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NPLEX I > Anderson Immuno/Micro > Flashcards

Anderson Immuno/Micro Flashcards

1
Q

Acid tolerant organisms…

A

Lactobacillus, Strep, H. Pylori

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2
Q 
Endo or exo toxin: 
LPS
Denatured by boiling 
Antigenic 
Form Toxoid 
Pyrogenicity
High specificity 
Protein 
Extracellular 
Part of outer membrane
A 
Endo 
Exo
Both
Exo
Endo, sometimes Exo
Exo
Exo
Exo
Endo
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3
Q

What are the three responses of the body to cold temperature?

A

Thyroid hormone - increased metabolism
Sympathetic nervous system - activates beta-receptors in brown fat to increase metabolism
Shivering - activated by posterior hypothalamus

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4
Q

What part of the hypothalamus is responsible for the body temperature set point?

A

Anterior hypothalamus

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5
Q

How do pyrogens affect the set-point temperature? How do they do that?

A

They increase it.

IL-1 triggers fever, via prostaglandins

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6
Q

How do aspirin and steroids reduce fever?

A

Aspirin - cox inhibitor - reduce prostaglandins

Steroids - block release of arachidonic acid from phospholipids

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7
Q

Heat exhaustion vs. stroke

A

Exhaustion - dehydrated from sweating, syncope, wet

Stroke - body temp approaches tissue damage, dry

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8
Q

All the immune cells mature in the bone marrow except ______ cells.

A

T-cells

Mature in the thymus

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9
Q

Name the immune cell:
Cell-mediated immunity
Ab (Humoral) immunity
Immunological surveillance

A

T-cells
B-cells
NK Cells, Macrophages

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10
Q

What is the classical vs. alternate activation of complement?

A

Classical - Ag/Ab rxn, strong

Alternate - activated w/o Ag/Ab rxn, weaker, starts at C3 locus

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11
Q

Name the interferon:
Made by leukocytes, inhibits tumor cell growth, stimulates NK cells
Made by fibroblasts
Made by T-cells, activates NK, killer-T cells, activates phagocytic cells

A

IF- alpha
IF - beta
IF -gamma

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12
Q

What does TNF-alpha do? TNF-beta?

A

Alpha - stimulates apoptosis

Beta - induces IL-10

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13
Q

Name the interleukin:
Fever, t-cell proliferation
Promote cellular immunity, secreted by CD4
Promote humoral immunity, secreted by CD4
Promote humoral immunity, secreted by T-cells
Fibroblast secretion, megakaryocyte potentiator

A 
IL-1
IL-2
IL-4 and 5
IL-10
IL-11
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14
Q

Which MHC:
Present viral antigen to CD8, activate CD8
Docking protein on MO which hooks to a CD4

A

MHC1

MHC2

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15
Q

Definition: Incomplete antigen, unable to stimulate immune response on its own. Reacts with other proteins making them antigenic.

A

Haptens

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16
Q 
Name the antibody and their response: 
"Allergy" 
"Secretory" 
"First Responder"
"Long Term"
A

IgE - Type 1 Hypersensitivity, parasitic infection
IgA - Mucosal, dimer
IgM - basis for ABO-blood type antigen rxn, short-lived, pentamer
IgG - MC, focuses NK cells, immunization

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17
Q 
Name the hypersensitivity rxn: 
Immune complex mediated
Antibody mediated 
IgE mediated, anaphylaxis 
Delayed, cytotoxic type
A

Type III, humoral
Type II, humoral
Type I, humoral
Type IV, cell-mediated (e.g. PPD TB test)

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18
Q

Name the AI dz:
Thymic hypoplasia, absences of T-cell immunity
Excessive systemic collagen/fibrosis of microvasculature
AI destruction of salivary/lacrimal glands
Type III and II auto-Ab, remitt/relapse, ANA
Inflammatory myopathy w/ skin involvement
Inflammatory myopathy w/o skin involvement

A 
DiGeorge's Syndrome
Scleroderma/Systemic Sclerosis 
Sjogren's Syndrome
SLE
Dermatomyositis
Polymyositis
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19
Q

What are the primary and secondary responses of T-cells?

A

Primary: T-cells are activated by APC, signaled directly to site of antigen

Secondary: T-cells cloned and stored in lymph nodes

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20
Q

What are the primary and secondary responses of B-cells?

A

Primary: Interleukin, prostaglandin, TNF, IF production
Activate complement, and draw MO to area

Secondary: memory B-cells respond, IgG produced, complement activated

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21
Q

Beta-hemolytic vs. alpha-hemolytic

A

Beta - complete hemolysis

Alpha - incomplete hemolysis

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22
Q

T/F: Gram + cocci tend to have NO flagella and are NON-motile, and NON-spore-forming.

A

T

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23
Q 
Staph or Strep: 
Beta-hemolytic 
Toxic Shock Syndrome, Food Poisoning 
Impetigo
Coagulase positive 
ASO titer +
A 
Staph and Strep
Staph
Staph or Strep
Staph 
Strep
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24
Q

Type of staph that is coagulase negative and usually due to surgical or wound infections and can cause subacute endocarditis.

A

S. epidermidis

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25
Q

Type of staph that is the least common and associated with UTIs. Also coagulase negative.

A

S. saprophyticus

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26
Q

What type of strep is grp A? grp B? What is each more closely associated with?

A

S. pyogenes - pharyngitis, impetigo, scarlet fever, rheumatic fever
S. agalactiae - post-partum infection, neonatal sepsis/meningitis

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27
Q

Name the strep:
Pneumonia, sinusitis, meningitis, otitis media
Endocarditis, bacteremia, dental caries

A

S. pneumoniae

S. viridans

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28
Q

What family are the Gm - diplococci?

A

Neiserria

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29
Q

MC STD in US? Second MC?

A

Chlamydia

N. gonorrhea

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30
Q

T/F: N. gonorrhea produces an IgG that neutralizes the IgA of humans.

A

N. gonorrhea produces a neutralizing IgA

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31
Q

What is the histological finding of N. gonorrhea?

A

Intracellular gm- diplococci inclusions in neutrophils

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32
Q

What is the difference between n. meningitidis and gonorrhea?

A

gonorrhea - can ferment in glucose

meningitidis - can ferment in glucose and maltose

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33
Q 
M/C organisms causing meningitis in each age grp: 
0-4wks
4-12wks
3mo-18yr
18yr-50yr
>50yr
A

Grp B strep, E. coli, Listeria monocytogenes
S. pneumoniae, grp B strep, E. coli, L. monocytogenes
S. pneumoniae, N. meningitidis
S. pneumoniae, N. meningitidis
S. pneumoniae, N. meningitidis, L. monocytogenes, aerobic gm - bacilli

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34
Q

What are the families of gm- spore-forming rods?

A

Clostridia and Bacillus

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35
Q

Name the clostridium:
Anti-cholinergic neurotoxin, descending paralysis
Gas gangrene
Inhibit glycine and GABA, tetanus
Pseudomembranous colitis, post-antibiotic therapy

A

Botulinum
Perfringens
Tetani
Difficile - MC, often normal flora

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36
Q 
Name the Bacillus: 
Found in soil (around animals), highly fatal 
GI and eye infections
Chinese food poisoning 
Highly fatal - cutaneous, inhalation, GI
A

anthracis
cereus
cereus
anthracis

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37
Q

What are the families of gm+ non-spore forming rod?

A

Corynebacterium and Listeria

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38
Q

Name the corynebacterium:
Pseudomembrane, gray coating which can cause severe hemorrhage.
Acne, cutaneous infections

A

C. diptheriae

Other

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39
Q

Name the infection:
Targets pregnant women, neonates, elderly, immunocompromised. Granulomotosis infatiseptica. Replicates in MO, with help from listeriolysin O and thus avoids Ab and other bactericidal agents. Likes to go to heart and brain.

A

Listeria monocytogenes

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40
Q

All members are facultative anaerobes, ferment glucose, oxidase negative, reduce nitrates to generate energy.

A

Gm - rods (salmonella, eschericia, shigella, klebsiella pneumoniae, enterobacter, citrobacter, yersinia, proteus, pseudomonas, legionella)

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41
Q

What sugar does E. coli ferment?

A

Lactose

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42
Q

What are the four groups of E. Coli and where do they live?

A

Enterotoxigenic and Enteroaggregative - small intestine
Enteropathogenic - large intestine, infantile non-bloody diarrhea
Enteroinvasive - large intestine/colon, watery diarrhea w/ small bloody stools
Enterohemorrhagic - colon, verotoxin (shiga-like toxin), blood stool

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43
Q

What is the worse variety of E. coli and why?

A

E. Coli 0157:H7

44
Q

Name the salmonella:
Typhoid fever, rigid belly, rose spots on stomach
More acute onset, egg shells, resolves 2-7d

A

S. typhi

S. enteritidis - MC

45
Q

What are the two types of shigella? How do they create sx?

A

S. dysenteriae
S. sonnei (MC in US)

Shiga-toxin - more aggressive than salmonella
Transmitted via four F’s

46
Q

Name the organism:
Alcoholics, “currant jelly” sputum
Nosocomial usually
Transmitted via flea bite, 75-90% fatal, pneumonia or bubonic
Looks like appendicitis, w/ polyarthritis, close proximity to large animals

A

Klebsiella pneumoniae
Enterobacter aerogenes
Y. pestis
Y. enterocolitica

47
Q

Name the organism for diarrhea according to incubation time, type of diarrhea, and presence of emesis:
4-12hr, watery/profuse, ++emesis, no fever
2-7d, watery/profuse, +emesis
1-4d, variable/bloody, mild emesis, severe abd pain, + fever
1-3d, bloody, mild emesis, severe abd pain, mild fever
8-72hr, variable/watery, mild emesis/abd pain, no fever

A 
S. aureus, C. perfringens
E. coli, giardia
Salmonella, Campylobacter, Shigella, Enteroinvasive E. coli, Entamoeba histolytica
Hemorrhagic E. coli, C. difficile 
V. cholerae, Enterotoxigenic E. coli
48
Q

Name the organism:
UTI, elevated pH, increased stone formation, “urea-splitting”
Burn infections, resistant to antibiotics, fruity odor, CF
Transmitted via standing water, pneumonia or flu-like

A 
Proteus mirabilis and vulgaris 
Pseudomonas aeruginosa
Legionella pneumophilia (Pontiac fever, Legionnaires dz)
49
Q

Gm - curved rods

A

H. pylori, Campylobacter jejuni, V. cholerae

50
Q

Name the organism:
Gastric ulcers, risk for adenocarcinoma of the stomach
Shellfish vector, MC cause of bacterial enteritis in US, fecal-oral transmission, self-limiting
“Rice-water” stools, 20L/day fluid loss
24hr incub, explosive diarrhea for 72hr

A

H. pylori
C. jejuni
V. cholerae (O1 more deadly than non-O1 antigen)
V. parahemolyticus

51
Q

Gm - coccobacilli

A

Hemophilus, bordetella

52
Q

Name the organism:
Childhood sinusitis, meningitis, epiglottitis, otitis, COPD pneumonia
Painful genital ulcer “Chancroid”
Assoc w/ BV, “strawberry cervix”, + whiff test
“Whooping cough”, death can occur due to hypoxia/pneumonia

A

H. influenzae
H. ducreyi
H. vaginalis

53
Q

Acid-fast rods

A

Mycobacterium

54
Q

Name the mycobacterium:
Gohn complex, granulomatous, can go to any organ
Leprosy/Hansen’s dz
Lung dz in immunocompromised patients, bird vector

A

M. tuberculosis
M. leprae
M. avium

55
Q

Spirochetes

A

Treponema, borrelia, leptospira

56
Q

Name the treponema:
Syphilis
Trench mouth
Yaws

A

T. pallidum
T. pertenue
T. vincentii

57
Q

Describe the stages of syphilis.

A

Primary: painless chancre, regional LA
Secondary: general rash, fever, disseminated, highly infectious
Late (tertiary): Gumma, tabias dorsalis, encephalitis
Congenital: no sx. at birth, onset of rash/systemic dz later

58
Q

Erythema migrans, tick-borne dz, two stages of infections.

A

Borrelia burgdorferi (Lyme)

59
Q

Biphasic illness beginning w/ fever, chills, and intense HA. Can resemble aseptic meningitis, uncommon

A

Leptospira interrogans (Weil’s dz)

60
Q

Wall-less bacteria - smallest free living bacteria

A

Mycoplasma pneumonia, ureaplasma urealyticum

61
Q

What does the cellular membrane of M. pneumonia contain that no other bacterial membrane does?

A

Cholesterol

62
Q 
M. pneumonia or U. urealyticum: 
Gm -, strictly aerobic 
Non-specific urethritis in men
"walking pneumonia" 
"Fried egg" appearance on agar
Resp/sexual transmission (w/ Chlamydia)
A 
M. pneumonia 
U. urealyticum
M. pneumonia
M. pneumonia
U. urealyticum
63
Q

Name the Rickettsia:
Louse borne, Typhus, severe fever/HA, macular rash
Tick borne, Rocky Mountain Spotted Fever, MC in US
Flea borne, Murine (endemic) typhus, chest maculopapular rash, flu sxx

A

R. prowazeki
R. rickettsii
R. typhi

64
Q

Obligate intracellular bacteria

A

Chlamydia, Rickettsia

65
Q

Name the chlamydia:
Preventable blindness, MC STD in US
Pharyngitis, bronchitis, sinusitis
Parrot fever, myocarditis, encephalitis, hepatitis

A

C. trachomatis
C. pneumoniae
C. psittaci

66
Q

What two organisms would you be concerned about with someone handling birds?

A

C. psittaci
H. avium
Cryptococcus neoformans

67
Q

Name the fungal infection:
Ohio/Mississippi valley, flu-like resp illness, similar to TB
California desert/SW, cough, fever, chest pain, “Valley fever”
Chicago, ulcerative granulomata of the skin/bone

A

Histoplasma capsulatum
Coccidiodes immitis
Blastomyces dermatiditis

68
Q

Name the opportunistic fungal infection:
Normal in small quantity, problem in immunocompromised (IC)
Allergic trigger, “fungus balls” that is movable, lung function
Fungal CNS infections in IC, pigeon carrier
“Cosmopolitan organism”, AIDS, pneumonia

A

Candida albicans
Aspergillus
Cryptococcus neoformans
Pneumocystis carinii

69
Q 
Name the herpes virus and pathogenesis: 
HSV I
HSV II
HSV III
HSV IV
HSV V
HSV VI
A

Oral herpes - vesicles, live in trigeminal nerve
Genital herpes - vesicles, live in lumbar/sacral ganglia, can also cause aseptic meningitis
Varicella zoster - chicken pox/shingles - LPS
Epstein Barr virus - Mono, Burkitt’s Lymphoma, B-cell lymphocytes in salivea, histo: downey cell
Cytomegalovirus - likes neuro/eye tissue, infantile meningitis, “Mono-like”, saliva/sexual secretions/vertical transmission
Roseola infantum

70
Q

Most common cause of diarrhea in children

A

Adenovirus - DNA virus

71
Q 
Which HPV: 
Warts 
Condylomata
Cervical HPV
Vulvar HPV
A

HPV 1-4
HPV 6, 11
HPV 16, 18, 31, 33
HPV 16, 18

72
Q 
Measles or Mumps
Rubeola- RNA virus
Viral parotitis 
Koplik's spots, maculopapular rash
Resp droplet transmission
Cough, coryza, conjunctivitis (3 C's)
Sequelae: sterility, DM 
Sequelae: subacute sclerosing pan-encephalitis (SSPE)
A 
Measles
Mumps
Measles
Both
Measles
Mumps
Measles
73
Q

Paramysoviruses

A

RSV, measles, mumps, parainfluenza

74
Q

Most common cause of FATAL acute resp infxn of infants.

A

Resp syncytial virus - bronchiolar necrosis and mucus plugging, small airway susceptible to distress

75
Q

Organism that causes croup, SUB-epiglottic swelling. What is your DDX?

A

Parainfluenza virus

DDX: H. influenza epiglottitis

76
Q 
Name the hepatitis: 
Fecal-Oral transmission, abrupt onset
DNA virus
Endemic to Mexico, Africa, Indochinese 
Fatality in women 15-25% 
RNA virus 
Can become chronic
Requires Hep B infxn
High risk of cirrhosis, hepatocellular carcinoma
A 
Here you go! 
Hep A and E
Hep B
Hep E
Hep E
Hep A, C, D, E 
Hep B, C, D 
Hep D 
Hep C and B
77
Q

When is foreign travel more likely to be relevant in a case?

A

If travel occurs 30-60d ago.

78
Q

Common cold virus.

A

Rhinovirus

79
Q

T/F: Influenza virus has no GI symptoms.

A

T

80
Q

Adult vs. child influenza

A

Adult: rapid onset high fever, malaise, myalgia, pharyngitis, non-productive cough

Child: same sx, higher fever, otitis, GI pain/vomiting, croup (non-productive cough)

81
Q

Which type of influenza (A, B, or C)
Pandemic
Local epidemic
Mild URT infxn

A

A
B
C

82
Q

What are the polio vaccines? Which is live/dead?

A

Salk (dead) and Sabin (live)

83
Q

What virus causes Hand-Foot-Mouth Dz?

A

Cocksackie

84
Q

What is the most common viral cause of myocarditis?

A

Cocksackie B

85
Q

What aspect of the spinal cord can be infected by polio virus?

A

Anterior horn producing paralysis

86
Q

What is the pathognomonic histo finding of rabies?

A

Negri bodies

87
Q

What virus causes German Measles?

A

Rubivirus (Rubella)

88
Q

Togaviruses

A

Rubella, alpha/flavi viruses ( West Nile, Eastern Equine, Dengue, Yellow fever)

89
Q

Which alpha/flavi viruses are transmitted via mosquito?

A

Dengue, Yellow Fever (black vomit), West Niles, Eastern Equine, Japanese/St. Louis/Russion Encephalitis

90
Q

Describe the timeline of HIV in terms of sx and CD4 counts.

A

Infection: 1-8mo, mono-like illness, resp signs
Stage 1: 8-36mo, CD4 drop from 700 to 2500, latent sx, chronic LA, some opportunistic infxn
Stage 2: 36-60mo, CD4 150-250, sub-clinical immune dysfunction
Stage 3: 60-72mo, CD4 50-150, AIDS
Stage 4: 72+mo, CD4 0-50, AIDS

91
Q

What is the clinical diagnosis of AIDS?

A

HIV + and CD4 count less than 200

92
Q

What is the only DNA virus that replicates in the cytoplasm?

A

Poxvirus

93
Q 
Name the condition: 
Variola major (15-40% mortality) and minor (1% mort)
Resp droplet spread
Lesions extend to deep dermis (scarring)
All lesion at same stage of development
Centrifugal that moves peripherally
A

Smallpox

94
Q 
Name the condition: 
Molluscipoxvirus
Small raised papule w/ crater or pus center
Self-limited, in kids
Assoc w/ HIV patients
A

Molluscum contageosum

95
Q

T/F: Parvovirus is the ONLY dsDNA virus.

A

F. ssDNA

96
Q

What is the smallest DNA virus and what condition does it cause?

A

Parvovirus B19, Fifth Dz- slapped cheek rash, arthritis in adults

97
Q

What is the ONLY dsRNA virus?

A

Reovirus (Rotavirus)

98
Q

What are some prion dz?

A

Kuru, Creutzfeld-Jacob, Scrapie, Wasting syndrome, BSE

99
Q

What are the TORCH conditions?

A 
Toxoplasmosis
Other - Syphilis, Varicella-Zoster, Parvo B19
Rubella
Cytomegalovirus (CMV)
Herpes
100
Q 
Name the flagellated protozoa: Giardia or Trichomonas
Non-bloody foul diarrhea/flatulence 
Sexual transmission
Foul-smelling green vaginal d/c 
Water-borne
A

Giardia lamblia
Trichomonas vaginalis
Trich
Giardia

101
Q

What disease is caused by trypanosomes?

A

African Sleeping Sickness or Chagas Dz - unilateral eye swelling, cardiomegaly, megaesphogus, megacolon

102
Q

What are sz of leishmania? What is the vector?

A

Cutaneous (Oriental sore) or visceral manifestation,

Sandfly

103
Q

Sporozoa

A

Plasmodium, Toxoplasma gondii, cryptosporidium, babesia

104
Q 
Name the parasite: 
Malaria
Kitty litter infxn
Water borne diarrhea
Tick-borne, arthralgia/fatigue, attacks RBCs
A

Plasmodium spp.
Toxoplasmosis gondii
Cryptosporidium parvum
Babesia bigemina - can look like Lyme

105
Q

Name the worm:
Roundworm, likes liver/lung, LONG (20-35cm)
Pinworm
Hookworm, microcytic anemia
Trichinosis, via pigs, cardiac/nervous tissue infxn

A

Ascaris lumbricoides
Enterobius vermicularis
Necator americanus
Trichinella spirilis

106
Q

Name the worm:
Elephantiasis, clog lymphatics
Snail host, bladder/bowel/liver dz
Tapeworms, long, cause nutrient def (esp B12)

A

Filariasis
Schistosoma spp. (blood fluke)
Taenia spp (T. solium (pork), T. saginata (beef))

NPLEX I (12 decks)

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