I&I Flashcards Preview

PPE > I&I > Flashcards

Flashcards in I&I Deck (56):
1

State cytokines released by Th1 and Th2

Th1 - TNF alpha, IFN-gamma
Th2 - IL 4, 5, 10

2

characteristics of HIV? pathology and acute symptoms?

pathogen - SS+ RNA
Binds to GP120 on cell --> reverse transcriptase + integrase then incubation for 1-3 weeks
acute - fever, rash, myalgia

3

detection and treatment of HIV?

Detect - PCR, p24 antigen via ELISA. All after 6 months
Treatment - HAART therapy - 2NRT inhibitors, integrase inhibitor, fusion inhibitor, protease inhibitor, NNRTI

4

Acute and chronic symptoms of Hep B?

acute - after 1-6 mths fever, malaise, jaundice
Chronic - jaundice, liver failrue, cirrhosis,, liver cancer

5

define microbiota

commensal bacteria both pathogenic and symbiotic that live on a body surface

6

Give examples of microbiota

HPV, herpes simplex
Gram + - s aureus, strep viridans, cornyebacterium
gram - - enterobacteriacae
dermatophytes

7

what are the gram positive bacteria?

Strange, staphys act list entered my new carrier bag
streptococcus, staphylococcus, actinomyces, listeria, enterococcus, mycobacteria, pneumonia, cornyebacteria, bacillus

8

mechanism of infection of a surface/

adherence via fimbriae > invasion + multiplication > biofilm > quorum sensing > host response of fever and granuloma

9

what bacteria infect heart valves?

native + >1yr prosthetic - HACEK group, strep viridans, candida, staph aureus

10

how do you diagnose and treat infected surfaces?

blood culture + sonication
treat with antibiotics or surgery

11

Explain the sensitisation and effector phase of type 1 hypersensitivity reactions

sensitisation - antigen contact --> IgE produced
effector - antigen binds to IgE on mast cell --> release of chemoattractants, cytokines, histamines --> effects depend on location

12

treat and manage anaphylaxis?

treat - adrenaline, monitor pulse oximetry, BP
manage - steroids, antihistamines, anti-ige

13

give examples of hospital acquired infections

pneumonia, UTI, legionella, MRSA, c diff

14

how do you diagnose and treat c diff

stool and elisa diagnose
treat - metronidazole or vancomycin

15

treat mrsa?

vancomycin

16

norovirus characteristics?

ss+ rna

17

define basic reproductive number

no of cases 1 case generates on average over the course of the infectiuous period
1 - infection will spread

18

what are the principles of antimicrobial stewardship

prevent inappropriate use of antibiotcs and resistance, minimise adverse effects, reduce cost of infection

19

what are some possible causes of chronic infections?

VITAMIN DEI
vascular, infection, trauma, autoimmune, metabollic, idiopathic, neoplasia, degenerative, environmental, inflammation

20

what is the pattern of inheritance of cf? what organisms infect a cf patient? what disease can cf progress to?

autosomal recessive
h influenzae --> staph aureus --> atypical mycobacteria --> pseudomonas aeroginosa
can become COPD

21

why does DM lead to increased risk of infection?

hyperglycaemia and acidosis results in reduced humoral immunity (antibodies) and decreased neutrophil and lymphocyte function

22

what diseases are DM patients at higher risk of?

otitis externa - pain and discharge of external ear and meatus
rhinocerebral mucormycosis - mould infection of sinuses due to DKA resulting in soft tissue and bony necrosis
UTIs

23

what symptoms does a immunocompromised patient have?

SPUR - severe, persistent, unusual, recurrent

24

Give example b cell deficiencies

CVID - b cells dont mature
IgA or IgG deficiency
Brutons - X linked
Hyper IgM syndrome - cant switch to IgG

25

what cell secretes antiobides? what are the types of antibodies and what is their funciton?

B cell secretes. MAGED
IgA - mucosal areas + saliva, sweat, tears, breast milk
IgD - immature b cells
IgE - allergies and parasitic worms
IgG - majority of antibody immunity against pathogens. Only ab that can cross placenta
IgM - eliminates pathogens in early stages of humoral immunity

26

give examples of phagocyte deficiencies -

cyclic neutropenia, leukocyte adhesion deficiencym chronic granulomatous disease

27

give example t cell deficiencies. How do you treat

digeorge syndrome, SCID
CATCH 22
Dg treat - antibiotics, correct calcium and heart, no live vaccines, X irradiated and CMV -ve blood, BM transplant

28

give examples of secondary immunodeficiency

HIV, malnutrition, liver disease, drug induced, splenectomy

29

give examples of encapsulated bacteria

strep pneumoniae, n mengitidis

30

how do you manage asplenic patients

penicillin prophylaxis, immunisation, medic bracelet

31

function of spleen?

removes opsonised and encapsulated bacteria, synthesis Antibodies

32

how do b cell deficiencies present? manage?

resp infections, gi complications,
manage - prophylaxis, immunoglobin replacement, avoid radiation

33

how do phagocyte deficiencis present? manage?

ulcer, osteomyeleitis, abscesses
manage - prophylaxis, stem cell transplant

34

how does SCID present?

failure to thrive, deep abscesses, decreased lymphocyte, viral + fungal infection

35

how do organisms cause disease?

exposure --> adherence --> invasion --> multiplication --> dissemination

36

antibiotics in the beta lactam group?

MCCP
monobactams, carbapenems, cephalosporins, penicillin

37

what are the resistance mechanisms in bacteria/

vertical (reproduction), horizontal (transformation (from environment), transduction (bateriophage), conjugation)

38

sepsis commonest pathogen?

n meningitidis

39

SIRS diagnoses?

2+ from
RR > 20, HR >90, temp >38, WBC 12x10(9)

40

what is sepsis and severe sepsis?

sepsis - sirs + infection
severe sepsis - sepsis + organ hypoperfusion or failure

41

how do you manage sepsis ASAP/

sepsis 6 within 1 hr
IV fluids and antibiotics, blood culture, serum lactate, urine output measured, oxygen

42

what is the characteristics of innate and adaptive immunity?

innate - fast, non specific, no memory
adaptive - slow, specific, memory

43

what structures and cells involved in innate and adaptiv eimmunity?

innate - WBCs, anatomical barriers, inflammation, complement proteins
adaptive - b and t lymphocytes

44

how do macrophages recognise pathogens?

have Pathogen recognition receptors (PRRs) to recognise PAMPs + phagocytose

45

how do macrophages kill?

oxygen dependent - superoxide
oxygen independent - lactoferrins, proteases, lysozyme

46

what complement proteins do you know nad their functions

c3a and 5a - chemoattractants for phagocytes
c3b and 4b - opsonise
c5-9 - membrane attack complex

47

How do you treat malaria

falcifiparum - quinine / artemesinin
other species - chloroquine

48

pathology of enteric fever and symptoms?

caused by salmonella enterica, adheres to ileal lymphoid tissue called peyers patches.
symptoms - fever, malaise, abdo pain, consitpation, hepatosplenomegaly, dry cough, intestinal hemorrhage

49

how do you investigate and treat enteric fever?

investigate - blood culture, raised LFTs, lymphopenia
treat - typhoid vaccine, ceftriaxone

50

symptoms of brucellosis and treatment/

symptoms - fever, myalgia (most important), arthralgia
doxycycline

51

characteristics of flu A

-ss RNA

52

legionella symptoms?

fever, diarrhoea, chils, myalgia, tiredness

53

what is antigenic drift and shift?

drift - mutation
shift - combo of different strains

54

how are extracellular PAMPs targetted?

phagocytosed by antigen presenting cells (APCs) --> MHS class 2 binds to PAMP --> activates CD4 cell --> activates B cells, eosinophils, mast cells

55

how are intracellular PAMPs targetted

antigen enters ER --> Binds to MHC1 --> activates CD8 --> activates killer t cells --> release perforins and granzymes

56

why does organ rejection occur?

MHC incompatability