendazole/pyrantel pamoate
|
|
What is used to tx L. Donovani?
|
Sodium Stibogluconate
|
|
What is used to tx Loa loa?
|
diethylcarbamazine
|
|
What is used to tx malaria?
|
Chloroquine ( primaquine for vivax, ovale), sulfadoxine + pyrimethamine, mefloquine, quinine
|
|
What is used to tx Onchocerca Volvulus?
|
Ivermectin
|
|
What is used to tx Paragonimus Wetermani?
|
Praziquantel
|
|
What is used to tx S. Stercoralis?
|
Ivermectin/thiabendazole
|
|
What is used to tx schistosoma?
|
Praziquantel
|
|
What is used to tx T. Cruzii?
|
Nifurtimox
|
|
What is used to tx T. Spiralis?
|
Thiabendazole
|
|
What is used to tx taenia solium infection?
|
Praziquantel/niclosamide; albendazole for cysticercosis
|
|
What is used to tx Toxocara Canis?
|
diethylcarbamazine
|
|
What is used to tx toxoplasma?
|
sulfadiazine + pyrimethamine
|
|
What is used to tx Wuchereria. Bancrofti?
|
diethylcarbamazine
|
|
What organism can you presume is causing a nosocomial infection if respiratory equipment or burns are involved?
|
Psudomonas aeruginosa
|
|
What organism is the leading cause of UTI and shows a metallic sheen on EMB agar?
|
E. coli
|
|
What parasites have antigen variation?
|
trypanosomes (programmed rearrangement)
|
|
What pathogen is associated with hyperalimentation?
|
Candida albicans
|
|
What pathogen is associated with water (ie. aerosols)?
|
Legionella
|
|
What pathogen likely causes nosocomial infections from respiratory therapy equipment?
|
Pseudomonas aeruginosa
|
|
What pathogen likely causes nosocomial infections in the renal dialysis unit?
|
HBV
|
|
What patient population is susceptible to Mucor disease?
|
Ketoacidotic diabetic patients and Leukemic patients
|
|
What population does not have any flora?
|
Neonates delivered by cesarean section have no flora but are rapidly colonized after birth
|
|
What ratio is UTIs found more in women vs. men? Why?
|
10 to 1 because women have short urethrae more likely to be colonized by fecal flora
|
|
What stain do you use for lung tissue when you are detecting P. Carinii (PCP)?
|
silver
|
|
What state predisposes you to P. Carinii infection?
|
Immunosuppression
|
|
What STD is associated with Argyll-Robertson pupil?
|
3' Syphilis
|
|
What STD is associated with clue cells?
|
Garnerella
|
|
What STD is associated with Genital warts and loilocytes? What is the causative agent?
|
- Condylomata acuminata- HPV 6 and 11
|
|
What STD is associated with jaundice? What is the causative agent?
|
#NAME?
|
|
What STD is associated with opportunistic infections, Kaposi's sarcoma, lymphoma? What is the causative agent?
|
#NAME?
|
|
What STD is associated with painful penile, vulvar or cervical ulcers? What's the causative agent?
|
#NAME?
|
|
What STD is associated with painful ulcers, lymphadenopathy, rectal strictures? What is the causative agent?
|
#NAME?
|
|
What STD is associated with urethritis, cervicitis, conjuntivitis, Reiter's syndrome, Pelvic Inflammatory Disease (PID)? What is the causative agent?
|
Chlamydia- Chlamydia trachomatis
|
|
What STD is associated with vaginitis? What is the causative agent?
|
#NAME?
|
|
What STD is characterized by painful genital ulcer? What is the causative agent?
|
#NAME?
|
|
What STD is likely in a patient with a painless chancre? What causes it?
|
- 1' Syphilis- Treponema pallidum
|
|
What STD is likely in a patient with fever, lymphadenopathy, skin rashes, condylomata lata? What causes it?
|
- 2' Syphilis- Treponema pallidum
|
|
What STD is likely in a patient with gummas, tabes dorsalis, general paresis, aortitis, Argyll-Robertson pupil? What causes it?
|
- 3' Syphilis- Treponema pallidum
|
|
What STD is likely in a patient with urethritis, cervicitis, PID, prostatitus, epididymitis, arthritis? What organism causes it?
|
#NAME?
|
|
What test can be used to detect polysaccharide capsular antigen of Cryptococcus?
|
latex agglutination test
|
|
What types of infections can Candida Albicans cause?
|
systemic or superficial fungal infections
|
|
What UTI-causing organism has a bue-green pigment, fruity odor and is usually nosocomial and drug-resistant?
|
Pseudomonas aeruginosa
|
|
What UTI-causing organism is characterized by a large mucoid capsule and viscous colonies?
|
Klebsiella pneumoniae
|
|
What UTI-causing organism is mobile, causing 'swarming' on agar and also produces urease and is associated with struvite stones?
|
Proteus mirabilis
|
|
What UTI-causing organism is often nosocomial and drug-resistant?
|
Enterobacter cloacae
|
|
What UTI-causing organism sometimes produces a red pigment, is often nosocomial and drug-resistant?
|
Serratia marcescens
|
|
When do you start prophylaxis in HIV patients?
|
when the CD4 drops below 200 cells/mL
|
|
Where do the mucor and rhizopus species fungi proliferate?
|
in the walls of blood vessels and cause infarction of distal tissue
|
|
Where is Blastomycosis endemic?
|
States east of the Mississippi River and Central America
|
|
Where is Coccidioidomycosis endemic?
|
Southwest US, California (San Joaquin Valley or destert (desert bumps) 'Valley fever')
|
|
Where is Histoplasmosis endemic?
|
Mississippi and Ohio River valleys
|
|
Where is Paracoccioidomycosis endemic?
|
Rural Latin America
|
|
(T or F) Viral nucleic acids with same structure as host are infective alone; others require special enzymes (contained in intact virion.)
|
same
|
|
All viruses are haploid except _________?(1)
|
Retroviruses, which have two identical ssRNA molecules (diploid).
|
|
Bites from what 3 animals are more prone to rabies infection than a bite from a dog?
|
Bat, Raccoon, and Skunk
|
|
Define complementation?
|
When one of 2 viruses that infects the cell has a mutation that results in a nonfunctional protein. The nonmutated virus 'complements' the mutated one by making a functional protein that serves both viruses.
|
|
Define genetic drift.
|
Minor changes based on random mutations.
|
|
Define genetic shift.
|
Reassortment of viral genome(such as when human flu A virus recombines with swin flu A virus.)
|
|
Define phenotypic mixing?
|
When virus A acquires virus B coat proteins and acts like virus B buts its progeny will have virus A genome and coat.
|
|
Define reassortment?
|
#NAME?
|
|
Define recombination?
|
Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology.
|
|
Describe its incubation period and whether or not it has a carrier.
|
"Short incubation period (3 weeks)- No carriers
|
|
Describe the general concept of bacterial super infection which can occur with influenza infection?
|
A life-threatening illness where a bacterial infection is superimposed on an existing viral infection.
|
|
Describe the genetic and physical properties of influenza virus?
|
#NAME?
|
|
Describe the migration of rabies within the CNS.
|
It migrates in a retrograde fashion within the CNS up nerve axons.
|
|
Describe the physical shape and duration of incubation for rabies.
|
-Bullet-shaped capsid (illus. in book)-long incubation period (wks. - 3 months)
|
|
Describe the technique and purpose for performing a Tzanck test?
|
assay for herpes-make a smear of an opened skin vesicle to detect multinucleated giant cells
|
|
Does HDV have carriers?
|
Yes
|
|
dz. process of HSV
|
cyclical
|
|
Explain the concept of a slow virus infection.
|
Virus exists in patient for months to years before it manifests as clinical disease.
|
|
HCV is a common form of hepatitis in what US population?
|
IV drug users
|
|
How does a Monospot test work?
|
It detects heterophil antibodies by agglutination to sheep RBC's
|
|
How is RNA translated and processed in picornaviruses?
|
RNA is translated into one long polypeptide that is cleaved by proteases into many small proteins.
|
|
How many segments and what sense is the RNA genome of influenza viruses?
|
-8 segments-negative sense
|
|
How may serotypes do paramyxoviruses have except parainfluenza which has ___?
|
1- 4- RSV also has 2 serotypes
|
|
Into what class RNA or DNA do all segmented viruses fall?
|
RNA
|
|
Killed vaccines induce what type of immunity?
|
Humoral, with no possibility of the virus reverting to virulence
|
|
Live attenuated vaccines induce what type of immunity?
|
Humoral and Cellular-with a risk of the virus reverting to virulence
|
|
Mneumonic for Hep A
|
Hep A: Asymptomatic (usually)
|
|
Mneumonic for rotavirus symptoms: ROTA
|
Right Out The Anus
|
|
Mneumonic: Hep D
|
Hep D: Defective, Dependent on HBV
|
|
Mneumonic: Hep E
|
Hep E: Enteric, Expectant mothers, Epidemics
|
|
Mneumonic: Hep B
|
Hep B: Blood-borne
|
|
Mneumonic: picoRNAvirus
|
pico = 'small' RNA viruses
|
|
Name 2 common bacterial infections in AIDS pts.
|
TB, M. avium (intracellulare complex)
|
|
Name 2 common protozoan infections in AIDS pts.
|
Toxoplasmosis, cryptosporidiosis
|
|
Name 3 members of the arborvirus family.
|
Flavivirus, Togavirus, and Bunyavirus
|
|
Name 3 possible sequelae of measles infection?
|
-SSPE- encephalitis- giant cell pneumonia (rare;found in immunocompromised persons)
|
|
Name 4 common fungal infections in AIDS pts.
|
Thrush (Candida ablicans)- cryptococcosis (cryptococcal meningitis)- histoplasmosis- Pneumocystis pneumonia
|
|
Name 4 common viral infections in AIDS pts.
|
HSV- VZV- CMV- PML(progressive multifocal leukoencephalopathy-JC virus)
|
|
Name 4 herpesviruses using the mneumonic:Get herpes in a CHEVrolet.
|
CMV-HSV-EBV-VZV
|
|
Name 4 main segmented viruses using the mneumonic BOAR.
|
#NAME?
|
|
Name eveloped DNA viruses (3).
|
#NAME?
|
|
Name naked DNA viruses (3). PAP
|
-Parvo-Adeno-Papova'You need to be naked for a PAP smear.'
|
|
Name the 3 naked RNA virusesNaked
|
#NAME?
|
|
Name the characteristic cytoplasmic inclusions seen in neurons infected with rabies virus.
|
Negri bodies
|
|
Name the DNA viruses using the mneumonic'HHAPPPy viruses.'
|
#NAME?
|
|
Name the illness caused by rabies and 2 primary symptoms.
|
Fatal encephalitis with seizures and hydrophobia.
|
|
Name the members of the PaRaMyxovirus using the letters in bold (4 viruses).
|
#NAME?
|
|
Name the recombinant vaccine available (1).
|
HBV (antigen = recombinant HBsAg)
|
|
Name the RNA enveloped viruses (9).
|
#NAME?
|
|
Name the RNA nucleocapsid viruses (3).
|
#NAME?
|
|
Name the vaccines that are killed (4).
|
#NAME?
|
|
Name the vaccines that are live attenuated (6).
|
#NAME?
|
|
Of these 3 markers (HBsAg, HBsAb, HBcAg), which ones are positive in each of the 4 phases below:(acute disease, window phase, complete recovery, chronic carrier).
|
Acute: HBsAg, HBcAg- Window: HBcAg- Complete Recovery: HBsAb, HBcAg- Chronic Carrier: HBsAg, HBcAg
|
|
On HIV, what is gp41 and gp120?
|
envelope protein
|
|
On HIV, what is p24? (illus. p. 205)
|
rectangular nucleocapsid protein
|
|
Roughly, what are the time periods for acute, latent, and immunodeficient stages of HIV?
|
Acute: 1-3 months, Latent: 3 months-3years, Immunodefic: 3 yrs.-death
|
|
Use the mneumonic PERCH to name members of the Picornavirus family.
|
#NAME?
|
|
What 2 antigens are used to classify influenza?
|
Neuraminadase, Hemagglutinin
|
|
What age group is the primary target of paramyxoviruses?
|
children
|
|
What antiviral treatment is approved for influenza A (especially prophylaxis) but not for influenza B & C
|
Amantadine and Rimantadine
|
|
What antiviral treatment is approved for influenza A and B?
|
Zanamivir and Oseltamivir
|
|
What are Councilman bodies and what are they pathomneumonic for?
|
acidophilic inclusions seen in the liver of those with yellow fever
|
|
What are the 3 C's of measles?
|
-Cough- Coryza (acute rhinitis)- Conjunctivitis; Be sure to look for Koplik spots
|
|
What are the 4 C's of HCV.
|
Chronic, Cirrhosis, Carcinoma, Carriers
|
|
What are the 4 most common diseases caused by prions?
|
Creutzfeldt-Jakob disease (CJD: rapid progressive dementia)- kuru-scrapie(sheep)- 'mad cow disease'
|
|
What are the causes of SSPE and PML in immunocompromised pts.
|
#NAME?
|
|
What are the classic symptoms of yellow fever?
|
high fever- black vomitous- jaundice
|
|
What are the common diseases (1) and routes of transmission(1) for HHV-8?
|
Kaposi's sarcoma (HIV pts.)- sexual contact
|
|
What are the common diseases (2) and routes of transmission(2) for EBV?
|
infectious mononucleosis, Burkitt's lymphoma- resp. secretions, saliva
|
|
What are the common diseases (2) and routes of transmission(2) for HSV-2?
|
herpes genitalis, neonatal herpes- sexual contact, perinatal
|
|
What are the common diseases (3) and routes of transmission(1) for VZV?
|
varicella zoster (shingles)- encephalitis-pneumonia
|
|
What are the common diseases (3) and routes of transmission(2) for HSV-1?
|
gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis, herpes labialis- respiratory secretions and saliva
|
|
What are the common diseases (3) and routes of transmission(6) for CMV?
|
congenital infection, mononucleosis, pneumonia- congenital, transfusion, sexual contact, saliva, urine, transplant
|
|
What are the general characteristics of a prion?
|
infectious agent that does not contain RNA or DNA, consists only of protein
|
|
What are the primary symptoms of the mumps virus? (MOP)
|
#NAME?
|
|
What are two classic illness caused by arborviruses?
|
-dengue fever (break-bone fever)- Yellow fever
|
|
What general form of encephalopathies do prions present as?
|
spongiform encephalopathies
|
|
What genetic property does segmentation afford viruses and how does this play into flu epidemics?
|
#NAME?
|
|
What group has a high mortality rate from HEV?
|
pregnant women
|
|
What hematologic finding is characteristic of mono?
|
abnormal circulating cytotoxic T cells (atypical lymphocytes)
|
|
What is HBcAb, and what does it indicate?
|
Antibody to HBcAg; IgM HBcAb indicates recent disease
|
|
What is HBcAg?
|
Antigen associated with core of HBV
|
|
What is HBeAb, and what does it indicate?
|
Antibody to e antigen; indicates low transmissibility
|
|
What is HBeAg, and what does it indicate?
|
it is a 2nd different antigen marker of HBV core; indicates transmissibility (HBeAg=Beware)
|
|
What is HBsAb, and what does it do?
|
Antibody to HBsAg; provides immunity to hepatitis B
|
|
What is HBsAg, and what does it indicate?
|
Antigen found on surface of HBV; continued presence indicates carrier state
|
|
What is IgM HAVAb, and what is it used to detect?
|
IgM antibody to HAV; best test to detect active hepatitis A
|
|
What is meant by the 'window period' in HBV infection, and what is positive in this period?
|
It is the period between disappearance of HBsAg and appearance of Anti-HBs; HBcAb is pos. during this period.
|
|
What is the classic vector for arborvirus?
|
Arthropods (mosquitos, ticks, etc.)ARBOR=Arthropod Borne
|
|
What is the function of reverse transcriptase in HIV?
|
synthesize dsDNA from RNA for integration into host genome.
|
|
What is the major mode of protection from influenza virus?
|
Killed viral vaccine which is reformulated each year and is given to those in high risk of infection (elderly, health-workers, etc.)
|
|
What is the method behind ELISA/Western blot and during what period of HIV infection are they often negative?
|
look for abs to viral proteins; false negatives common in first 1-2 months of infection
|
|
What is the mneumonic for remembering the Tzanck smear?
|
Tzanck heavens I don't have herpes.
|
|
What is the only DNA virus that is not double stranded?
|
Parvoviridae (ssDNA)
|
|
What is the only RNA virus that has dsRNA?
|
Reoviridae has dsRNA
|
|
What is the viral cause of the common cold?
|
-Rhinovirus, 100+ serotypes-Rhino has a Runny nose.
|
|
What neurologic infection can picornaviruses (except rhinoviruses and hepatitis A viruses) cause?
|
Aseptic Meningitis
|
|
What physical finding is diagnostic for measles?
|
Koplik spots(bluish-gray spots on buccal mucosa)
|
|
What population should not receive a live vaccine?
|
Those who are immunocompromised and their close contacts.
|
|
What reproductive complication can mumps cause?
|
sterility; especially after puberty
|
|
What shape are all the DNA viruses? Which virus (1) is the exception?
|
#NAME?
|
|
What test is used to make the presumptive dx of HIV, and then, which test confirms the dx?
|
ELISA (sensitive w/ high false + and low threshold);Western blot (specific, high false - rate with high threshold)
|
|
What tests are gaining popularity for monitoring drug tx efficacy in HIV?
|
PCR/viral load tests that measure viral RNA in the blood
|
|
What type of genome does HIV have?
|
diploid RNA
|
|
What type of nucleic acid structure does rotavirus have?
|
segmented dsRNA (a reovirus)
|
|
What type of transcription occurs and what type of polymerase does HBV possess?
|
Reverse transcription- the virion contains an DNA-dependent DNA polymerase
|
|
What type of virus is HAV and how is it transmitted?
|
RNA picornavirus- fecal-oral route
|
|
What type of virus is HBV and how is it transmitted?
|
DNA hepadnavirus- parenteral, sexual, and maternal-fetal routes
|
|
What type of virus is HCV and how is it transmitted?
|
RNA flavivirus- via blood and resembles HBV in its course and severity
|
|
What type of virus is HDV and what is special about its envelope?
|
delta agent, it is a defective virus-requires HBsAg as its envelope
|
|
What type of virus is HEV and how is it transmitted?
|
RNA calicivirus- enteric transmission; causes water-borne epidemics
|
|
What variant of dengue fever is found in Southeast Asia?
|
hemorrhagic shock syndrome
|
|
What virus causes and what are the classic symptoms of mononucleosis?
|
EBV- fever, hepatosplenomegaly, pharyngitis, lymphadenopathy (esp. posterior auricular nodes)
|
|
What virus causes yellow (=flavi) fever, and what is its vector and reservoirs (2)?
|
flavivirus- Aedes mosquitos- monkey or human reservoir
|
|
What virus is the most common global cause of infantile gastroenteritis and acute diarrhea during winter (in the US).
|
Rotavirus
|
|
Where do enveloped viruses acquire their envelopes, and what virus is the exception to this rule?
|
#NAME?
|
|
Where in the cell do DNA viruses replicate, and which virus is the exception to this rule?
|
-Nucleus- exception: poxvirus in cytoplasm (carries DNA-dependent RNA polymerase)
|
|
Where in the cell do RNA viruses replicate, and what 2 viruses are the exception to this rule?
|
#NAME?
|
|
Which marker tests are appropriate for each phase of hepatitis infection:Incubation, Prodrome/acute illness, Early Convalescence, Late Convalescence.
|
HBsAg- HBsAg (Anti-HBc)- Anti-HBc- Anti-HBs (anti-HBc)
|
|
Which two DNA viruses don't have a linear genome?(they're circular)
|
Papovaviruses and Hepadnaviruses
|
|
Which two hepatitis viruses follow the fecal-oral route?
|
A and E; 'The vowels hit your bowels.'
|
|
Which two hepatitis viruses predispose to hepatocellular carcinoma?
|
HBV and HCV
|
|
Why is mono called the 'kissing disease?'
|
Peak incidence occurs during peak kissing years 15-20 yo-(saliva transmission)
|