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Lecture Final
Urinary, Blood, Blood Vessels, Heart
138
Anatomy
Undergraduate 1
05/22/2014

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Term
exotoxin
Definition
-mostly produced by Gram + organisms
-toxins only secreted while bacteria is alive
-secreted by bacterial cells to digest and break down large molecules outside the cell for use of the nutrients
-can be deactivated by heat and acid
Term
types of exotoxins
Definition
A-B toxin
membrane disrupting toxins
superantigens
Term
A-B toxin
Definition
most common exotoxin
-A has enzymatic activity
-B binds to host cell membrane and triggers endocytosis
-once inside, A alters cell function triggering B to be released
Term
membrane disrupting toxin
Definition
-exotoxin
-cause cell lysis (like streptococcus causing hemolysis)
Term
superantigens
Definition
-exotoxin
-stimulate strong immune response and cytokine release (like necrotizing fascitis)
Term
effects of exotoxins
Definition
-lysis/cell membrane damage (Strep, leukocidin)
-destroys blood vessels (erythrogenic)
-paralysis (Clostridium botulinum (flacid), tetani (contractive))
-diarrhea (Vibrio or Staph)
-inhibit protein synthesis (Diphtheria)
Term
endotoxin
Definition
-after cell dies (lysis) that toxin is released
-component of gram neg cell wall - part of lipopolysaccharide
-heat resistant
-cause release of cytokine called interleukins
Term
effects of endotoxins
Definition
-fever
-chills
-shock
-stomach ulcers - Helicobacter pylori
-TB - Mycobacterium
-weak immune response - not long lasting
Term
how do endotoxins work?
Definition
LPS - lipopolysaccharides - released from gram negative cell wall
IL-1 - cytokine released by macrophage which triggers fever
Term
Mechanical defense mechanisms
Definition
skin
fluids - tears, saliva, perspiration
Term
Flushing mechanisms
Definition
-a form of mechanical defense
-coughing/sneezing
-cilliary escalator moves microbes up and out
-fluids - tears, urination
Term
chemical defense mechanism
Definition
-sebum
-gastric juices
-lysozyme
-transferrin
Term
Lacrimal apparatus
Definition
tears move across eye to flush it
Term
Sebum
Definition
oil glands in skin give us a low pH (3-5)
Term
lysozyme
Definition
in nasal mucous, tears and saliva
-breaks down bacterial cell wall
Term
gastric juices (stomach acid)
Definition
very low pH (1.2-3)
Term
transferrins
Definition
-blood proteins that bind to iron
-reduce availability of iron to Bacteria
Term
normal microbial flora
Definition
compete with bad microbes - prevent colonization of bad microbes
Term
leucocytes - 5 types
Definition
-neutrophils - phagocytosis
-lymphocytes - specific immunity
-monocytes - mature into phagocytes - macrophages - goes into tissues
-eosinophils - fights parasites
-basophils - stimulates inflammation (histamine)
Term
lymphocytes (2 types)
Definition
T-cells - cell-mediated response - specific immunity
B-cells - produce antibodies
Term
phagocytosis
Definition
-neutrophils and monocytes/macrophages
-mechanism - chemotaxis; adherance (margination - blood vessel wall gets sticky); diapedesis (WBCs can transport out of capillaries); ingestion; digestion
Term
natural killer cells
Definition
seeks out and attacks abnormal eukaryotic cells
-release perforin protein and "granzyme" proteases which cause cytolysis
Term
MHC
Definition
Major Histocompatibility Complex - 1 - identifies cell as self
2 - only on macrophages and B-cells - allows cells to become Antigen Presenting Cells (APCs)
Term
Inflammatory Response
Definition
vasodilation - increased permeability of blood vessels
phagocytosis - begins with chemotaxis - phagocyte migration
tissue repair
fever
-4 cardinal signs (redness, heat, swelling, pain)
Term
Fever
Definition
-body temperature is controlled by the hypothalamus (thermostat)
-Gram negative LPS causes phagocytes to release IL-1
-IL-1 resets thermostat to higher temp, stimulating lymphocytes and causing chills
Term
kinins
Definition
vasodilation
Term
histamine
Definition
vasodilation
Term
prostaglandin
Definition
vasodilation
Term
leukotrienes
Definition
vasodilation
Term
interleukin-1
Definition
fever
Term
complement protein
Definition
30+ different "serum proteins" get activated by microbes
-cause cytolysis of microbes, inflammation and phagocytosis (opsonization)
Term
Classical complement protein activation pathway
Definition
initiated by Antigen-Antibody complex
-requires antibody in system -takes more time from initial exposure
Term
Alternative complement protein activation pathway
Definition
direct contact between bacteria and complement
-directly activated - quicker
Term
Lectin complement protein activation pathway
Definition
lectins from liver bind to carbohydrate on bacterial cell surface
-act on opsonin
Term
interferons
Definition
viral warning system - created by infected host cell
-protein goes to neighboring cells to stimulate it to produce antiviral proteins
-host specific, but not virus specific
Term
3 types of interferons
Definition
-alpha and beta - stimulate AVP
-gamma - induce phagocytosis of bacteria
Term
interferons as drug therapy
Definition
for cancer, herpes, hep B and C, MS
Term
immunity
Definition
resistance to a specific disease-causing microbe
Term
innate immunity
Definition
immunity you're born with - blood type antibody
Term
acquired immunity
Definition
acquired during a person's lifetime
-natural (getting sick) VS artificial (vaccine)
-active (lymphocytes get activated) VS passive (breast milk)
Term
characteristics of immunity
Definition
-specificity
-memory cells (remain in body lymph nodes)
-recognition of self/non-self
Term
immune globulins
Definition
gamma globulins or antibodies
Term
humoral immunity
Definition
-anitbody mediated
immunity in body fluids - B cells produce antibodies
Term
cell-mediated immunity
Definition
T-cells have to have direct contact
Term
antigen
Definition
-antibody generating molecule
-can be foreign proteins, lipoproteins, glycoproteins, nucleoproteins, polysaccharides, lipopolysaccharides
-proteins make the best antigens because they're large in size
Term
antigenic determinant OR epitope
Definition
small part of protein that identifies the antigen as such
-antibody binds to this to form an Ag-Ab complex
Term
haptens
Definition
when the Ag is too small to generate an immune response on its own, it binds to a carrier molecule (protein) to become antigenic
Term
polyclonal antibodies
Definition
recognize same Ag, but different epitope
Term
monoclonal antibodies
Definition
recognize same Ag and same epitope
Term
antibody
Definition
proteins made by the host that fit a specific antigen
Term
antibody shape
Definition
Y shaped - has stem and two antigen binding sites on tips
Term
constant region of antibody
Definition
Stem - (Fc region) - same for all antibodies of one class
Term
5 classes of antibodies
Definition
IgG - most abundant
IgM - first produced - pentamers - 5 antibodies cross linked - binds 10 antigenic determinants
IgA - stem allows this to be secreted in bodily fluids - dimer (duo)
IgD - found on surface of B-cells
IgE - found on surface of mast cells (inflammatory/allergic response)
Term
variable region of antibody
Definition
Y tips - antigen binding sites (2)
unique to each antigenic determinant
Term
Ab-Ag complex effects
Definition
agglutination
neutralization
opsonization
antibody-dependent cell-mediated cytotoxicity
inflammation
Term
agglutination
Definition
clumping of antigen together
Term
neutralization
Definition
blocks pathogen of toxin adhesion
Term
opsonization
Definition
stimulation of phagocytosis
Term
antibody-dependent cell-mediated cytotoxicity
Definition
activates killer T cells
Term
B cell activation
Definition
-B-cell has IgD on surface which can link to antigen directly or helper T cell can bring Ag to Ab on B cell
Term
clonal selection
Definition
after virgin B cell is linked to a specific Ag, it proliferates into two groups - plasma cells (produce Ab) AND memory cells (which are dormant and can create plasma cells later which create antibodies)
Term
primary immune response
Definition
takes 1-2 weeks to fight pathogen - host gets sick
Term
secondary immune response
Definition
anamnestic response - very fast/strong
Term
APC
Definition
antigen presenting cells - macrophage digests antigen
MHC II presents part of antigen on surface of macrophage
presented to helper T cells
Term
HLA
Definition
human APC (human leukocyte antigen)
Term
Virgin T cells
Definition
activated by clonal selection to produce differentiated T-cells
Term
Helper T cells
Definition
tag foreign cells
stimulate other T cells, B cells and macrophages through cytokines
use CD4 receptor to recognize antigen
mechanism - Helper T binds to Antigen-presenting-cell (APC)
-then APC releases IL-1
-IL-1 causes helper T to produce IL-2 which leads to differentiation of clone of helper Ts
Term
cytotoxic T cells
Definition
become cytotoxic T lymphocytes
secrete perforin and granzymes to lyse target cells
similar to natural killer cells
use CD8 receptor to target infected cell
Term
regulatory T cells
Definition
AKA suppressor T cells
suppress other T cells
modify inflammation
regulate tissue rejection/autoimmune disease
Term
IL-2
Definition
causes t-cell differentiation and increases inflammation/histamine response
Term
apoptosis
Definition
programmed cell death through blebbing and digestion by phagocytes
-100 million lymphocytes made each day - when they aren't activated they need to die to make room for new ones
-when apoptosis is out of whack, you have cancer - leukemia
Term
memory T cells
Definition
stay dormant until another exposure to relevant antigen
Term
leprosy AKA
Definition
Hansen's disease
Term
Leprosy causative agent
Definition
Mycobacterium leprae - grows best at 30 degrees - like in extremities
-long generation time (12 days)
-can only be cultured on "nude" mice and armadillos
-grows in myelin sheath of PNS
Term
tuberculoid or paucibacillary leprosy
Definition
shows as skin lesions
-healthy immune system limits disease
-loss of sensation can lead to secondary infection
-6 months antibiotics
Term
multibacillary or lepromatous form of leprosy
Definition
with poor immune system disfiguring nodules form all over the body
-infection of mucous membranes follow by tissue necrosis
-12 months antibiotics
Term
leprosy transmission
Definition
-contact between nasal mucosa and other fluids
-requires prolonged, intimate contact
-symptoms can take years to develop
Term
leprosy treatment
Definition
antibiotic combination
6 mo for paucibacillary
12 mo for multibacillary
Term
Polio/poliomyelitis causative agent
Definition
virus
Term
Polio/poliomyelitis symptoms
Definition
-starts with sore throat and nausea
-then infection in tonsils and lymph nodes
-motor neurons destroyed
-flacid paralysis
Term
Polio/poliomyelitis transmission
Definition
fecal-oral route - summer lake outbreaks
human contact
Term
Polio/poliomyelitis reservoir
Definition
humans
Term
polio prevention
Definition
vaccine - Salk vaccine (1954) - inactivated virus - 90 % effective
-Sabin Vaccine (1964) - live virus but there are shipping/storage issues
Term
Polio treatment
Definition
iron lungs - can recover
Term
post-polio syndrome
Definition
middle-aged adults who recovered develop muscle weakness
Term
polio outbreaks
Definition
1978 in Amish PA
1982 in Taiwan
1993 in Netherlands
2004-2006 in Nigeria
2004-2009 in India
2011 in Pakistan, Congo, Chad
current in Syria
Term
Rabies AKA
Definition
Fatal encephalitis
Term
Rabies causative agent
Definition
Rhabdovirus
Term
Rabies transmission
Definition
zoonoses; saliva of infected animal - bite, lick or aerosol
-only 5-15% of those exposed develop the disease
Term
Rabies symptoms
Definition
bite site starts with burning, coldness and tingling
-either "Furious" heightened alert OR "Paralytic" lethargy/calm
-then virus travels up limb and creates spastic paralysis
-when swallowing becomes painful, there's hydrophobia
Term
Rabies reservoir
Definition
Animals - dogs, vampire bats, raccoons, skunks, foxes
Term
rabies prevention
Definition
Vaccine - 3 injection series - limited to high risk personnel
Term
rabies pathogenesis
Definition
-virus multiplies in skeletal muscle and connective tissue
-moves into PNS, then CNS
-incubation period can be days to months, even if bite heals over
Term
rabies treatment
Definition
vaccine - before 1980 - 24 injections
after 1980 - 5 injections over 28 days; including immunoglobulins (passive immunity)
Term
Septicemia causative agent
Definition
normally Gram negative microbes
-contamination of circulatory system
Term
septicemia symptoms
Definition
-red mottled rash bc capillaries start to leak
-tissues blacken (especially at extremities) - looks like frostbite
-chills and fevers
Term
Septic shock
Definition
caused by Gram negative endotoxins
-blood pressure drops when plasma leaks into interstitial spaces
Term
Gram positive sepsis
Definition
Toxic Shock Syndrome - S. aureus, S. pyogenes
nosocomial infections - Enterococcus faecalis
infections in newborns - Group B strep - birth canal flora
Term
lymphangitis
Definition
red streaks under skin
Term
toxoplasmosis causative agent
Definition
Toxoplasma gondii (eukaryotic organism - protozoa) - not virus or bacteria
Term
toxoplasmosis symptoms
Definition
-healthy adults develop antibodies
-personality differences show involvement in nervous system
-highest risk to fetus in utero - miscarriage or stillbirth can turn into nervous system issues later
Term
toxoplasmosis reservoir
Definition
feces - especially cat
Term
toxoplasmosis pathogenesis
Definition
-can be from lack of handwashing after cat contact
-inhalation of kitty litter
-ingestion of meat
Term
TORCH
Definition
Toxoplasmosis; Other (syphillis); Rubella; Cytomegalovirus; Herpes Simplex II
Term
Influenza causative agent
Definition
Influenzavirus
Term
Influenza pathogenesis
Definition
-8 cassettes of segmented RNA genome
-3 subtypes - A and B most common
-antigenic drift - small genetic changes from human to human - slow mutations
-antigenic shift - large, major genetic changes that occur only occasionally when there are introductions of genetics from animal reservoirs
Term
Influenza Subtype A
Definition
-animal reservoirs - antigenic shift
-H - hemagglutinin - helps virus attach
-N - neuraminidase - helps virus detach
Term
Influenza subtype B
Definition
human reservoir - no antigenic shift, only antigenic drift
Term
Influenza subtype C
Definition
mild disease - doesn't cause epidemic
Term
Reyes Syndrome
Definition
aspirin can induce this - rash/fever/vomiting/lethargy to encephalitis
Term
Flu Pandemic
Definition
1918 - Spanish flu
1957 - Asian flu
1968 - Hong Kong flu
Term
Flu vaccine
Definition
carry 3 different antigens
choose most virulent strains based on demographics and geography
Term
flu antiviral drugs
Definition
Tamiflu - blocks neuraminidase - can create psychotic episodes
Term
Bird flu
Definition
low pathogenic - fewer eggs
high pathogenic - must kill entire population to prevent transmission
Term
Whooping cough causative agent
Definition
bordatella pertussis
Term
whooping cough symptoms
Definition
bacteria paralyze cilia of trachea
congestion makes it difficult to move air in + out
Term
whooping cough details
Definition
90% mortality rate in infants under 1 yr
many virulence factors
Term
whooping cough pathogenesis
Definition
-incubation - 7-10 days; up to 6 weeks
-catarrhal stage - cold-like symptoms
-paroxysmal stage - uncontrollable cough - up to 6 weeks
-convalescent stage - can last for months
Term
whooping cough complications
Definition
secondary infections - pneumonia, seizure, pnuemothorax, nose bleeds
Term
whooping cough transmission
Definition
high within household (80%)
droplet transmission
Term
whooping cough prevention
Definition
vaccine - whole cell - can lead to fever seizures
-acellular (1996) - combined with diphtheria and tetanus
Term
Hepatitis causative agent
Definition
virus
Term
hepatitis symptoms
Definition
inflammation of liver; flu-like, jaundice
Term
Hepatitis A transmission
Definition
fecal-oral route - can live for days on surfaces
Term
hep A pathogenesis
Definition
incubation 2-6 weeks (avg 4)
-acute - 3 weeks; full recovery
-50% subclinical
Term
hep A reservoir
Definition
human - shed in feces
Term
hep A prevention
Definition
inactivated vaccine
Term
hep A treatment
Definition
Ab within 2 weeks of exposure; rest
Term
hep B transmission
Definition
contact w body fluids
parenteral - breaks in skin
Term
hep B symptoms
Definition
50% asymptomatic
-flu-like
-change in taste
Term
hep B pathogenicity
Definition
90% full recovery (3-4 months after onset of jaundice)
10% chronic - especially if young
Term
hep B prevention
Definition
Vaccine
Term
hep B treatment
Definition
rest
interferons
nucleoside analogs
Term
hep C transmission
Definition
IV drug use; body fluids
Term
hep C pathogenesis
Definition
2-22 week incubation
55-85% become chronic
Term
hep C symptoms
Definition
can take 20 years to present
Term
hep C complications
Definition
cirrohsis, liver cancer
Term
hep C treatment
Definition
interferons with limited effectiveness
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