Term
| What are the 2 major applications of the knowledge of the immune system? |
|
Definition
1. use of vaccinations
2. diagnosis of disease |
|
|
Term
| Vaccination provides which type of immunity? |
|
Definition
|
|
Term
| Antisera provides which type of immunity? |
|
Definition
|
|
Term
| Which type of immunity lasts longer? |
|
Definition
|
|
Term
| What is the treatment of choice to replace antibodies in a patient that is immunodeficient? |
|
Definition
| immune serum globulin (ISG) gamma globulin |
|
|
Term
| Give an example of a specific immune globulin. |
|
Definition
| antisera to spider and snake bites, diphtheria, tetanus |
|
|
Term
| What is the principle behind giving vaccines? |
|
Definition
| stimulate a primary and secondary response that primes the immune sytem for future exposure to a virulent pathogen |
|
|
Term
| What are the 4 most common types of vaccination preparation? |
|
Definition
1. killed whole cells or inactivated viruses
2. live, attenuated cells or viruses
3. antigenic molecules derived from bacterial cells or viruses
4. genetically engineered microbes or microbial antigens |
|
|
Term
| What are the requirements for an effective vaccine? |
|
Definition
- low level of adverse side effects or toxicity
- protect against exposure to natural, wild forms of pathogen
- stimulate both antibody (B-cell) response and cytotoxic (T-cell) response
- long term, lasting effects (produce memory)
- not require numerous doses or boosters
- inexpensive, long shelf life, easy to administer
|
|
|
Term
| What is the difference between killed and attenuated vaccines? |
|
Definition
| killed vaccines do not multiply and require a larger dose and boosters |
|
|
Term
| What is an example of a killed vaccine? |
|
Definition
| cholera, plague, polio (salk), influenza, rabies |
|
|
Term
| What is an example of an attenuated vaccine? |
|
Definition
| polio (sabin), MMR, varicella, yellow fever |
|
|
Term
| What is a disadvantage to using an attenuated vaccine? |
|
Definition
| could be transmitted to other people and mutate back to a virulent strain |
|
|
Term
| What is the definition of an acellular vaccine? a subunit vaccine? Give examples |
|
Definition
vaccine based on the select component that carries the antigenic derterminant:
acellular - bacteria (ex. pneumococcus, meningococcus)
subunit vaccine - viruses (ex. Hep B)
|
|
|
Term
| What is a recombinant vaccine? Give an example. |
|
Definition
| genetic material from a pathogen is inserted into a live carrier microbe that is nonpathogenic; Hep B and Pertussis |
|
|
Term
| What is often used as a carrier in recombinant vaccines? |
|
Definition
| Vaccinia (nonpathologic virus) and adenoviruses |
|
|
Term
| How are the new DNA vaccines produced? |
|
Definition
| microbial DNA is inserted into a plasmid vector and inoculated into a patient, human cells will take up the plasmids and synthsize proteins based on the microbial DNA which are then recognized as foreign by the body initiating the immune response |
|
|
Term
| What are some advantages of the DNA vaccine? |
|
Definition
| very safe, small amount of antigen needed, stimulates both humoral and cell mediated immunity |
|
|
Term
| How are vaccines administered? |
|
Definition
| IM, SQ, intradermal, or oral |
|
|
Term
| What is one of the advantages of an oral vaccine? Give an example |
|
Definition
| stimulation of IgA at the portal of entry; Polio-Sabin, and adenovirus |
|
|
Term
| What are some of the adverse reactions to vaccines? |
|
Definition
- local reactions at the injection site (red, swelling, heat, pain)
- fever
- allergies (to medium not antigen)
- rare reactions such as: panencephalitis (measles), mutation back to virulent form causing paralytic dz (polio), neuro effects of unknown cause (pertussis and swine flu)
|
|
|
Term
| What type of patient should receive the pneumovax vaccine? |
|
Definition
|
|
Term
| What type of patient should receive the cholera vaccine? |
|
Definition
| travelers to endemic areas |
|
|
Term
| Which vaccines are included in routine immunization for infants and children? |
|
Definition
Age 0-6yrs: Hep B, rotavirus, DTP, H flu b, pneumococcal, polio, influenza, MMR, Varicella, Hep A, meningococcal
Age 7-18 yrs: DTP, HPV, meningococcal, pneumococcal, influenza, Hep A/B, polio, MMR, varicella |
|
|
Term
| Serological testing is based on which principle? |
|
Definition
| based on antibodies specifically binding to an antigen |
|
|
Term
| How are Ab-Ag reactions measured? |
|
Definition
| must be visible or measurable; visible by clumps, precipitates, color changes or release of radioactivity |
|
|
Term
| When performing the test are you testing for the antibody or the antigen? |
|
Definition
|
|
Term
| What substance are you testing if you are testing for the antibody? |
|
Definition
|
|
Term
| What substance are you testing when you are testing for the antigen? |
|
Definition
| an isolated colony or swab from the patient that contains antigen |
|
|
Term
|
Definition
| Reacts only with the certain Ab or Ag that it is testing for |
|
|
Term
|
Definition
| Able to react with a very small amount of Ab or Ag |
|
|
Term
| What are some types of immunologic assays? |
|
Definition
| Agglutination tests, precipitation tests, immunoelectrophoresis, complement fixation, fluorescent Ab tests, immunoassay tests |
|
|
Term
| What type of testing is utilized with ABO blood grouping? What substances are being tested? |
|
Definition
| agglutination; antisera combined with patient's RBCs |
|
|
Term
| A urine pregnancy test is which type of test? |
|
Definition
| Latex agglutination, latex particles that are coated with the antigen |
|
|
Term
| What type of sample is used for testing in the RPR, cold agglutinin, and Weil-Felix test? |
|
Definition
| patient's serum, testing for antibodies |
|
|
Term
| What is the difference between agglutination and precipitation? |
|
Definition
-
the size, solubility and location of the antigen
-
agglutination - whole cells (RBCs) or bacteria
-
precipitation - antigen is soluble
-
Both will form an insoluble aggregate
|
|
|
Term
| What is the tube agglutination test used for? |
|
Definition
| determining how many antibodies are in a patients serum - a titer |
|
|
Term
| What is being tested in precipitation testing? |
|
Definition
| patient's serum for antibodies |
|
|
Term
| How is precipitation testing performed? |
|
Definition
| performed in an agar gel medium; Ouchterlony method is a double diffusion method; Ag and Ab are placed in wells in the agar and they diffuse towards each other, forming a line of precipitate on contact |
|
|
Term
| What are some examples of precipitation tests? |
|
Definition
| VDRL, oucherlony method, immunoelectrophoresis, western blot |
|
|
Term
| What is immunoelectrophoresis used for? |
|
Definition
| to detect disorders in the production of antibodies |
|
|
Term
| What is the western blot test used for? |
|
Definition
| confirmation of HIV antibodies in a patient, can be used for other antibody and antigen testing |
|
|
Term
| What is complement fixation testing for? |
|
Definition
| can be testing for antigen or the antibody |
|
|
Term
| What is the principle of complement fixation testing? |
|
Definition
| complement will interact with Ab-Ag complexes - lysis will occur if the complement is NOT fixed |
|
|
Term
| What is the visible result of complement fixation testing if the Ab-Ag complex is present? |
|
Definition
| There will be NO hemolysis of the sheep RBCs |
|
|
Term
| How is the complement fixation test interpreted if lysis does occur? |
|
Definition
| as a negative response - no immune complexes were formed |
|
|
Term
| How is the presence of an immune complex visualized in the fluorescent antibody test? |
|
Definition
| a monoclonal antibody labeled by a fluorescent dye and interacts with antigens and antibodies |
|
|
Term
| What is the difference between direct and indirect testing with fluorescent antibody testing? Give an example of each type |
|
Definition
direct - testing for antigen (ex. syphilis, gonorrhea, chlamydia, pertussis, plague)
indirect - testing for antibody (ex. FTA-ABS) |
|
|
Term
| What type of tests are RIA and ELISA tests? |
|
Definition
| Immunoassays, extremely sensitive testing that permits rapid and accurate measurement of trace antigens or antibodies |
|
|
Term
What is principle of radioimmunoassay (RIA)?
|
|
Definition
| Ags or Abs are labeled with radioactive isotopes and measured |
|
|
Term
| What is the principle of Enzyme Linked Immunosorbent assay? (ELISA) |
|
Definition
| a positive result is visualized when a colored product is released by an enzyme-substrate reaction (Ab or Ag) |
|
|
Term
| Give examples of ELISA testing |
|
Definition
Ab testing for HIV, Hep A and C, cholera, helicobacter, and rickettsia;
antigen testing - useful for measuring nanogram amounts of hormones, drugs and serum proteins |
|
|
Term
| Which test is useful in following HIV patients? |
|
Definition
| specific testing for CD4 and CD8 T-cells |
|
|
Term
| Which test is an example of in vivo testing? |
|
Definition
|
|
Term
| What are the 4 types of hypersensitivity reactions? |
|
Definition
I - Immediate hypersensitivity
II - Ab mediated
III - Immune complex mediated
IV - T-cell mediated |
|
|
Term
| What is immunodeficiency? How is cancer related to immune response? |
|
Definition
| decrease or lack of immune response; may be due to decreased surveillance or tumor suppressor genes may be missing or inactivated |
|
|
Term
| What type of hypersensitivity is asthma? anaphylaxis? |
|
Definition
|
|
Term
| What are some of the theories of the pathophys of allergies? |
|
Definition
| increased IgE production, increased reactivity of mast cells, and increased susceptibility of target tissue to allergic mediators |
|
|
Term
| What is the difference between the sensitizing dose and the provocative dose? |
|
Definition
-
Sensitizing dose (priming exposure) - first contact with an allergen, IgE binds with mast cells and basophils
-
Provocative dose (further exposure): subsequent exposure with the same allergen binds to the IgE-mast cell complex
|
|
|
Term
| What are some of the symptoms of allergies and what causes the majority of symptoms? |
|
Definition
| rash, itching, redness, increased mucous discharge, pain, swelling, and difficulty breathing from the release of mast cell chemical mediators on target organs |
|
|
Term
| How long can IgE-mast cell complexes remain in the body? |
|
Definition
|
|
Term
| What is degranulation referring to? |
|
Definition
Cytoplasmic granules of the mast cells and basophils contain physiologically active cytokines which are released when stimulated by the antigen reacting with the IgE |
|
|
Term
| Which cytokine is the most abundant and potent? |
|
Definition
|
|
Term
| What are some of the responses to histamine? |
|
Definition
| constricts smooth muscle of bronchi and intestines, dilates arterioles and venules, wheal and flare reaction in the skin, pruritis and headaches, hypotension, tachycardia, circulatory failure and shock |
|
|
Term
| Which cytokine is referred to as the "slow reacting substance of anaphylaxis?" |
|
Definition
|
|
Term
| What are the prominent effects of leukotriene? |
|
Definition
| prolonged bronchspasm, vascular permeability, and mucous secretions in the asthmatic patient |
|
|
Term
| What are some other cytokines involved with allergies? |
|
Definition
| serotonin, prostaglandines, bradykinin |
|
|
Term
|
Definition
| sudden, massive release of chemicals into the tissues and blood which act rapidly on the target organs causing repiratory and circulatory disruption that can be fatal in a few minutes |
|
|
Term
| What are the most common instigators of anaphylaxis? |
|
Definition
| bee stings, injection of antibiotics or serum |
|
|
Term
| What is the most useful testing for allergies? |
|
Definition
|
|
Term
| What are some of the methods of treatments for allergies? |
|
Definition
| avoidance of the allergen; medications that block the action of lymphocytes, mast cells, or chemical mediators, densensitization therapy |
|
|
Term
| What classes of meds are commonly used for treatment of allergies? |
|
Definition
| corticosteroids, mast cell stabilizers, leukotriene inhibitors, antihistamine |
|
|
Term
| What is the theory behind desensitization therapy? |
|
Definition
| formation of high levels of allergen specific IgG which removes the allergen from the system before in can bind with IgE thus preventing the degranulation of mast cells |
|
|
Term
| What is type II hypersensitivity? |
|
Definition
| involve antibodies (IgG and IgM) and complement, leading to lysis of foreign cells, including transfusion reactions |
|
|
Term
| How many alleles can be inherited for blood typing? Which one is dominent? |
|
Definition
3 alleles - A, B, or O
O is recessive; A and B are equally dominant |
|
|
Term
| Which antigens and antibodies does a patient with O blood have? |
|
Definition
| no A or B antigens, antibodies towards A and B (anti-A and anti-B) |
|
|
Term
| Which Ags and Abs does a patient with AB blood have? |
|
Definition
| A and B antigens - no antibodies towards A or B |
|
|
Term
| Which antigens and antibodies does a patient with B blood have? |
|
Definition
| B antigen - anti-A antibodies |
|
|
Term
| Which type of patient is the universal donor? universal recipient? Why? |
|
Definition
| O; AB; antigens and antibodies |
|
|
Term
| What happens if a patient receives the wrong blood type? |
|
Definition
transusion reaction; massive hemolysis of donor cells leading to systemic shock and kidney failure (cell debris blocks the glomeruli), death is common
milder reactions - fever, anemia, jaundice |
|
|
Term
|
Definition
| Rh factor - person is either positive or negative |
|
|
Term
| How are Rh antibodies developed? |
|
Definition
| only after prior sensitization, not like ABO antibodies |
|
|
Term
| Which allele is dominant in Rh factor? |
|
Definition
|
|
Term
| What is erythoblastosis fetalis? How does it occur? |
|
Definition
| Hemolytic disease of the newborn (HDN) - Rh– mother develops antibodies against Rh+ RBCs of the fetus with her first pregnancy. Antibodies then attack subsequent pregnancies if the fetus is Rh+ causing hemolysis of the fetuses RBCs |
|
|
Term
| How can erythroblastosis fetalis be prevented? |
|
Definition
The mother is passively immunized with Rh antiserum containing antibodies against the Rh+ antigen – RhoGAM |
|
|
Term
| When is RhoGAM administered? |
|
Definition
28 to 32 weeks gestation and again immediately prior to birth to react with any Rh+ fetal RBC’s – only in Rh- women |
|
|
Term
| What is type III hypersensitivity? |
|
Definition
| soluble foreign antigens stimulate antibodies that produce small, soluble Ag-Ab complexes which are too abundant for efficient removal and incite a damaging inflammatory response |
|
|
Term
| What is an arthus reaction? Serum sickness? |
|
Definition
Both are type III hypersensitivity reactions
arthus - localized
serum sickness - systemic |
|
|
Term
|
Definition
| immune system has lost tolerance to self molecules and forms autoantibodies and sensitized T-cells against them |
|
|
Term
| What type of patients are more prone to autoimmune diseases? |
|
Definition
| more common in females especially in childbearing years |
|
|
Term
| Are all autoimmune diseases systemic? Give and example |
|
Definition
No, some are organ specific
ex. Hashimoto's thyroiditis, rheumatic fever, goodpasture syndrome (kidney) |
|
|
Term
| What is the proposed autoimmune theory for the development of type I diabetes or MS? |
|
Definition
| viral infection theory - viruses alter the cell receptors therefore causing immune cells to attack the tissues with the altered receptors |
|
|
Term
| What is the proposed autoimmune theory for the development of Hashimotos thyroiditis? |
|
Definition
| sequestered antigen theory - some tissues are sequestered behind anatomical barriers during embryonic growth, later in life the tissue becomes exposed to the immune system through trauma, infection, etc and is perceived as foreign |
|
|
Term
| What are some of the organs involved with Systemic Lupus Erythematosus? |
|
Definition
| kidneys, bone marrow, skin, nervous system, joints, muscles, heart, GI tract, and intracellular materials such as nucleoproteins (DNA/RNA) and mitochondria |
|
|
Term
| What are the symptoms associated with SLE? |
|
Definition
| kidney failure, blood abnormalities, lung inflammation, myocarditis, and skin lesions |
|
|
Term
| What is the most prominent feature of rheumatoid arthritis? |
|
Definition
progressive, debilitating damage to multiple joints
autoantibodies attack the synovial membrane of the joints, activating the inflammatory response which leads to chronic inflammation, development of scar tissue and joint destruction |
|
|
Term
| What other organs can be affected by RA? |
|
Definition
| lungs, eyes, skin, and nervous system |
|
|
Term
| What organ in affected by autoimmune antibodies in type I diabetes? |
|
Definition
| the beta (islet) cells of the pancreas |
|
|
Term
| What is the most prominent feature of myesthenia gravis? |
|
Definition
| muscle weakness caused by autoantibodies binding to the receptors for acetylcholine |
|
|
Term
| What is the pathophysiology of multiple sclerosis? |
|
Definition
| damage to the myelin sheath of neurons in the white matter by both T-cells and autoantibodies |
|
|
Term
| Is MS an immediate response or a delayed reaction? |
|
Definition
| Delayed - A delayed response to Ag involving activation of and damage by T-cells |
|
|
Term
| What is type IV hypersensitivity? |
|
Definition
| Cell-mediated involving the T-cells of the immune system |
|
|
Term
| What are the most commonly seen results of Type IV hypersensitivity? |
|
Definition
| TB skin testing, contact dermatitis, transplant graft rejection |
|
|
Term
| What causes the t-cell mediated reaction in graft rejection? |
|
Definition
| MHC (HLA) receptors on the foreign tissue |
|
|
Term
| What is graft vs host disease? |
|
Definition
| The graft bone marrow contains lymphocytes that attack the host |
|
|
Term
| What components of the immune system are involved with immunodeficiency diseases? |
|
Definition
| Deficiencies involve B and T cells, phagocytes, and complement |
|
|
Term
| What is the primary manifestation of immunodeficiency diseases? |
|
Definition
| recurrent, overwhelming infections |
|
|
Term
| What is the difference between primary and secondary immune disease? |
|
Definition
| Primary is congenital, secondary is acquired |
|
|
Term
| What is agammaglobulinemia? |
|
Definition
| Poor b-cell functioning leading to severely reduced or absent antibodies |
|
|
Term
| What is the etiology of t-cell deficiencies? |
|
Definition
|
|
Term
| What is SCID? What is the treatment? |
|
Definition
| Severe combined immunodeficiency - both b-cell and t-cell functions are missing or defective; sterile surroundings, fetal liver or stem cell grafts, bone marrow transplants, blood transfusions, and gene therapy |
|
|
Term
| What is the most recognized infectious cause of immunodeficiency? |
|
Definition
|
|
Term
| What are some other causes of secondary immunodeficiency? |
|
Definition
| measles, leprosy, tuberculosis and malaria; Radiation, burns, corticosteroids, drugs to treat cancers, pregnancy and aging |
|
|
Term
| What is cancer and how is the immune system involved in the disease process? |
|
Definition
| the new growth of abnormal cells; Overgrowth of abnormal tissue arises due to malfunction of immune surveillance |
|
|
Term
| What are some other factors that play a role in the development of cancer? |
|
Definition
| Both hereditary and environmental factors |
|
|
Term
| How are genetics related to cancer? |
|
Definition
| A specific alteration in a gene can lead to cancer, Predisposition for some cancers is inherited |
|
|
Term
| What is a proto-oncogene and an oncogene? |
|
Definition
| regulates the onset of mitosis during normal growth; The oncogene overrides normal mitotic controls and cause the cell to divide continuously |
|
|
Term
| What is the role of viruses in the development of cancer? |
|
Definition
| Some viruses carry oncogenes whose products cause transformation of host cells into cancer cells or a viral genome may be inserted into chromosome and override the cell’s growth controls. |
|
|
Term
| Give an example of a virus that is known to cause cancer. |
|
Definition
|
|
Term
| How does the immune system usually remove cancerous cells? |
|
Definition
| Cell-mediated immunity – T-cytotoxic, natural killer cells (NK) & macrophages |
|
|
Term
| Which types of cocci bacteria are the most clinically important? Which are gram positive and gram negative? |
|
Definition
|
|
Term
| What test will differentiate staph species from streptococcus species? Which one is positive? |
|
Definition
| Catalase – staph is catalase positive |
|
|
Term
| What species appears as gram + cocci in chains? Gram + cocci in clusters? |
|
Definition
| Streptococcus; staphylococcus |
|
|
Term
| Why are cocci called pyogenic? |
|
Definition
|
|
Term
| What test is used to differentiate staph aureus from other staph species? |
|
Definition
| S. Aureus is coagulase positive, the rest are coag negative |
|
|
Term
| What substance aids S. aureus in tissue destruction? |
|
Definition
|
|
Term
| Where is S aureus isolated from in patients who are carriers of the organism? |
|
Definition
| Anterior nasal pharynx (nares) |
|
|
Term
| What are some local diseases that are caused by S. aureus? Systemic? Toxic diseases? |
|
Definition
-
Localized – abscess, folliculitis, furuncle, carbuncle, impetigo
-
Systemic – osteomyelitis, pneumonia, meningitis, bacteremia
-
Toxigenic disease – food poisoning, scalded skin syndrome, toxic shock syndrome
|
|
|
Term
| You have a 2 y/o patient with yellow blisters and some erythema on his arm – what is the DX and the bacterial agent? |
|
Definition
| Bullous impetigo – S. aureus |
|
|
Term
| What substance is responsible for food poisoning from S aureus? |
|
Definition
|
|
Term
| What substance is responsible for a painful bright red rash occurs over the entire body then causes desquamation of the epidermis? |
|
Definition
|
|
Term
| Which species of staphylococcus can cause wound infections? |
|
Definition
| S. aureus, S. epidermidis, S. hominis, S capitis |
|
|
Term
| Which species of staphylococcus can cause UTI’s especially in sexually active adolescent females? |
|
Definition
|
|
Term
| Are penicillins effective against staph infections? Why? |
|
Definition
| No – they produce penicillinase |
|
|
Term
| What is a common initial presentation of MRSA? |
|
Definition
| “spider bite” or small pimple type lesion |
|
|
Term
| What types of classification systems are used for streptococcus species? |
|
Definition
| Lancefield and the hemolysis reaction on blood agar |
|
|
Term
| Which species of strep are Beta hemolyic? Alpha hemolytic? |
|
Definition
| A,B,C,G & some D strains; S. pneumoniae and the viridans group |
|
|
Term
| Which strep species causes the most serious disease? Why? |
|
Definition
| Group A (S. pyogenes) – enzymes and toxins |
|
|
Term
| What are some diseases caused by strep Gp A? |
|
Definition
| Pharyngitis, scarlet fever, impetigo, erysipalis, necrotizing fasciitis, pneumonia, rheumatic fever, glomerulonephritis |
|
|
Term
| Why is Gp B streptococcus medically significant? |
|
Definition
| May cause premature delivery of the fetus and neonatal septicemia, meningitis and pneumonia |
|
|
Term
| Why is the viridans group of bacteria medically significant? |
|
Definition
| May cause subacute bacterial endocarditis |
|
|
Term
| What is the most common pathogen of bacterial pneumonia? What else is it commonly seen in? |
|
Definition
| S. pneumoniae; otitis media |
|
|
Term
| What is unique about the structure of S. pneumoniae? |
|
Definition
| Several strains form capsules providing virulence |
|
|
Term
| Are there vaccines available for S. pneumoniae? Which ones? |
|
Definition
| The capsular vaccine is for older patients and the new conjugate vaccine is for children. |
|
|
Term
| Describe the gram stain results from the discharge in a patient with gonorrhea. |
|
Definition
| Intracellular gram negative diplococci |
|
|
Term
| What other disease commonly occurs with gonorrhea? |
|
Definition
|
|
Term
| What is a serious disease seen in neonates born to moms with gonorrhea? How is it prevented? |
|
Definition
| ophthalmia neonatorum – antibiotic eye drops given at birth to all babies |
|
|
Term
| What is meningococcus? Why is it medically significant? |
|
Definition
| N. Meningitis – epidemic bacterial meningitis - very rapid onset; endotoxin causes hemorrhage and shock; can be fatal quickly. |
|
|
Term
| A 45 y/o male is complaining of fevers/chills, productive cough, and pleuritic chest pain. On exam, he has crackles/rales in his LLL. What is the most likely bacterial pathogen? |
|
Definition
|
|
Term
| What type of skin lesions may be seen with bacterial meningitis? Why does it occur? |
|
Definition
| Endotoxin causes vascular collapse, hemorrhage, clotting disorders and visible petechiae on the body. |
|
|
Term
| Which species of bacteria form endospores? |
|
Definition
| Bacillus spp and Clostridium spp |
|
|
Term
| What is the causative agent of anthrax? |
|
Definition
|
|
Term
| What form of anthrax is most common and the least pathogenic? |
|
Definition
|
|
Term
| Describe a lesion of cutaneous anthrax. |
|
Definition
| Starts as a papule that becomes necrotic which ruptures and becomes a painless black eschar |
|
|
Term
| What is the major pathogenicity of pulmonary anthrax? |
|
Definition
| Exotoxins that produce toxemia which results in capillary thrombosis and cardiovascular shock. Death can occur in a few hours. |
|
|
Term
| How is pulmonary anthrax treated? Is there a vaccine? |
|
Definition
| Treated with penicillin or tetracycline which is effective against the bacteria however does not resolve the effects of the toxins. Vaccine – purified toxoid given in 6 injections over 1.5 years with annual boosters |
|
|
Term
| What are the 2 forms of illness seen with B. cereus? |
|
Definition
| Emetic form and diarrheal form |
|
|
Term
| What is the causative agent of gas gangrene? What type of environment is needed for optimal growth? |
|
Definition
| Clostridium perfringens; causes gas gangrene in damaged or dead tissues (predisposing conditions are surgery or tissue trauma, especially in anaerobic setting |
|
|
Term
| What causes the RBC rupture, edema & tissue destruction seen in gas gangrene? |
|
Definition
|
|
Term
| How can gas gangrene be prevented? |
|
Definition
| rigorous cleansing of wounds, decubitus ulcers and surgical sites |
|
|
Term
| What is the causative agent of antibiotic-associated colitis that is a major cause of diarrhea in hospitals? |
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Definition
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Term
| How does antibiotic-associated colitis occur and what is the pathophysiology of the disease? |
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Definition
| Treatment with broad-spectrum antibiotics kills the other bacteria, allowing C. difficile to overgrow - Produces entertoxins that damage intestine – necrosis of the intestinal mucosa |
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Term
| What is the causative agent of tetanus? What toxin is responsible for the disease? |
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Definition
| Clostridium tetani ; Tetanospasmin |
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Term
| What causes the muscle spasms from tetanus infection? |
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Definition
| Tetanospasmin stops the inhibition of contractions resulting in uncontrollable severe muscle contractions |
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Term
| How is tetanus treated? Is there a vaccine? |
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Definition
| Antitoxin – tetanus immune globulin (TIG); PCN or TCN and removing infected tissue; Vaccine – 5 doses during infancy/childhood with boosters every 10 years |
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Term
| What is the causative agent of botulism? What 3 diseases are caused by this agent? |
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Definition
| Clostridium botulinum – food poisoning, infant botulism, wound botulism |
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|
Term
| What is the most potent microbial toxin known? How does it cause disease? |
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Definition
| Botulin - prevents the release of acetylcholine preventing muscle contraction – death occurs from respiratory compromise |
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|
Term
| Is there a vaccine for botulism? |
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Definition
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|
Term
| What types of patients are most susceptible to Listeria monocytogenes? |
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Definition
| immunocompromised patients, fetuses (mother infected and passes through the placenta harming fetus) & neonates |
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|
Term
| What is the causative agent of erysipeloid? |
|
Definition
| Erysipelothrix rhusiopathiae |
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|
Term
| What is the causative agent of diphtheria? |
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Definition
| Corynebacterium diptheriae |
|
|
Term
| What physical exam findings may be seen with diphtheria? |
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Definition
| sore throat, enlarged lymph nodes and severe swelling of the neck – Pseudomembrane of the oropharynx |
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|
Term
| What is the causative agent of acne? |
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Definition
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|
Term
| The Mycobacteria species have which type of staining properties? |
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Definition
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|
Term
| Which Mycobacteria species causes TB? Leprosy? Pneumonia in HIV patients? |
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Definition
| Mycobacterium tuberculosis, Mycobacterium leprae, Mycobacterium avuim-M. intracellular complex |
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Term
| If a patient is exposed to TB, what is the likelihood that he will get the disease? |
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Definition
| Only 5% infected people develop clinical disease – generally humans are resistant to TB |
|
|
Term
| Which organs may be affected by TB? |
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Definition
| Majority of cases (85%) are pulmonary but can occur in any organ of the body |
|
|
Term
| What type of lung lesions may be seen in TB? |
|
Definition
| Tubercles, caseous lesions, cavitations, calcified lesions, tiny to small nodules |
|
|
Term
|
Definition
| Reactivation of bacilli - patient experiences more severe symptoms - Violent coughing, greenish or bloody sputum, fever, anorexia, weight loss, fatigue |
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|
Term
| What is the screening test for TB? What are some other tests? |
|
Definition
| tuberculin skin testing, Chest x-rays, Direct identification of acid-fast bacilli in specimen, Laboratory cultural isolation |
|
|
Term
| What are some contraindications to PPD testing? |
|
Definition
| previous + reactions, history of BCG vaccine |
|
|
Term
| Is the PPD test reliable in all patients? |
|
Definition
| No, false negatives occur in patients who lack t-cells |
|
|
Term
| Which medications are used for the treatment of TB? Is there a vaccine? |
|
Definition
| Rifater (isoniazid (INH), rifampin, pyrazinamide) is considered the best combination to cure the disease and prevent further resistance. Yes, but not completely effective |
|
|
Term
| How is M. Leprae cultured? What are the 2 forms of the disease? Which is worse? |
|
Definition
| It has never been grown in the lab – unable to be cultured; Tuberculoid and Lepromatous; Lepromatous |
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|
Term
| Which areas of the body are more prone to disfiguring lesions of leprosy? |
|
Definition
| Cooler areas like the nose, chin, brows |
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|
Term
| What type of neurological symptoms are seen in leprosy? |
|
Definition
| Nerve damage leads to wasting of muscles – drop foot and claw hands. Sensory nerve damage leads to trauma and loss of fingers and toes. |
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|
Term
| What causative agent is involved with a complication of tooth extractions, necrotizing lung disease, peritonitis after trauma, ulcers and appendicitis? |
|
Definition
|
|
Term
| What causative agent is causes a lung disease very similar to TB? |
|
Definition
|
|
Term
| Which gram negative bacilli are aerobic? Which of those are opportunistic pathogens? |
|
Definition
Pseudomonas Species, Brucella Species, Francisella Species, Bordetella Species, Alcaligenes Species;
pseudomonas and Alcaligenes |
|
|
Term
| What are some of the diseases caused by pseudomonas species? Is it easy to treat? |
|
Definition
| Otitis externa, hot tub folliculitis, pneumonia, UTI, abscesses, otitis, corneal disease, Endocarditis, meningitis – mostly as an opportunistic pathogen – not easy to treat |
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|
Term
| What is the causative agent of undulant fever? How is it contracted? |
|
Definition
| Brucella Species; zoonotic disease from infected animals |
|
|
Term
| What is the causative agent of tularemia? |
|
Definition
|
|
Term
| What is the causative agent of pertussis? What are the 2 phases of the disease |
|
Definition
| Bordetella pertussis; catarrhal and paroxysmal |
|
|
Term
| Why is the incidence of pertussis increasing? |
|
Definition
| Decreased number of people getting immunized |
|
|
Term
| What is the causative agent of Legionnaires disease & Pontiac fever? What is a common reservoir for this agent? |
|
Definition
| Legionella pneumophila - artificial aquatic environments like a water cooler or air conditioning systems |
|
|
Term
| What are some of the clinical features of Legionnaires disease? |
|
Definition
| Fever, cough, diarrhea, abdominal pain, pneumonia fatality rate of 3-30% |
|
|
Term
| Which bacterial species are considered enteric pathogens? Do they cause disease in the GI tract? |
|
Definition
| E.coli, klebsiella, proteus, enterobacter, serratia and citrobacter – usually pathogenic in other systems not the GI tract (opportunistic) |
|
|
Term
| What is a coliform? Non-coliform? |
|
Definition
- Coliforms are gram neg bacteria that ferment lactose
- Noncoliforms are non-lactose fermenters
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|
|
Term
| Which strain of E.coli causes hemorrhagic syndrome & permanent kidney damage? |
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Definition
|
|
Term
| What are some diseases caused by E.coli? |
|
Definition
| traveler’s diarrhea, UTIs, neonatal meningitis, pneumonia, septicimia and wound infections |
|
|
Term
| Which coliform causes pneumonia and produces a red pigment? |
|
Definition
|
|
Term
| Which non-coliform lactose-negative enterics are true pathogens? |
|
Definition
|
|
Term
| What is the causative agent of typhoid fever? |
|
Definition
|
|
Term
| Which part of the GI tract is affected by salmonella species? Shigella species? |
|
Definition
| Small intestines, large intestines |
|
|
Term
| What is the causative agent of dysentery? |
|
Definition
|
|
Term
| What is the causative agent of plague? What is the most common vector for plague? |
|
Definition
|
|
Term
| What the 3 types of plague? Is there treatment available? Vaccine available? |
|
Definition
| Bubonic, pneumonic, septicemic; 95% survival rate with antibiotic Tx; Killed or attenuated vaccine available but only lasts for a few months |
|
|
Term
| What pathogen is implicated in animal bites? |
|
Definition
|
|
Term
| What is the common causative agent of acute bacterial meningitis, epiglottitis, otitis media, sinusitis, pneumonia, & bronchitis? |
|
Definition
|
|
Term
| What is the causative agent in bacterial conjunctivitis? |
|
Definition
|
|
Term
| What is the causative agent of chancroid? |
|
Definition
|
|
Term
| How are ABO antibodies developed? |
|
Definition
| Serum has antibodies developed during infancy |
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