9. Immunology Flashcards
HBV
Main particle Acute infection progression (4) Length of incubation period Chronic infection progression (4) Length of incubation period Definition of chronic HBV (2) Treatment HBeAg is the sign of
Dane particle
Infection, incubation, clearance of antigens, creation of anti-HBs
2-3 months
Infection, incubation, HBsAg persists, no anti-HBs develop
2-3 months
Chronic when antibody to core Ag present but no antibody to HBsAg
Antivirals
A highly infectious individual
HCV
Acute infection progression (2)
Length of incubation period
Infection, incubation
6-12 months
Chronic infection more likely
HIV
HIV replicative cycle (4) Infection cause and progression (3) End point Definition of AIDS (2) Types of indicator conditions (4) Management (2) Examples of group 1 lesions associated with HIV (2)
Types of BBVs (3), main routes of transmission (3) and risk of infection with exposure (3)
HIV contents released into cell, reverse transcriptase copies it into DNA, viral proteins are made, viral proteins bud from and potentially kill the cell
CD4 destruction, acute seroconversion illness, prolonged latency period
AIDS
HIV and one/more indicator conditions
Lymphoma, TB, pneumonia, Kaposi sarcoma
Treat opportunistic infections, HAART
Candidosis, Non-Hodgkin’s lymphoma
HBV - unprotected sex - 1/3
HCV - IVDU - 1/30
HIV - unprotected sex - 1/300
Sepsis
Definition of bacteraemia
Definition of septicaemia
Septicaemia diagnosis
SIRS criteria (3)
Definition of sepsis Diagnosis of sepsis (2) Features of sepsis (5) Types of sepsis (3) Sepsis 6 (6)
Gram -ve septicaemia due to
Gram +ve septicaemia due to (2)
Transient presence of bacteria in blood
Persistant presence of bacteria in blood and signs and symptoms
From blood tests
Temperature <36/>38C, HR > 90bpm, WCC <4000/>12000 cells/mm3
Host response to infection - uncontrolled, unregulated, self-sustaining intravascular inflammation
Infection and SIRS criteria
Cytokine storm, endothelial damage, microvascular dysfunction, impaired tissue oxygenation, organ injury
Sepsis, severe sepsis (sepsis and organ failure), septic shock (severe sepsis and shock refractory to fluid resuscitation)
Give oxygen (SATS > 94%), take blood cultures, IV antibiotics, give fluid challenge, measure lactate, measure urine output
Endotoxin release
Teichoic acid and peptidoglycan
Sharps injuries
Definition of exposure
Definition of significant exposure
Definition of exposure prone procedure
Exposure prevention (3)
Sharpe injury protocol (7)
PEP for BBVs (2)
Sharp object, contaminated with blood/body fluids that pierces/breaks the skin
Exposure with blood/body fluid contaminated from patient with a BBV
Invasive procedure, when the HCW hand is in contact with normally sterile parts of the body/where fingertips are not always visible, where injury to the HCW would lead to exposure to the patient’s blood
PPE, hand hygiene, safe sharps and waste disposal
Be sharps AWARE - allow to bleed, wash, assess injury, risk of source blood, establish contact. Take baseline bloods from HCW and patient, patient sharps injury assessment form
HBV and HIV. HBV PEP only required when unvaccinated/vaccinated non-responder
Chain of infection
Circle of six (6)
Methods of portal of exit (2)
Methods of portal of entry (2)
Definition of virulence
Definition of infectious dose
Definition of colonisation (2)
Surface antigens of influenza (2)
Infectious agent, reservoir, portal of exit, mode/means of transmission, portal of entry, susceptible host
Cough, sneeze
Aerosols, inhalation
Ability to cause disease
ID50 - dose required to cause infection
Presence of micro-organism in/on host with growth and multiplication but no infection
Haemagglutinin H1-15, neuraminidase N1-9
Environmental contamination
Definition of high risk equipment
Definition of medium risk equipment
Definition of low risk equipment
Definition of minimal risk equipment
Features of breaking the chain of infection (6)
Definition of detergent
Definition of disinfection
Features of high level disinfectant
Features of low level disinfectant
Critical - in contact with normally sterile body sites
Semi-critical - in contact with intact mucous membranes
Non-critical - in contact with intact skin
Not in contact with intact skin
Surface design, surface material, cleaning (physical removal of dirt), PPE, aerosol control, vaccinations
Group of synthetic organic water-soluble agents with wetting agent, emulsifying and soil holding emulsifying properties
Removal/destruction of microbes, usually not including bacterial spores
High level - kill all microbes but not large numbers of bacterial spores
Low level - kill most vegetative bacteria, some fungi and some viruses in a practical time period (<10mins)
Antibiotics
Definition of antibiotics
Ideal antimicrobial actions (3)
Antimicrobial targets (4)
How does antibiotic resistance occur (4)
Function of normal flora (2)
Barriers for microbes entering the gut (3)
Chemical substance produced by one organism that is destructive to another - break down cell walls
Selective toxicity, minimal host toxicity, -cidal activity
Inhibit cell wall synthesis, inhibit protein synthesis, inhibit nucleic acid replication and transcription, inhibit essential metabolite synthesis
From misuse - using out of date antibiotics, someone else’s, inappropriate use (for common cold), using in animal feed
Synthesis and secrete vitamins
Low pH, saliva, bile
Skin and soft tissue infections
Type of micro-organism (2), virulence factor and infections caused (4) by S. aureus
Features of surgical wound infection (4)
Type of micro-organism (2), virulence factors (2) and infections caused (2) by S. pyogenes
Type of micro-organism (2), virulence factor and infection caused by S, anginosus
Virulence factor and infections caused by herpes simplex virus
Type of micro-organism, virulence factor and infections caused by anaerobes
Virulence factor and infections caused by C. albicans
Gram +ve coccus. PVL toxin. Epidermis (impetigo), dermis (erysipelas), hair follicle (folliculitis) and surgical wound infections
Sore, red, swollen, discharge
Gram +ve bacillus. Superantigens, toxic shock syndrome. Angular cheilitis, subcutaneous fat (cellulitis) infections
Gram +ve bacillus. Intermedilysin. Acute dento-alveolar abscesses
Cell lysis. Gingival stomatitis
Clostridium difficile. Alpha-toxin. C. diff colitis
Phospholipase. Erythematous candidosis
