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MIP 351 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

In 1918 the causative agent of influenza was wrongfully determined to be a bacterium isolated from the throat of patients – what is this an example of?

A

Normal flora

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2
Q

The microbiome is the collection of all _____ in the human body

A

Microbial genomes

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3
Q

The microorganisms living in (or colonizing) the human body

A

human microbiota

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4
Q

What is the fine balance between flora and host with no disease known as

A

symbiosis

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5
Q

When there is an imbalance between flora and host –> can cause disease

A

dysbiosis

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6
Q

List seven ways the microbiome helps human health

A
  1. Protects against pathogens
  2. Synthesizes vitamins
  3. Develops the immune system
  4. Promotes intestinal angiogenesis
  5. Promotes fat storage
  6. Ferments dietary fiber, producing SCFA
  7. Modulate the central nervous system
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7
Q

How does the microbiome stimulate the development of an active immune system?

A

Cross-reactive antibodies protect against related pathogens

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8
Q

How does the microbiome protect against colonization by pathogens

A

Competes for nutrients and produces anti-microbial compounds

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9
Q

What is the current view on the sterility of the womb?

A

The placenta and fetus are sterile, first exposure to bacteria comes from vagina or through c-section

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10
Q

At what age is full colonization thought to be achieved?

A

2-3 years old

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11
Q

Potentially pathogenic bacteria colonization is more likely for which type of birth

A

Caesarean

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12
Q

Should cerebral spinal fluid contain bacteria?

A

No – the central nervous system should not

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13
Q

What does the bacterial population on skin mainly consist of?

A

Mainly Gram +, some Gram - that can be transient/permanent, and bacteriophages that may contribute to homeostasis

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14
Q

Are the eyes and ears sterile?

A

The eyes have bacteria and the outer ear has bacteria, but the inner ear is sterile

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15
Q

List two bacteria that often colonize the upper respiratory tract

A

Staphylococcus aureus and Streptococcus pneumoniae

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16
Q

Is there normal flora in lungs?

A

Yes

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17
Q

Out of the digestive system, which organ has the least amount of bacteria?

A

The stomach because it is a highly acidic environment

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18
Q

Why did researchers initially believe bacteria outnumber human cells by ten-fold

A

Because they were sampling from the colon (which has a very large number of bacteria)

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19
Q

Which parts of the urinary tract are sterile?

A

The urethra and bladder are colonized, the ureters and kidney are sterile

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20
Q

Which parts of the reproductive tract are sterile?

A

The vagina and penis are colonized, the uterus and ovaries/testes are sterile

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21
Q

List four sterile sites in the body

A
  1. CSF
  2. Blood
  3. Tissues/organs
  4. Bone marrow
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22
Q

The presence of normal flora that can be transient or permanent, often providing some benefit to the host, and doesn’t disrupt normal body functions

A

colonization

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23
Q

Causing damage to the host due to microbial factors or due to host immune response, can be due to opportunistic or strict pathogens

A

infection

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24
Q

TB, gonorrhea, and the plague are all caused by what type of pathogens

A

strict pathogens

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25
Q

List Koch’s postulates

A
  1. Pathogen is present in every case of disease and not in healthy patients
  2. Can be isolated and grown in pure culture
  3. Causes the same disease when healthy host is inoculated
  4. The same pathogen must be isolated from the diseased host
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26
Q

The skin and mucosal surfaces are what type of natural barrier

A

Physical

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27
Q

Flushing/sloughing is what type of natural barrier

A

Mechanical

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28
Q

Acids, enzymes, and bile are what type of natural barrier

A

Chemical

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29
Q

The normal flora are what type of natural barrier

A

microbiological

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30
Q

What is the difference between stratified epithelia and simple epithelia

A

Stratified is directly exposed to the environment and is not easily penetrated, simple is a single layer that must allow for absorption in internal areas and is more vulnerable to penetration

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31
Q

How must bacteria enter the host?

A

Through injury or between cells

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32
Q

A protein in the epidermis that is resistant to enzymatic digestion by most microbes

A

Keratin

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33
Q

what cleaves NAM-NAG in peptidoglycan at mucosal surfaces

A

lysozyme

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34
Q

The bile salts in the small intestine do what to help the gastrointestinal tract

A

They disrupt bacterial membranes and DNA

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35
Q

What type of bacteria have teichoic acids linked to peptidoglycan that can be antigenic

A

Gram positive

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36
Q

List the four functions of innate immune cells (neutrophils, dendritic cells, macrophages)

A
  1. Phagocytosis
  2. Present antigens
  3. Secrete immune molecule signals
  4. Initiate the adaptive immune response
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37
Q

What cells are abundant in the blood, are very short-lived, move into tissue in response to infection, and are the primary component of pus (they explode)

A

neutrophils

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38
Q

What cells are phagocytic, are few in number (with a slightly longer life), and have a precursor that circulates in the blood and differentiates after migrating into tissue

A

macrophages

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39
Q

What is the key player at the center of the innate and adaptive immune response

A

dendritic cells

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40
Q

What is the cause of erythema (redness), edema (swelling), heat, & pain in an infection

A

cytokines

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41
Q

What does the production of pro-inflammatory and chemotactic cytokines result in?

A
  • Vasodilation of blood vessels and migration of leukocytes into tissue
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42
Q

What type of cytokines are IL-1, IL-6, IFNGamma, and TNF

A

pyrogens (fever-causing)

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43
Q

What affects the hypothalamus, elevates body temperature, and stimulates killing by leukocytes

A

pyrogen cytokines

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44
Q

Where is complement produced?

A

The liver

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45
Q

Where is complement produced?

A

The liver

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46
Q

What three functions does the complement cascade carry out

A
  1. enhanced phagocytosis (opsonization)
  2. chemoattraction (recruits phagocytes to site of infection)
  3. destroys pathogenic bacteria (cytolysis)
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47
Q

What does C3a do?

A

increase permeability of blood vessels

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48
Q

What does C3B do?

A

enhances phagocytosis by macrophages

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49
Q

What does C5a do?

A

inflammation & chemoattractant for phagocytes

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50
Q

What does C5b do?

A

Initiates membrane attack complex

51
Q

What type of bacteria are more protected against the MAC and why

A

G + because of the thick peptidoglycan layer

52
Q

Which complement pathways are innate and which are adaptive

A

Alternative and MBL = innate, classical pathway = adaptive

53
Q

What sticks to peptidoglycan, teichoic acid, LPS, etc. on the surface of microbes

A

C3b

54
Q

Mannose binding lectin binds to receptors on bacteria but not in humans why?

A

Human cells covered by sugars such as sialic acid

55
Q

IFNGamma triggers differentiation into what type of helper cell

A

Th1

56
Q

IL-4 and IL-13 trigger differentiation into what type of helper cell

A

Th2

57
Q

What type of helper cells target intracellular infections

A

Th1

58
Q

What are the most potent antigens that stimulate both humoral and cell-mediated immunity

A

proteins

59
Q

What antigens stimulate only humoral immunity

A

Carbohydrates/sugars

60
Q

What are weak antigens of the adaptive immune response

A

Lipids and nucleic acids

61
Q

CD4 T cells bind to what type of MHC

A

MHCII

62
Q

What type of helper T cell stimulates the cellular immune response (phagocytes and CTLs)

A

Th1

63
Q

What type of helper T cell stimulates the humoral response (B cells)

A

Th2

64
Q

BCRs can recognize what types of antigens

A

Proteins, polysaccharides, and lipopolysaccharides

65
Q

What type of MHC receptors do B cells have

A

MHC-II

66
Q

Are memory cells produced in cases of T cell independent (TI) antigens

A

NO

67
Q

What is the difference between TI-1 and TI-2 antigens

A

TI-1 = LPS, recognized by TLR or BCR
TI-2 = bacterial capsular polysaccharide, repetitive structure cross-links BCR

68
Q

Children under 5 cannot mount an effective response to what type of antigens

A

TI-2 antigens

69
Q

What antibody is located in the membrane of B cells, is the first Ab synthesized in an infection, is a pentamer, agglutinates bacteria, and activated the classical complement cascade

A

IgM

70
Q

What antibody is the main one in human serum, makes up 80% of the Ab pool, is able to cross the placenta, and opsonized pathogens/activates the classical complement cascade

A

IgG

71
Q

What is the antibody most prominent in mucosal tissues, is produced in its secretory form through oral vaccination, prevents attachment, is transferred to newborns through breast milk, and is the key Ab to protect against enteropathogens

A

IgA

72
Q

What antibody makes up a small percentage of the pool, is responsible for allergic reactions, binds to Fc receptors on mast cells/basophils to cause histamine production, and is important in controlling parasitic infections

A

IgE

73
Q

What antibody is found in trace amount in blood serum, is a monomer, is found in the B cell membrane (serving as antigen-binding receptor), and cannot cross the placenta

A

IgD

74
Q

Where do all complement cascade pathways converge

A

Production of C3 convertase

75
Q

What type of vaccine has live pathogen that is not virulent due to being grown at a different temperature, mutated, genetically modified, passaged in a laboratory, etc.

A

Live attenuated

76
Q

A killed whole pathogen (bacteria cells) makes up what kind of vaccine?

A

Inactivated vaccine

77
Q

List pros and cons of inactivated vaccines

A
  • safe and easy to produce
  • inactivation needs to be confirmed, immunity not as long-lasting, leads to Th2 response, does not elicit IgA response, requires larger doses/booster shots
78
Q

What function to adjuvants have and what type of vaccines require them

A

trap and slow release of antigen, inactivated vaccines

79
Q

Polysaccharide-capsule vaccines, conjugate vaccines, and recombinant protein vaccines are what type of vaccines

A

Subunit vaccines

80
Q

List the pros and cons of subunit vaccines

A

Pros - safe
cons - may lack PAMP (innate –> adaptive ppor), may only result in humoral response

81
Q

How do vaccines with capsular polysaccharide become effective in children under 2

A

conjugate vaccines

82
Q

What is the main antibody generated by a conjugate vaccine

A

IgG

83
Q

What type of vaccine is made up of inactivated bacterial exotoxin

A

Toxoids

84
Q

What types of antibodies do oral and systemic vaccination produce

A
  • oral = secretory IgA
  • systemic = IgG/IgM depending on antigen
85
Q

Beta-lactam drugs, vancomycin, and bacitracin all target what

A

Peptidoglycan synthesis

86
Q

Polymyxin B targets what

A

membrane integrity

87
Q

Sulfamethoxazole/trimethoprim (SXT) target what

A

folic acid synthesis

88
Q

tetracyclines, aminoglycoside, and macrolides/lincosamides target what

A

protein synthesis

89
Q

fluoroquinolones and metronidazole target what

A

bacterial DNA

90
Q

What are the four main considerations when choosing an antibacterial agent

A
  1. Susceptibility of pathogen
  2. Site of infection
  3. Patient factors
  4. Safety
91
Q

What are the five main mechanisms of antibacterial agents?

A
  1. Inhibit cell wall synthesis
  2. Inhibit protein synthesis
  3. Affect nucleic acid synthesis
  4. Disrupt cell membrane function/structure
  5. Interfere with normal metabolic pathways
92
Q

Which type of bacteria have interbridges made up of amino acids between NAM-NAG strands

A

G +

93
Q

Penicillins, cephalosporins and cephamycins, carbapenems, and monobactams are what type of antimicrobial agent

A

beta lactams

94
Q

What is the mode of action of beta lactams

A

Transpeptidase irreversibly binds to beta lactam instead of D-ala-D-ala (competitive inhibition)

95
Q

what is transpeptidation

A

crosslinking of NAM-NAG strands

96
Q

Natural penicillins are only effective against what type of bacteria

A

gram +

97
Q

what is the difference between narrow spectrum and broad spectrum semisynthetic penicillins

A

narrow – only G+, more resistant to penicillinases
broad – also effective against G-

98
Q

what is the benefit of cephalosporins and cephamycins

A

have two R groups that allow for more molecular modifications

99
Q

what is the advantage of 3rd, 4th, and 5th generation cephalosporins and cephamycins

A

they can target both G- and G+, can cross the blood-brain barrier, and are more resistant to beta-lactamases

100
Q

list benefits and downsides of carbapenems (meropenem included)

A
  • protection against beta lactamases
  • gram negative resistance common in nosocomial infections
101
Q

Monobactams have what structure and are only active against what type of bacteria

A

Single beta lactam ring and only effective against G-

102
Q

What is the glycopeptide (vancomycin and teichoplanin) mechanism of action and downside

A

Binds D-Ala-D-Ala and inhibits enzyme binding, not effective against G-

103
Q

What is the polypeptide (bacitracin) mechanism of action

A

inhibits dephosphorylation/recycling of bactoprenol, which stops addition of NAM-NAG units

104
Q

What type of bacteria are resistant to bacitracin and how is this usually delivered

A

G -, topically but can sterilize GI tract before surgery

105
Q

What do anti-mycobacterials target

A

mycolic acid synthesis, arabinogalactan synthesis, and D-Ala-D-Ala synthesis

106
Q

What type of antimicrobials disrupt cellular membranes

A

lipopolypeptides and polypeptides

107
Q

How do polymyxin B and E function

A

Bind to LPS, alter membrane permeability, used topically/can cause kidney toxicity

108
Q

Macrolides and lincosamides bind to which ribosome subunit

A

50S

109
Q

Aminoglycosides and tetracyclines bind to which ribosome subunit

A

30S

110
Q

How do macrolides and lincosamides function

A

bind to exit tunnel of polypeptide chain, preventing protein elongation

111
Q

Macrolides are typically not useful for what type of bacteria

A

G -

112
Q

Clindamycin works for what and does not work for what

A

G - anaerobes
does not work for G - aerobes and enerococci

113
Q

How do aminoglycosides function

A

Binds to 16S RNA which causes misreading or premature release of ribosome

114
Q

Aminoglycosides are most effective against what

A
  • Aerobic G -
    (streptococci and enterococci are resistant –> can’t cross peptidoglycan)
115
Q

What is a good way to make aminoglycosides functional for G + bacteria as well

A

Couple with beta lactam or glycopeptide to interfere with peptidoglycan synthesis

116
Q

How do tetracyclines function

A

Block binding to tRNA to ribosome to inhibit protein synthesis

117
Q

How do tetracyclines enter and what are some tips to make more effective

A

enter via porins or active transport, good for intracellular bacteria, orally well absorbed, calcium/milk decreases absorption, avoid sun exposure, can cross the placenta (no to pregnant women and children under 7)

118
Q

What do quinolones, metronidazole, and refampin target

A

nucleic acid synthesis

119
Q

How do quinolones function

A

bind to bacterial type II topoisomerase (higher affinity for bacterial than human)

120
Q

What are some advantages or quinolones

A

broad spectrum, well absorbed and distributed, and relatively nontoxic

121
Q

How does metronidazole function

A

reduced in anaerobic environment, damages DNA/proteins/membranes

122
Q

Synthetic sulfonamides, dapsone, and trimethoprim function how

A

inhibiting folic acid –> precursor to purines and pyrimidines

123
Q

List some benefits of sulfonamides and trimethoprim

A
  • broad spectrum
  • good for tissue distribution
  • UTIs/sinus infections/middle ear infection
  • can cross blood-brain barrier

MIP 351 (3 decks)

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