Term
|
Definition
bacteria with no cell wall, uses sterols from host in membrane... has very simple genome... uses adhesion proteins to bind to host cell, is not internalized |
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Term
mycoplasma pneumoniae kills cells by? |
|
Definition
adheres to host cell and secretes peroxide and superoxide |
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Term
Mycoplasmal "walking" pneumonia |
|
Definition
mild, atypical pneumonia and bronchitis... causes mild symptoms |
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Term
Why can't mycoplasmal pneumonia be treated by B-lactams? |
|
Definition
no cell wall, can't be treated with anything that works on cell walls |
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|
Term
How is mycoplasmal pneumonia spread? |
|
Definition
respiratory droplets... makes it common in school/college kids |
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Term
Be able to identify light/heavy chain and variable/constant region |
|
Definition
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|
Term
6 functions of antibodies |
|
Definition
nuetralization - occlude surface of toxin or pathogen :: Interfere with pili and flagella :: agglutination (makes for easier phagocytosis) :: Opsonization (enhances phagocytosis) :: compliment activation via the classical pathway :: tag for destruction - NK cells bind to Fc part of antibody and kill attached cell |
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Term
|
Definition
antibody-dependent cullular cytotoxicity :: NK cells seek out antibody-bound cells and kill them |
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Term
5 different kinds of antibodies, classified based on Fc part |
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Definition
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Term
|
Definition
first response, pentamer (allows for agglutination because it has so many binding sites) |
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Term
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Definition
most common in blood, longest lived (21 days), can cross placenta |
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Term
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Definition
main secreted in mucus, dimer, in breast milk - 1st line of defense in babies |
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Term
|
Definition
Dunno... found on memory B cells |
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Term
|
Definition
involved in allergic response, extension of Fc region allows it to bind to mast cells |
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Term
|
Definition
all start with IgM, some receive cytokine signals from Th cells which tells them to switch the heavy chain gene to IgG or IgA |
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Term
how is the class switching system involved in immune memory? |
|
Definition
first exposure produces IgM, and eventually some IgG.. second exposure produces mostly IgG in larger amount and much more quickly -- this is the basis for vaccinations |
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Term
How can so few antibody genes result in so many antibody proteins? |
|
Definition
somatic recombination - antibody genes are put together by combining parts (genetic cut and paste) :: Heavy chain v, D, and J regions and light chain V and J regions plus random imprecise joining |
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Term
|
Definition
pre-B cells, lymphoid stem cell precursors |
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Term
Each B cell produces how many types (VDJ combo) of antibody? |
|
Definition
one -- so we have about a billion B cells |
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Term
When does somatic recombination happen? |
|
Definition
before birth -- we are born with all the antibody-producing capacity we will ever have. |
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Term
|
Definition
B cells produce surface-bound antibodies before birth :: receptors bind antigens from a bacterium :: B cell engulfs antigen via endocytosis and presents it on MHCII :: If there is an activated Th cell nearby whose T cell receptor recognizes the same antigen, the Th cell binds to the B cell MHCII/antigen complex :: the Th cell secretes cytokines which causes the B cell to divide and produce clones of itself, some of which turn into plasma cells and some turn into memory cells |
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Term
|
Definition
when B cells divide to produce clones of itself (some are plasma cells and some are memory B's) |
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Term
|
Definition
secrete antibodies (IgM first, the IgG and IgA) |
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|
Term
Why do only specific B cells get activated and not just any? |
|
Definition
because their surface receptors have to recognize the antigen |
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|
Term
Why are some B cells never used? |
|
Definition
because they never run into the antigen that they have surface receptors for |
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|
Term
Why do some b cells recognize self? |
|
Definition
VDJ joining is random - nothing directs it to make only antibodies |
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Term
Clonal deletion (negative selection) |
|
Definition
Eliminating B cells that recognize self -- in bone marrow any B cells that bind antigen are made to die because the body assumes the bone marrow is not infected :: in circulation, any B cell that binds to an antigen but does not get activated by a Th cell becomes anergic and eventually dies |
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Term
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Definition
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|
Term
why do t cell receptors only have one antigen binding site, whereas antibodies have two? |
|
Definition
because t cell receptors only have 1 arm |
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|
Term
Th cell surface molecule vs. Tc cell surface molecule. |
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Definition
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|
Term
T_ bind to MHC2 and T_ bind to MHC1 |
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Definition
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|
Term
MHC2 complexes are only on ___ cells, whereas MCH1 are on all cells |
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Definition
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|
Term
Th cells secrete ___, whereas Tc cells secrete ____. |
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Definition
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|
Term
MHC1 presents from ____, whereas MHC2 presents from. What significance is this? |
|
Definition
cytoplasm (inside cell), exogenous antigens (didn't originally come from within cell) ... MHC1 can also present self antigens because it presents anything that might be in the cytoplasm |
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Term
|
Definition
1. TCR binding to MHC2 and antigen, CD4 binding to MHC2 :: 2. Co-stimulatory peptide B7 binding to CD28 |
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Term
|
Definition
by APC upon binding of PMP to TLR |
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Term
|
Definition
|
|
Term
|
Definition
1. TCR binding to MHC1 and antigen, CD8 binding to MHC1 :: 2. CD28 binding to B7 of APC OR cytokine (IL-2) is released from activated Th cells |
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|
Term
T cells bind ___ antigens, whereas B cells bind ___ antigens |
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Definition
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|
Term
the 2nd signal in t cell activation ensures that? |
|
Definition
t cells are only activated by phagocytes that have engulfed pathogens |
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|
Term
What happens to T cells that don't receive the 2nd activation signal? |
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Definition
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|
Term
|
Definition
important to prevent random immune responses that can be harmful to the body |
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|
Term
naive vs. effector T cells |
|
Definition
naive - haven't seen any "trouble" yet :: effector - activated, have an effect |
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Term
Activated Tc cell function |
|
Definition
Bind to cell wtih correct antigen on its MHC1, release cytotoxins that induce apoptosis in target cell, release cytokines that help stimulate nearby macrophages |
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Term
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Definition
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|
Term
3 functions of activated (effector) Th cells |
|
Definition
stimulate proliferation and differentiation of B cells that have engulfed T-dependent antigens, binds to MHC2 of macrophage and secretes cytokines to boost the macrophage response, activates self to proliferate Th cells and clonal selection |
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|
Term
B cells can only engulf things bound to __ (#) receptor(s) |
|
Definition
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|
Term
Th cells can activate B cells to produce ____. |
|
Definition
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|
Term
B cells usually need to be bound to ___ to avoid anergy, the exception to this rule is if they bind ____. |
|
Definition
T cells, repeating antigens |
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Term
|
Definition
T-independent antigen conjugated to a protein |
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|
Term
How does a conjugate vaccine work? |
|
Definition
A B cell binds to the T-independent antigen in the vaccine and internalizes the whole conjugate. It digests it and presents the protein on MHC2. A Th cells recognizes the protein and stimulates B cells to make antibodies to the original T-independent antigen. Also creates memory B cells and plasma cells. |
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|
Term
Why are conjugate vaccines so much stronger than polysaccharide vaccines? |
|
Definition
polysaccharide vaccines bind on many B cell receptors, so the B cell cannot engulf the whole thing (it thinks its too big to engulf) -- thus it cannot create any memory B or plasma cells :: conjugate vaccines bind to only 1 BCR, so it can engulf it, present it on MHC2, and make memory and plasma B cells |
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|
Term
How to Th cells boost the macrophage response? |
|
Definition
makes more lysosomes, nitric oxide is added to the oxidative burst, and giant cells and granulomas form -- basically, it enhances the phagocytic response |
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Term
|
Definition
long lived, can be reactivated by just binding an antigen (no need for CD28/B7 signal) |
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Term
|
Definition
AKA regulatory T cells - reduce the T cell response once antigen is gone (when infection is gone) |
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|
Term
T cell clonal deletion occurs where |
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Definition
|
|
Term
__% of T cells are selected against (deleted) |
|
Definition
|
|
Term
|
Definition
T cells must bind to MHC1 in the thymus to be stimulated to develop, so T cells that fail to recognize MHC could never fuction and are left to die |
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|
Term
Negative T cell Selection |
|
Definition
T cells must NOT bind to an antigen on the MHC in the thymus (because any antigens are self antigens), so if it does, the binding is too tight for them to be released into ciruclation |
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|
Term
Why do cancer and virus-infected cells proliferate? |
|
Definition
they don't have MHC1, so they failt to cancel the kill signal |
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|
Term
|
Definition
they bind to Fc part of an antibody whos Fab parts are bound to a bacterium via ADCC, then bind to killer receptor on any other cell (kill signal), release cytotoxins to kill attached cell |
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|
Term
Why don't NK cells kill every cell in our body? |
|
Definition
if MHC1 is also present, the "Kill signal" is canceled |
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|
Term
T-independent vs T-dependent antigens |
|
Definition
T-dependent- B cell receptors need to bind to T cell |
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|
Term
|
Definition
produce by your own body in response to normal events |
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|
Term
|
Definition
produced by another, or inresponse to unnatural events |
|
|
Term
|
Definition
you are producing your own Ig (vaccines, for ex.) ... takes time |
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|
Term
|
Definition
you are receiving someone else's Ig (antibodies) :: ex: IgG from placenta, IgA from breastfeeding, antiserum (snake antivenoms, etc) |
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|
Term
antiserums are ___, ____ immunity |
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Definition
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|
Term
|
Definition
when there are enough people immune to an infection that the infection cannot spread rapidly for lack of hosts ... "enough people" depends on the disease |
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|
Term
antiserums, immunglubulin shots are ____-term only |
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Definition
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|
Term
weakened form of the infectious agent that does not produce disease but DOES grow in the body |
|
Definition
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|
Term
how are live attenuated vacciens made? |
|
Definition
passage through artificial host (something that it doesn't normally infect), which will weaken it ... or knock out genes associated with infection in lab |
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|
Term
Why are live attenuated vaccines more effective? |
|
Definition
because the organisms actually grow in the body, it elicits a stronger immune response |
|
|
Term
oral live attenuated vaccines |
|
Definition
triggers B cell response in tissues -- results in IgA production ... can also be nasal spray |
|
|
Term
Injected live attenuated vaccine |
|
Definition
triggers circulating B cells - produces IgG |
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|
Term
How do you know how to give a vaccine (orally or injected)? |
|
Definition
give the vaccine how the bug would normally be transmitted - if it's inhaled or injested, give it orally/nasally |
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Term
|
Definition
actual infectious agent is not present - usually elicits a weaker immune response by has no risk to even an immunocompromised patient. |
|
|
Term
why do inactivated vaccines usually involve a series of shots? |
|
Definition
because organisms are not actually living in your body, so it elicits a weaker immune response |
|
|
Term
Inactivated vaccines usually include an adjuvant... why? |
|
Definition
enhances B7 production by dendritic cells -- boosts immune response |
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|
Term
|
Definition
|
|
Term
|
Definition
pathogen inactivated with formalin |
|
|
Term
|
Definition
vaccine against inactivated toxin, not whole bacterium |
|
|
Term
|
Definition
isolate a specific PMP on the pathogen and just make the vaccine with these parts |
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|
Term
|
Definition
|
|
Term
Protein conjugate vaccines use T-independent or T-dependent antigens? |
|
Definition
|
|
Term
All vaccines induce humoral immunity, Good (attenuated) vaccines induce ____ immunity |
|
Definition
|
|
Term
attenuated/inactive vaccines have longer life |
|
Definition
|
|
Term
two reasons to use inactivated vaccines |
|
Definition
for immunocompromised patients, and for warm climates |
|
|
Term
Edible vaccines are basically just ___ vaccines. |
|
Definition
|
|
Term
how do dna-based vaccines provide immunity without exposure to a disease agent? |
|
Definition
inject a pathogen's dna into the patient's cells, so you make the pathogen's proteins for a short time... then you can present the bad proteins on MHC and activate an immune response |
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|
Term
advantage of edible vaccines |
|
Definition
you can have them wherever you can grow them ... for example norovirus vaccine in potatoes |
|
|
Term
|
Definition
detecting antibodies for a pathogen in a patient who previously had none ... going from antibody negative to antibody positive titer |
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|
Term
|
Definition
maximum dilution that still gives a positive result for the antibody... so a titer of 1:256 is more concentrated (has more antibodies) than 1:16 |
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|
Term
Importance of antibody titer |
|
Definition
compare convalescent serum to pre-immune serum to see if you have been infected |
|
|
Term
|
Definition
PIS - serum before infection (average in population) |
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|
Term
|
Definition
antibody titer as you recover from disease |
|
|
Term
|
Definition
produced from a single B cell |
|
|
Term
|
Definition
produced from whole blood serum, contains IgG to many epitopes |
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Term
|
Definition
precipitate of an otherwise insoluble antigen due to antibodies cross linking antigens and forming large, insoluble aggregates -- requires an optimized antibody antigen ratio -- like agglutination |
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Term
|
Definition
Either an antibody or an antigen is loaded into center well in agar plate... load serum from patients in separate wells in circle around center... if the patient's serum reacts iwth the antigen/antibody in the middle, a precipitant forms as a line between the two |
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|
Term
Immunoelectrophoresis test |
|
Definition
mixture of antiens separated by electrophoresis based on charge, a patient's serum is added to a trough in the gel... if the patient's antibodies react with the antigen, a line of precipitate will form |
|
|
Term
3 kinds of tests for precipitin |
|
Definition
agglutination, immunoelectrophoresis, and immunodiffusion |
|
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Term
|
Definition
bind known antibodies with fluorescently tagged Fc ends to patient sample that may contain the antigen ... looks for antigen in the patient |
|
|
Term
Indirect antibody testing |
|
Definition
look to see if patient is making antibodies against a particular antigen... binds antibodies from the patient to a known antigen on the slide, then bind anti-Fc secondary antibodies (that are usually fluorescently tagged) to primary antibodies |
|
|
Term
Why do indirect tests take longer to work? |
|
Definition
because you're looking for an antibody, which takes a while to make. |
|
|
Term
Why do indirect tests take longer to work? |
|
Definition
because you're looking for an antibody, which takes a while to make. |
|
|
Term
|
Definition
enzyme-linked immunosorbant assay... uses microtiter plates.. antibodies or antigens are tagged with enzyme that creates a certain color... change in color = positive |
|
|
Term
example of an indirect ELISA test? |
|
Definition
|
|
Term
|
Definition
confirmatory AIDS test if indirect ELISA is positive -- electrotransfer separates antigens |
|
|
Term
Koch's postulates proved what? |
|
Definition
how bacteria make you sick |
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|
Term
Koch's Postulates (and revisions) |
|
Definition
The bacterium must be present in every disease case (toxins - bacteria aren't present, and idiopathology), The bacterium must be isolated from the disease case and grown in pure culture (most bacteria can't be grown in pure culture anyway, and diseases are often caused by multiple bacteria), The specific disease must be reproduced from pure culture in a healthy susceptible host inoculated with the bacterium (still do - except now we usually use animal model instead of humans -- problem with AIDS, we don't have a good animal model), The bacterium must be recoverable from the susceptible host. |
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|
Term
Derivative of Koch's postulates that we now use |
|
Definition
Molecular Koch's postulate -- isolates infective GENE from bacteria |
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Term
|
Definition
organism is in your body and causing disease... more organism = more sick... kill organism = cure |
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Term
|
Definition
toxin produced by organism causes disease - organism doesn't have to be present at all -- antibiotics have no effect on course of disease |
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|
Term
First step in infection is ___ |
|
Definition
adhesion of the organism to host cells |
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|
Term
how do bacteria bind to host cells? |
|
Definition
pili with special adhesin proteins at the tip (called fimbriae) bind to specific receptors on your cells |
|
|
Term
Why do our cells have receptors for bacteria? |
|
Definition
we don't on purpose - the receptors are actually for something else and the bacteria have evolved to be able to use them. (ex: Nicerria Gonorrhea binds to CD46 whihc is usually a cancel kill signal for NK cells |
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|
Term
Pathogens must out-compete ___ to colonize successfully. |
|
Definition
|
|
Term
How do pathogens outcompete native flora to colonize successfully? |
|
Definition
IgA protease destroys IgA, iron siderophores steal iron from host, secreted effectors enhance binding and uptake via Type 3 SS (get taken up into cells quickly by causing ruffles in host cell membranes) |
|
|
Term
|
Definition
produced by pathogenic strains and enhance invasion and/or colonization of host by bacterium (make a bacterium more virulent) |
|
|
Term
Genes for Virulence factors are often passed between bacterial cells as a unit called ____... this is an example of _____. |
|
Definition
pathogenicity island, horizontal gene transfer |
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|
Term
pathogenicity islands as compared to swapping homework |
|
Definition
swapping one gene at a time would be like swapping one problem at a time, so they swap as pathogenicity islands (PAIs), which is like transferring an entire assignment at once |
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|
Term
____ is well known for swapping virulence factors via PAIs... makes it hard to stop |
|
Definition
|
|
Term
How bacteria get into body |
|
Definition
Penetrate skin (often through trauma or insect bite), penetrate mucus membranes gut, urogenital, resp tract(via ruffling of epithelial cells, uptake by M cells, and direct phagocytosis) |
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|
Term
Why would you want to get phagocytized if you're a pathogen? |
|
Definition
macrophages are much stronger once they've been activated by Th cells, so the bacteria can survive if they've been phagocytized BEFORE the macrophage is activated |
|
|
Term
how do bacteria hide inside cells? |
|
Definition
via actin rockets -- avoids humoral immunity (antibodies) which is outside the cells ... ex: shigella taken up by M cells, spread to epithelial cells via macrophags, spread within epithelial cells by actin rockets |
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|
Term
how do bacteria get the actin rockets? |
|
Definition
|
|
Term
how do bacteria avoid complement? |
|
Definition
host cells avoid alternate complement by blocking C3b... bacteria (esp Ng) steal the host C3b regulatory protein |
|
|
Term
How do self cells avoid complement? |
|
Definition
we have a C3b regulatory protein, which prevents activating complement |
|
|
Term
ways to avoid phagocytosis |
|
Definition
C5a peptidase - prevents PMN recruitment by digesting C5a :: Lysins - lyse phagocyte (leukocidins) :: capsules - special surface proteins such as M protein block PMPs :: Fc receptors (Staph protein A) bind the Fc part of Ig and presents "self" antigen to body |
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|
Term
3 ways bacteria can live in phagocytes |
|
Definition
break out of phagosome and live in the cytoplasm ... prevent phagosome/lysosome fusion ... live in phagolysosome |
|
|
Term
How do bacteria avoid antibodies? |
|
Definition
IgA protease, antigenic variation (Ng pilus "cassette switching"), hyaluronic acid (self antigen) capsule |
|
|
Term
5 ways bacteria can hide in the body |
|
Definition
avoid antibodies, live in phagocytes, avoid phagocytes, avoid complement, and avoid immune system by living in cells |
|
|
Term
___ is the only endotoxin, and it's only found in gram pos/neg bacteria |
|
Definition
|
|
Term
The vaccine for LPS is only against what part? |
|
Definition
|
|
Term
How does LPS endotoxin lead to septic shock? |
|
Definition
serum protein LBP (lipid-binding protein) binds LPS from lysed bacterial cells, then binds to lymphocyte surface protein CD14 and TLR4.This induces citokine secretion which increases WBC production and capillary permeability (diapedesis)... systemic infection = septic shock |
|
|
Term
components of septic shock |
|
Definition
hypovolemia, organ failure, DIC (disseminated intravascular coagulation), death |
|
|
Term
how do you make sure IV fluid is LPS-free? |
|
Definition
Limulus amoebocyte assay (LAL) test -- amoebocytes are motile RBCs in the horseshoe crab... even very small concentrations of LPS causes these to clot |
|
|
Term
Endotoxin effect on host vs exotoxin effect |
|
Definition
endotoxin - always same effect, exotoxin - variable. |
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|
Term
Endotoxin/exotoxin induces fever |
|
Definition
|
|
Term
Where are the genes for endotoxin carried? exotoxin? |
|
Definition
endo - on chromosome, exo- on plasmid or PAI |
|
|
Term
Where is endo/exotoxin is secreted whereas endo/exotoxin is part of cell membrane |
|
Definition
|
|
Term
Why is there no vaccine against endotoxin? |
|
Definition
because the only vaccine is against the o-polysaccharide part of LPS, but the toxic part is Lipid A |
|
|
Term
|
Definition
B- binding part... binds to receptor, is not toxic itself.. often used as subunit vaccine (cholera) :: A- active (Toxic) part |
|
|
Term
3 ways the A part of A-B toxin works |
|
Definition
mess up cell signaling via signal kinase, alter cAMP concentration by affecting H2O balance in cell, interferes with translation |
|
|
Term
How are A-B toxins named? |
|
Definition
AB5 = 1 A part, 5 B parts... A2B = 2 A parts, 1 B part |
|
|
Term
How does anthrax kill cells? |
|
Definition
2 A parts - one is lethal factor - cytotoxin interferes with sensor kinase :: one is edema factor - messes with cAMP to cause edema |
|
|
Term
The B part of anthrax is called |
|
Definition
|
|
Term
|
Definition
A-B, cellulolytic, tissue damaging, superantigen |
|
|
Term
2 types of cellulolytic toxin |
|
Definition
hemolysins and phospholipases |
|
|
Term
|
Definition
B - totally kills blood cells, highly virulent, a - kills some blood cells, those that aren't killed are oxidized and turn kind of greenish, gamma - no hemolysins (basically hemolysin negative) |
|
|
Term
what kind of hemolysin is naturally occurring in the human throat? |
|
Definition
|
|
Term
How do phospholipases kill cells? |
|
Definition
remove phospholipid head group so water can't bind -- basically creates a cell with a water layer and a lipid layer... not a cell at all |
|
|
Term
2 types of tissue damaging toxins |
|
Definition
expoliative and hyaluronidase |
|
|
Term
|
Definition
sloughs off outer layer of skin -- Stapholococcus scalded skin syndrome (SSSS) |
|
|
Term
|
Definition
Stapholococcus scalded skin syndrome - not dangerous unless bacteria get in, easily spread, mostly in babies and boys who first start shaving... destroys connection between epidermis and dermis |
|
|
Term
|
Definition
tissue damaging toxin that destroys connective tissue between cells (hyaluronic acid)... allows bacteria to penetrate deep within tissues - often used for anesthesia |
|
|
Term
How does superantigen toxin work? |
|
Definition
Crosslinks TCR to MHC2 without antigen (links T cells nonspecifically), results in massive T cell activation which causes Septic shock (patient usually bleeds to death) |
|
|
Term
2 examples of superantigen toxin |
|
Definition
Toxic shock syndrome toxin and necrotizing fasciitis |
|
|
Term
How can your immune response kill you via inflammation? |
|
Definition
phagocytes recruited by inflammation (Type III and Type IV HS) damage tissue ... meningitis and PID (N.g. and chlamydia) |
|
|
Term
How can your immune response kill you via antibodies? |
|
Definition
immune complexes stick in glomeruli after infection (acute golmerulonephritis), or immune mimicry |
|
|
Term
Acute glomerolonephritis is a Type ___ HS |
|
Definition
|
|
Term
|
Definition
bacterially-induced autoimmune disease - bacteria mimic own antibodies so closely that your body starts attacking them :: ex: rheumatic heart disease (acute rheumatic fever) caused by antibodies to strep M recognizing the autoantigen on heart muscle |
|
|
Term
4 ways viruses can avoid inactivation by the immune system |
|
Definition
produce IFN repressors (stop cell cynthesis of IFN), produce p53 inhibitors (inhibit apoptosis), Produce MHC analog (UL18) which reverses NK-mediated killing of viral infected cells, cause cell fusion into syncytia to avoid exposure to serum antibodies |
|
|
Term
What is an example of a disease that produces p53 inhibitors to inhibit apoptosis |
|
Definition
papillomavirus E6 protein |
|
|
Term
How does cytomegalovirus work? |
|
Definition
produces MHC analog (UL18) to reverse Nk-mediated killing of viral infected cells |
|
|
Term
3 types of fungal infections |
|
Definition
toxins, dermatophytes produce keratinase, inhaling spores |
|
|
Term
most serious fungal infections are caused by? |
|
Definition
inhaling spores of dimorphic fungi |
|
|
Term
dermatophyte fungal infections |
|
Definition
invade superficial skin (ringowrm, athlete's foot) |
|
|
Term
|
Definition
aflatoxin and ergot poisoning |
|
|
Term
Malaria, and how it avoids immune system |
|
Definition
protozoal infection - plasmodium lives in RBC so it's not exposed to humoral immunity... no MHC, so not exposed to cellular immunity |
|
|
Term
How do trypanosomes avoid the immune system? |
|
Definition
protozoa - surface antigen variation |
|
|
Term
How do schistosomes (protozoa) avoid the immune system |
|
Definition
surface receptors for host proteins |
|
|
Term
|
Definition
normally keeps us from getting respiratory infections by: goblet cells secrete mucose in nasal passages, which trap bacteria then cilia sweep it out |
|
|
Term
3 methods of respiratory protection |
|
Definition
mucociliary escalator, native flora, lysozyme and blinking |
|
|
Term
the mucociliary escalator can be paralyzed by |
|
Definition
tobacco smoke, alcohol/alcoholism, narcotics |
|
|
Term
the eustachian tube connects the ___ and the ____. |
|
Definition
|
|
Term
The lacrimal duct connects the ___ and the ___. |
|
Definition
tear gland and the nasopharynx |
|
|
Term
|
Definition
pain, fever, hard to swallow, red throat, patches of pus.. NO cough or runny nose |
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Term
Strep throat is caused by? |
|
Definition
S. pyogenes (Group A strep) |
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Term
virulence factors associated with Group A strep |
|
Definition
C5a peptidase (damages complement), Hyaluronic acid capsule (looks like self), M Protein (C3b protease damages complement and antigen responsible for late sequelae), G protein - Fc binding protein, exotoxins, hymeolysins, streptokinase |
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Term
late sequelae of strep throat |
|
Definition
rheumatic fever develops if strep is untreated |
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Term
How can untreated strep throat lead to bacterial endocarditis in dental patients? |
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Definition
rheumatic fever is late sequela, then antibodies are made against the M protein, the antibodies erode heart valvues, which allows a rough surface for biofilm attachment, viridian group strep (which is normal mouth flora) can now colonize the heart valve, causing bacteria endocarditis |
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Term
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Definition
toxin affects heart and kidneys, dead cell sin throat form pseudomembrane which blocks the airway |
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Term
How is diphtheria developed? |
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Definition
AB toxin is produced in host when there is low Fe content, the B part binds to cells in heart, kidneys, and back of throat... A part stops protein synthesis |
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Term
why do people die of diphtheria? |
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Definition
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|
Term
How do you prevent diphtheria? |
|
Definition
spread by resp droplets, so stay away from someone with it - also vaccines (DTaP, with booster every 10 years) |
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Term
|
Definition
antitoxin - via passive immunity - DIG (diphtheria immunoglobulin) |
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Term
2 bacteria that ALWAYS cause ENT infections |
|
Definition
haemophilus influenzae type b, strep pneumoniae |
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Term
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Definition
Pinkeye - lost of pus, caused by H. influenzae, strep pneumonia, n. gonorrhoeae, psudomonas from cosmetics |
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Term
What is characteristic of pseudomonas infections? |
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Definition
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Term
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Definition
middle ear infection - bacteria in pharynx travels up eustachian tube to ear canal - very painful, may cause eardrum to rupture, no fever, caused by H. influenzae and s. pneumoniae |
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Term
Why do little kids get ear tubes? |
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Definition
Because their eustachian tubes are too small to let bacteria drain out |
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Term
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Definition
headache, swelling, pus in nasal secretions, caused by s. pneumoniae and h. influenzae |
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Term
when would you use antibiotics for ENT infections? |
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Definition
only for recurring infections (3x/6mos) |
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Term
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Definition
filling of lungs with fluid... inflammatory response to lung infection, high fever, shortness of breath, pink sputum |
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Term
why do you have pink sputum in pneumonia? |
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Definition
PMNs and diplococci present in lung serum (indicative of infection) |
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Term
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Definition
23-valent (polysaccharide, not great)... only for adults |
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Term
Most common cause of community-acquired bacterial pneumonia |
|
Definition
strep pneumonia (LRT pneumonia) |
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Term
2 major causes of the common cold |
|
Definition
rhinovirus and adenovirus |
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Term
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Definition
causes about 50% of colds, is a picornavirus, naked, ssRNA, ok with high pH in URT, but not in low pH of stomach |
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Term
How does rhinovirus work? |
|
Definition
binds to epithelial cell receptors, causes cell death induces immune mediators, secretions, swelling |
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Term
___ is the most common infectious disease at about 3 cases/yr/person |
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Definition
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|
Term
How can the same person get several rhinovirus colds each year? |
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Definition
there are over 100 different rhinoviruses, and you are only immune to one for 5-10 years after you've gotten it |
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Term
potentially effective treatment for the common cold |
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Definition
pleconaril - binds to capsid and inhibits receptor binding and uncoating (phase II trials) |
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Term
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Definition
naked, dsDNA virus... causes cold AND fever, pus may be present |
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Term
2 diseases caused by adenovirus, other than colds |
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Definition
viral conjunctivitis and diarrhea (some strains can survive stomach) |
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Term
How is adenovirus spread? |
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Definition
resp droplets during acute phase, feces several weeks afterwards |
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Term
how do you treat adenovirus? |
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Definition
just treat symptoms -- vaccine available, but not commercially |
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Term
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Definition
virolent paroxysms of coughing, so sever that vomiting occurs.. try to catch breath between coughs = whooping |
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Term
Why is pertussis currently on the rise in the US? |
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Definition
it was thought of as a childhood disease (bc symptoms usually occur in children) so we stopped immunizing adults only to find out that adults can still get it asymptomatically and spread it to kids |
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Term
What causes pertussis? and what effect does it have? |
|
Definition
Bordetella pertussis toxin (AB5 toxin) -- A part ADP-ribosylates an inhibitor of cAMP synthesis (knowck out inhibitor of cAMP = increased fluid production) |
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Term
Why did we switch from the DPT vaccine to DTaP? |
|
Definition
DPT - whole cell vaccine, some people had allergic response to it, DTaP is acellular pertussis |
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Term
Tuberculosis is caused by? symptoms? |
|
Definition
mycobacterium tuberculosis - fatigue, fever, weight loss, blood tinged cough |
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Term
How can infection with mycobacterium tuberulosis lead to granuloma formation? |
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Definition
initially produces exudative lesion (typical inflammatory response), then may lead to a productive lesion (granuloma) because it gets inside a machrophage but doesn't die - so the macrophage keeps activating more and more t cells -- can lead to dissemination or lung fibrination |
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Term
What might happen to non-granulomous TB infections? |
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Definition
either heals or necrotizes lung |
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Term
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Definition
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Term
|
Definition
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|
Term
How might TB be diagnosed (pre- and post-death) |
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Definition
spots on liver (granulomas) or lungs (fibrination) ... or upon autopsy a hole in bones |
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Term
How is TB spread and what does it do once its in the body? |
|
Definition
resp droplets - invade alveolar macrophages and prevent phagolysosome fusion |
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Term
Why is TB on the rise in the US? |
|
Definition
AIDS - proliferates in immunocompromised people |
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Term
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Definition
chemo with multiple drugs :: DOT - directly observed therapy (bc people will sell the drugs on the street) :: MDR - multiple drug resistant :: XDR - extremely drug resistant (virtually untreatable) |
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|
Term
How is TB prevented in most of the world? |
|
Definition
BCG vaccine - live, non-pathogenic strain |
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Term
How is TB prevented in the US? and why don't we do what everyone else does? |
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Definition
PPD or Mantoux Skin test (if you have TB, you'll have activated T cells that create a skin rxn)- because TB isn't a big enough problem to need to vaccinate everyone, and those who have been vaccinated present a positive skin test (Type IV HS), so it's impossible to know who actually has it... we'd rather know who has it. |
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Term
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Definition
orthomyxovirus, enveloped ssRNA in 8 segments - two envelope proteins, hemagglutinin and neuraminiduase |
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Term
why is it important that flu is a segmented virus? |
|
Definition
allows genetic reassortment - why theres a new strain every year |
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|
Term
hemagglutinin and neuraminidase |
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Definition
H allows binding, N allows release ... of flu virus |
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|
Term
what causes antigenic drift |
|
Definition
minor changes in flu virus because it is an RNA virus - no proofreading |
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Term
|
Definition
in flu virus - major changes when RNA segments are reassorted in alternate host (human or pig)-- responsible for major flu epidemics (1918) |
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Term
3 major flu pandemics of the last 100 years |
|
Definition
1918 (spanish flu) - H1N1 - most deadly, killed healthy adults :: 1957 (asian flu) - H2N2 - very old people immune because it was common in 1870s :: 1968 (Hong Kong flu) - H3N2 - mild |
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Term
Why isn't the bird flu a problem yet? |
|
Definition
H5 doesnt bind well to human cells -- needs about 2 more mutations |
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Term
|
Definition
amantadine (blocks binding of hemagglutinin and virus uncoating) :: oseltamivir and tamaflu (prevents neuraminidase from relasing the virus so it can't spread |
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Term
|
Definition
vaccines annually (50-70% effective, whereas normal vaccines are 95%) -- usually injected killed virus, new flu-mist vaccine a little better bc its live attenuated |
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|
Term
#1 cause of LRT infection in babies |
|
Definition
respiratory syncytial virus |
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|
Term
what kind of virus causes RSV |
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Definition
|
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Term
|
Definition
Sin Nombre - fever muscle aches nausea and loss of lung function shock and death = very rapid pneumonia and hypovolemia |
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Term
Hantavirus in what region |
|
Definition
SW USA - Navajo population --- inhaled in dust aerosols from infected rodents |
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Term
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Definition
fungal disease - mold spores enter lung and develop into pherules, which release endospores --- symptoms from immune response to endospores, most severe in immunocomp. |
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|
Term
what do Histoplasmosis spores look like? |
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Definition
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|
Term
Where is histoplasmosis common? |
|
Definition
Ohio/Mississippi river valley - most common in cavers |
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Term
How is histoplasmosis treated? |
|
Definition
antifungals - amphotericin, azoles |
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|
Term
F plasmid... "F" stands for? |
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Definition
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|
Term
Resistant bacteria develop naturally through ____. |
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Definition
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|
Term
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Definition
Cell with F plasmid inserted in it |
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Term
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Definition
F plasmid is inserted in HFR cell, then when it leaves it takes with it the genes around it, some of which may have antibiotic resistance |
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Term
|
Definition
F plasmid with multiple (2 or 3) antibiotic resistance genes in it |
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|
Term
Responsible for rapid transfer of multiple antibiotic resistance between bacterial cells |
|
Definition
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|
Term
What problem do R plasmids cause? |
|
Definition
If you have one R plasmid with resistance to a certain antibiotic and you get sick and are treated with that antibiotic, it's no big deal because you only have 1 R plasmid in 1 bacterium... but lots of other cells (bacteria) will be killed off in the infection, leaving room for the R plasmid bacterium to replicate... now you have lots of cells with that R plasmid. If you are treated with that antibiotic again, it will no longer be effective because you have too many resistant bacteria. |
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Term
|
Definition
furuncle (boil) - inflammatory response to growth of S. aureus |
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Term
Key enzyme in staph infections |
|
Definition
coagulase - prevents immune system cells from getting to infection by blocking off area that's infected |
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|
Term
Staph infection of hair follicles |
|
Definition
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|
Term
|
Definition
scalded skin syndrome (bullous exfoliation), toxic shock syndrome (superoxide) |
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|
Term
What staph has coagulase? |
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Definition
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|
Term
When does S. epi cause infections? |
|
Definition
people with catheters or implanted medical devices (metal plates)... s. epi forms biofilm on foreign devise and cannot be treated |
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|
Term
How are staph infections spread? |
|
Definition
contact and fomites (sheets and clothing) -- kids may get it by sleeping in daycare centers |
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|
Term
Notorious MDR staph infection |
|
Definition
|
|
Term
Antibiotic specifically for MRSA |
|
Definition
|
|
Term
|
Definition
strep skin infection - very painful infection of fat tissue underneath skin and causes inflammation |
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|
Term
|
Definition
Usually strep skin infection, also can be staph... crusty rash found most often in preschoolers, spread by fomites and contact... problem comes from late sequelae (autoimmune) |
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|
Term
Problem with most strep infections |
|
Definition
Late sequelae - autoimmune disease, immune mimicry -- caused when we start making antibodies against an infection |
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Term
|
Definition
Rheumatic fever, acute glomeruli nephritis (AGN) |
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|
Term
|
Definition
Strep infection with superantigen and tissue activating toxins - bacterial and cytokine induced tissue damage -- common in IV drug users who share drugs |
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|
Term
Why should strep infections be treated quickly? |
|
Definition
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|
Term
Treatment for strep skin infections |
|
Definition
keep from spreading, isolate carriers, penicillin (except for toxins), anti-inflammatory drugs |
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|
Term
____ infections are opportunistic skin infections in wounds and burns. ___% of deaths in burn patients is caused by this. |
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Definition
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|
Term
Telltale sign of pseduomonas infections |
|
Definition
green... either green color to skin, green sputum in resp infections, etc |
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|
Term
Pseudomonas causes about 85% of deaths in what resp disease? |
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Definition
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|
Term
#1 complication of RK and Lasik surgery |
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Definition
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|
Term
common cause of nosocomial UTI after catheritization |
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Definition
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|
Term
horizontal gene transfer of R plasmids is common in ____. |
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Definition
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|
Term
Major problem with pseudomonas |
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Definition
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|
Term
Treatments of pseudomonas |
|
Definition
focused on prevention, not much you can do once biofilm is established... topical antimicrobials on wounds... used multiple drug therapy for long term treatment because of R plasmids |
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|
Term
Bacterial disease caused by spirochaete (cork-screw bacteria) called borrelia burgdorferi |
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Definition
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|
Term
How do you get infected with lyme disease? and how do you know you have it? |
|
Definition
nymph of deer tick (almost impossible to see)... bull's eye rash develops |
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|
Term
Problem wtih lyme disease |
|
Definition
late sequelae - heart conduction abnormalities, arthritis |
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|
Term
2 main places where you find lyme disease |
|
Definition
new england states and minnesota down through chicago |
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Term
|
Definition
avoid vectors (wear long pants and sleeves), antibiotics (tet and pen derivative) |
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|
Term
___ is caused by an anaerobic spore-former called clostridium tetani |
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Definition
|
|
Term
|
Definition
AB toxin where B part binds to presynaptic neruons and A part inhibits neuroinhibitors, so ALL muscles contract |
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|
Term
Most cases of tetanus come from? |
|
Definition
bad tattoos and piercings, stepping on a rusty nail -- any deep penetration wound |
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Term
|
Definition
vaccination (DTaP) and boosters every 10 years (tetanus shot), tetanus immune globulin antitoxin given immediately after injury, surgical debridement, muscle relaxants, NOT CNS depressants |
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|
Term
gangrene is caused by what bacterium |
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Definition
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|
Term
|
Definition
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|
Term
What kind of accident would cause gangrene |
|
Definition
blunt trauma injuries, especially under anaerobic conditions |
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|
Term
Death from gangrene happens because? |
|
Definition
bacteria releases gas, which is toxic and causes toxic shock |
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Term
|
Definition
usually just have to cut off bad tissue |
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Term
|
Definition
bacteria in animals that is transmitted to us when we are bitten by them... causes edematous abscess within a few hours after bite |
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|
Term
Why do dog and cat bites cause inflammation so quickly? |
|
Definition
because our body is not used to that bacteria, so our immune system takes longer to respond to it |
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|
Term
pasturella in chickens causes? |
|
Definition
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|
Term
pasturella in cattle causes |
|
Definition
shipping fever - copious nasal discharge, septicemia, pneumonia, death in 18 hrs. |
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|
Term
pasturella in rabbits causes |
|
Definition
snuffles - progresses to lethal hemorrhagic pneumonia (bloody lungs) |
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|
Term
|
Definition
cat scratch disease - lymph node swelling |
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Term
|
Definition
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|
Term
|
Definition
|
|
Term
why are about half of kittens infected wtih bartonella henslae? |
|
Definition
it lives in cat RBCs - so its easily transmitted by fleas |
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|
Term
How is cat scratch disease treated? |
|
Definition
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|
Term
disease caused by a variety of herpes virus called varicella-zoster virus, a ds DNA enveloped virus |
|
Definition
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|
Term
Chickenpox causes a ____ rash, meaning all three stages are present at once |
|
Definition
maculo-papulo-pustular (flat spots, raised spots, leaking pus) |
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|
Term
Chickenpox is varicella-zoster virus... what does that mean? |
|
Definition
varicella = chickenpox, zoster = shingles |
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|
Term
Chickenpox as a latent virus |
|
Definition
|
|
Term
|
Definition
stillbirth or serious developmental problems |
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|
Term
___ is a known reactivator of herpes virus. It reactivates along a ____, which is fed by one neuron. |
|
Definition
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|
Term
Chickenpox in early teens (9-15 yr olds) who took aspirin for the chickenpox come down with ____, which is a ____ disease. |
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Definition
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|
Term
|
Definition
|
|
Term
what kind of virus is measles |
|
Definition
|
|
Term
|
Definition
choria (runny nose), cough, and conjunctivitis |
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|
Term
about 50% of people with measles get ___ in pharynx, caused by? |
|
Definition
Koplik's spots... caused by dead cells in resp epithelium |
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|
Term
____ are pathonomic for measles, meaning? |
|
Definition
Koplik's spots -- if you have Koplik's spots, you have measles |
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|
Term
Measles grows in ___ cells, which results in? |
|
Definition
T cells - reduced cellular immunity |
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Term
|
Definition
vaccine (MMR) required in developed world, 2 injection regimen |
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|
Term
___ is AKA Rubella and is caused by a small enveloped ssRNA togavirus |
|
Definition
|
|
Term
symptoms of german measles |
|
Definition
slight fever, mild symtpoms, very fine rash |
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|
Term
german measles spread by ? |
|
Definition
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|
Term
Problem with German measles |
|
Definition
vertical transmission - from mom to baby - causes congenital rubella syndrome = blind, deaf, heart disease, retardation |
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|
Term
|
Definition
human papillomavirus (HPV) |
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|
Term
how does HPV work to cause warts? |
|
Definition
replicates in epithelial cells, causing abnormal cells with the E6 protein... causes wart |
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Term
|
Definition
HPV virus produces it, prevents p53 from checking DNA for abnormalities - causes wart |
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|
Term
2 kinds of HPV that cause cervical cancer, and how? |
|
Definition
type 16 and 18... are proviruses (integrate DNA into host DNA) to cause chromosomal abnormalities |
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|
Term
Candida albicans infections |
|
Definition
yeast infections - diaper rash, thrush (white cheesy growth in mouth, common in infants and AIDS patients), vaginal yeast infections .. normal flora that grows in moist places |
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|
Term
|
Definition
produce cutaneous fungal infections (below surface of skin) - tinea infections (athlete's foot, ringworm, etc) |
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|
Term
Sporotrichosis infections |
|
Definition
AKA "Rose gardener's disease" fungal infection caused by punctures from plant thorns, which introduces dimorphic spores... nodules form along lymph nodes |
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|
Term
|
Definition
no VDJ joining - no B or T cells |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
Type of antibody that would be most effective for agglutinating bacterial cells? |
|
Definition
IgM - because its a tetramer |
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|
Term
Breast fed babies recieve what antibodies that bottle fed babies dont? |
|
Definition
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|
Term
What happens if you are exposed to an antigen which none of your B cell receptors recognize? |
|
Definition
Your innate immune system will deal with it. |
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|
Term
What happens if you have a B cell receptor that recognizes an antigen but no T cell receptor recognizes that same antigen? |
|
Definition
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|
Term
What happens if you produce a B cell that does not recognize any antigen you're exposed to? |
|
Definition
nothing - the b cell just doesn't replicate |
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|
Term
Can T cells agglutinate bacteria? |
|
Definition
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|
Term
What type of cell produces the surface protein B7? |
|
Definition
Phagocytes after they have phagocytized a foreign cell |
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|
Term
A cancer vaccine that has recently passed phase I clinical trials uses adenovirus that's been genetically engineered to carry the B7 gene. How does this work? a. stimulate antibody production from B cells b.enhance actiation of Tc cells by nonAPCs c. enhance phagocytosis of tumor cell d. allow effector Th cells to secrete antibodies |
|
Definition
Enhances activation of Tc cells by nonAPCs |
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|
Term
live attenuated polio vaccine is given orally whereas attenuated flu vaccine is given as a nasal mist, why? |
|
Definition
memory mucosal B cells exist at the site of infection |
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|
Term
What do immunodiffusion and ABO blood typing have in common? |
|
Definition
antibody-antigen complexes form |
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|
Term
A patient has been exposed to TB but has formed granulomas. He gets tested every 6 mos to determine whether the TB has broken out of the granuloma. What type of test should be used? |
|
Definition
Direct fluorescent antibody |
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|
Term
IN a direct ELISA test, antibodies are attached to the bottom of a microtiter well. HOw can we be sure the Abs have the Fab part pointing up? |
|
Definition
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|
Term
EHEC is E. coli that has acquired toxin and pilus genes from Shigella. This is an example of? |
|
Definition
HGT of pathogenicity islands |
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|
Term
Pt. had strep 3 weeks ago and now present with cardiac insufficiency and valve malformations. what has happened? |
|
Definition
he is producing anti-strep antibodies |
|
|
Term
What is a characteristic of a chronic illness? prevalence much higher than incidence, or prevalence only slightly higher than incidence? |
|
Definition
prevalence much higher than incidence |
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|
Term
Atypical pneumonias differ from typical pneumonias, in that atypical pneumonias require more/less treatment? |
|
Definition
|
|
Term
|
Definition
to avoid humoral immune system |
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|
Term
A patient with a cold also has a fever, and red itchy eyes. She is most likely infected with what? |
|
Definition
adenovirus - cold, fever, conjuctivitis (rhinovirus is JUST cold) |
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|
Term
2 bacteria that cause biofilms |
|
Definition
pseudomonas and staph epidermidis |
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|
Term
During the course of an acute illness, an indirect ELISA will... a. only detect the antigens associated with the illness b. become positive sooner in an illness than a direct ELISA would c. become positive but return to negative shortly after illness is cured d. be developed by adding a second antibody that recognizes the first e. need to be done 4 or 5 times to determine with what the patient is infected |
|
Definition
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|
Term
A classic allergy response (Type I HS) requires two exposures to the allergen. After one exposure, what happens? a. Th cells becomes activated b. IgM is secreted into the tissues where it waits for the second exposure. c. Mast cells become caoted with IgE d. smaller than usual immune complexes form e. nothing happens until the second exposure |
|
Definition
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|
Term
A pathogenicity island is a? a. cluster of virulence factors that can be transmited by HGT b. group of pathogenic bacteria boudn to an M cell c. patch of membrane receptors to which pathogenic bacteria bind d. plasmid on which multiple antibioti resistance genes are located e. tissue or organ that commonly serves as a site for bacterial portal of entry |
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Definition
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|
Term
What is the function of Staph protein A? |
|
Definition
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|
Term
Why are scientists concerned that the overuse of a signel antibiotic might select for multiple antibiotic resistnaces in bacteria? |
|
Definition
R plasmids mean that selection of any antibiotic resistance selects for them all. |
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|
Term
What type of cell do NK cells kill? |
|
Definition
|
|
Term
|
Definition
if any lines are present, it means the disease is present |
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|
Term
In the disease Lupus, autoantibodies are directed against: a. DNA, B. B cells C. epithelial cells d. Acetylcholine e. anything you touch or eat |
|
Definition
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|
Term
The most common immune disorder in the US is selective IgA deficiency. People who suffer from this will be more likely to get ___ that other people? |
|
Definition
resp and digestive illness |
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|
Term
Which of the following is not a signal that a pathogen's 2-component regulatory syustem recognizes to induce virulence factor genes? low pH, high free iron concentraiton, presence of cytokines, increased temperature, binding to receptors on macrophages |
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Definition
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|
Term
M cell ruffling is in response to? |
|
Definition
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|
Term
How is LPS toxic to humans? |
|
Definition
It binds strongly to macrophages, causing a response that can lead to hypovolemia |
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|
Term
Which of the following is a method for viruses to evade the host immune defenses? a. produce a protein that prevents host cell apoptosis in response to dna damage b. use host actin to spread intracellularly c. produce antiphagocytic lipid capsule d. prevent recruitment of MAC e. survive nad replicate within phagolysosome |
|
Definition
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|
Term
Which of the following is not used as a target for antiviral drugs? a. nucleic acid synthesis b. receptor binding c. proteolysis of a polyprotein d. viral budding from host cell e. viral folic acid metabolism |
|
Definition
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|
Term
What do tetanus and gangrene have in common? |
|
Definition
They both require anaerobic conditions to grow |
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|
Term
What do measles and german measles have in common? |
|
Definition
both spread via resp droplets |
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|
Term
Haemophilus influenzae type B causes most common respiratory infections (sinusitis, conjuntivitis, otitis media, etc.), but you aren't supposed to be treated with antibiotics unless it recurs more than 3x in 6 mos. why do you need antibiotics at that point? |
|
Definition
chronic Hib infections can cause ear damage and even meningitis |
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|