finals - bacterial infection Flashcards
meaning it is naturally occurring wherein
it has a standardize response to all
antigens
innate immunity
This type of immunity lacks memory.
innate or natural immunity
One of the examples of
innate immunity is the ___ and ___ materials that we have in
our body
exogenous and
endogenous
an example of endogenous innate immunity
hydrochloric acid
it serves as a prevention when
it comes to the growth of the bacteria
during the digestion process
hydrochloric acid
It is an enzymes that we can found in
many secretions such as tears and
saliva
lysozomes
example of soluble innate components that protect us from the pathogenic bacteria and these are the ___
interleukins (IL), prostaglandins, and leukotrienes which causes fever
examples of acute phase reactants
C-reactive protein, haptoglobin, and
ceruloplasmin
it works by either coating the bacteria or
removing the substances that might promote bacterial growth
acute phase reactants (APR)
are mainly involved in inflammation - INCREASES
acute phase reactants
which polypeptide substance works and influences acute phase reactant
cytokines
The phagocytic process is
enhanced by the activation of the ___
alternative
complement cascade
how do complement cascade activates and helps to enhance phagocytosis?
triggered by the microbial cell walls or
other products of the microbial
metabolism.
adaptive or acquired
immunity it is also known as the
“_____”
specific immunity
it is not present at
birth but they have a diverse response
for each antigen.
adaptive or acquired immunity
Secondary response is better
than primary response because it has a
____
memory b cells.
antibody production is specifically against ____
exotoxins and other secreted bacterial products
after neutralizing the exotoxins and forming of antibodies, it will activate the ____
complement pathway
____ bind to a particular bacteria and
they will eliminate those immune complexes. It is also
associated with extracellular bacteria
Anti-exotoxin antibodies
Eliminate immune complexes kapag nag meet ang anti exotoxin antibody and the bacterial infections through
___.
Neutralization
once the classical pathway is activated, the new branch of immune response will incur ____
cell-mediated immunity
Cell-mediated Immunity: mainly responsible to those intracellular bacteria such as _____
.
Mycobacterium tuberculosis,
Listeria monocytogenes,
Rickettsial species, and
Legionella pneumophilia
3 MAIN MECHANISMS FOR WAS OF IN BACTERIA IN INHIBITING OR
OPPOSING IMMUNE RESPONSE
- Avoiding Antibody
- Blocking Phagocytosis
- Inactivating the Complement Cascade
ways to avoid antibody by bacteria
genetic mutation
down-regulation of MHC
Some bacteria can alter their bacterial antigen as a result of genetic
mutation in effect wherein antibody is unable to bind to epitope.
genetic mutation
Nakakapabigay ng new bacterial antigen
genetic mutation
genus that can perform genetic mutation
S. agalactiae, S. pyogenes
MHC mechanism:
they are able to accept and reject.
MHC main feature:
they are able for antigen recognition (Class I and
Class II but not Class III kasi it cannot express on the cell surface)
___ are
all examples of bacteria that can release IgA (IgA2)
N. gonorrhoeae, H. influenzae, and Streptococcus sanguinis
factors that can inhibit phagocytosis
Chemotactic factor, adhesion,
digestion
by blocking phagocytosis, the bacteria are blocking ___
adhesion and digestion
in blocking phagocytosis of bacteria, it inhibits the formation of ___
phagocytosis
Inhibit the formation of phagolysosome.
blocking phagocytosis
this genus specie inhibit the release of chemotactic factors
that would bring phagocytic cells to the area.
Neisseria gonorrhoeae:
cell walls of S. pyogenes produce and ___that interferes with adhesion to the phagocytic cell.
M protein
what is the virulence factor of Streptococcus pyogenes
M protein
the _____ type of bacteria tend to block phagocytosis
encapsulated bacteria
what are the example of encapsulated bacteria
▪ Neisseria meningitidis
▪ Streptococcus pneumoniae
▪ Yersinia pestis
▪ Haemophilus influenzae
▪ Klebsiella pneumoniae
these microorganisms block phagocytosis by
blocking fusion of lysosomal
granules with phagosomes after being engulfed by the phagocyte
(phagolysosome).
Mycobacterium tuberculosis, Mycobacterium. leprae, and Salmonella spp:
blocking phagocytosis
Resisting digestion involves the___ products after the
bacteria are phagocytized
production of extracellular
Resisting digestion involves the production of extracellular products after the bacteria are phagocytized. The primary effect is the release of ___ into the cytoplasm of the phagocytic cells, subsequently killing the WBC.
lysosomal contents
extracellular products of S. aureus
Leukocidin
extracellular products of L. monocytogenes
Listeriolysin
extracellular products of S. pyogenes
Streptolysin
Leukocidinis produced by
staphylococcus aureus
Listeriolysin is produced by
listeria monocytogenes
streptolysin is produced by
streptococcus pyogenes
in inactivating complement cascade
____ bacteria: do not bind the complement component C3b
(important in enhancing phagocytosis)
Encapsulated
acts as opsonin and takes place in alternative and lectin pathway.
C3b
process in which helps to facilitate the eating in the
process of phagocytosis.
opsonins
____ are gram-positive spherical, ovoid, or lance-shaped organisms
that are catalase negative and are often seen in pairs or chains in gram stain.
Streptococci
the group which streptococci is associated into is the ___ group
lancefield group
Streptococci are divided into groups or ____ on the
basis of certain cell wall components.
serotypes/serogroups
what are the group A streptococci
streptococcus pyogenes
what are the group B i n streps
streptococcus agalactiae
group c streptococcus
Streptococcus equisimilis,
Streptococcus equi,
Streptococcus zooepidimicus, and Streptococcus dysagalatiae
group d streptococcus
Streptococcus bovis,
Enterococcus faecalis,
Enterococcus faecium
streptococcus
Outermost cell wall components contains two major protein known as the__n
M and T protein
these determine the serotype/serogroup of the streptococcus
spp.
M and T protein
Virulence factor of streptococcus
M and T protein
Interior to the protein layer is the_____ that divides streptococci into 20 defined groups, designated A through H and K through V.
group-specific carbohydrates
is one of the most common and ubiquitous
pathogenic bacteria and causes a variety of infection.
which group of strep is it?
group A Streptococcus pyogenes
is the major virulence factor of the group A strep
M protein
in streptococcus pyogenes,
Additional virulence factors include ____, proteins
excreted by bacterial cells as they metabolize during the course of
streptococcal infections.
exoantigens or exotoxins
→ responsible for the rash seen
in scarlet fever and also appear to contribute to pathogenicity.
Pyrogenic exotoxins A, B, and C
Production of __ also add to its virulence
exoenzymes
Production of exoenzymes also add to its virulence factor.
These include:
Streptolysin O, deoxyribonuclease B (DNase B), hyaluronidase,
nicotinamide adenine dinucleotidase (NADase), and streptokinase.
Detection of Streptococcal Antibodies
The most important antibodies are __
▪ Anti-streptolysin O (ASO)
▪ Anti-DNase B
▪ Anti-NADase
▪ Anti-hyaluronidase
Presence of these antibodies is an indication of Group A streptococcus
infection and is seen in many conditions/disease like:
▪ Scarlet fever
▪ Acute glomerulonephritis
▪ Acute Rheumatic Fever
▪ Necrotizing fasciitis
▪ Streptococcal toxic shock syndrome
Sequelae of streptococcus:
Rheumatic Fever
Post-Streptococcal Glomerulonephritis
Anti-Streptolysin O Agglutination Test / ASO Agglutination Test
Employs the principle of ___ Agglutination
Passive or Indirect
what is the significant titer in ASO or anti streptolysin O agglutination test
240 todd unit or 240 IU/mL (Adults);
320 Todd units or 320 IU/mL (Child)
ASO was been Replaced by __
Nephelometry
Automated procedure that provides rapid, quantitative measurement
of ASO titers
Nephelometry
give what is happening in the nephelometry of streptococcus testing
Reacts with patients Anti-Streptolysin →
forms immune
complex (precipitation) →
resulting in an increased light scatter that the instrument converts to peak rate signal.
what is the serological reaction that occurs in nephelometry of streptococcus testing
precipitation
what is the antigen reagent in streptococcus nephelometry
streptolysin
is conducted More of sequelae in streptococcus
Anti-DNase B Testing
indicative of Streptococcal glomerulonephritis and rheumatic
fever
Anti-DNase
Anti-DNase can also be detected in __
acute rheumatoid fever
what is the normal titer in Anti-DNase B testing
for children between the ages of 2 and 12 years
range from 240 to 640 units
the range for anti dnase b testing in strep is always based on children becoz?
they are the target host of streptococcis
in strep what is the example of Slide Agglutination Test
Streptozyme Testing
what is the principle of streptozyme testing?
Passive in Agglutination
In strep
Can detect multi-enzyme therefore it is non-specific.
Streptozyme Testing
Streptozyme Testing uses _____ which is attached to the exoenzyme of streptococcus
formalin, aldehyde fix, sheep RBC
Detects antibody to streptolysin, streptokinase, hyaluronidase, DNase, and
NADase
Streptozyme Testing
This gram-negative, microaerophilic spiral bacterium is the major cause of
both gastric and duodenal ulcers
H. PYLORI (HELICOBACTER PYLORI)
H. PYLORI (HELICOBACTER PYLORI) can survive the acid in the stomach because ___
it converts urea to ammonia which will surround the bacteria and protects it from acid.
remember that ammonia is alkaline
Produces Urease enzyme
H. PYLORI (HELICOBACTER PYLORI)
If untreated, H.pylori infection will last for the patient’s life and may
lead to ___
gastric carcinoma
Detection of helicobacter pylori
Cultivation,
histologically examining gastric biopsy tissue,
performing a urease biopsy test,
urea breath testing,
enzyme immunoassays for bacterial antigens in the feces,
molecular tests for H. pylori DNA, and antibody tests.
method of choice for the Detection of antibodies in Helicobacter pylori
ELISA - enzyme linked immunosorbent assay
(more accurate and
specific).
what immunoglobulin is related to the chronic stage of ulcer in H pylori
IgG
what immunoglobulin is related to the acute ir early stage of ulcer in H pylori
IgM
___remains the most commonly acquired spirochete disease in the
United States.
Syphilis
United States.
The causative agent of syphilis is __
Treponema pallidum subspecie pallidum
Organism involved in syphilis are the Spirochetes (not specific to Treponema. It is also associated with __ and ___)
Leptospira and; borella
a sexually transmitted infection that is a Member of the family Spirochaetaceae
syphilis
a family member of spirochaetaceae
___, the agent of yaws
T. pallidum subspecies pertenue
a family member of spirochaetaceae
___, the cause of nonvenereal
endemic syphilis
T. pallidum subspecies endemicum
a family member of spirochaetaceae
___, the agent of pinta
T. carateum
mode of transmission of syphilis
▪ Direct contact
They can be easily destroyed by heat and cold.
▪ Principal MOT: Sexual contact
▪ Congenital infections can also occur during pregnancy. Since merong maternal IgG na pwedeng magcross sa placenta.
what is the principal mode of transmission of syphilis
sex
Primary Stage of Syphilis
1st stage
a lesion formed at the 1st or primary stage of syphilis
chancre
chancre are lesions that can be observed after how many days of infection?
10-90 days
1st stage (Primary Stage of Syphilis)
aka __
primary syphilis
1st stage (Primary Stage of Syphilis)
May give positive result on ___
Direct detection (microscopic, IFA)
__microscopy is used to observe spirochetes.
Darkfield
stages of syphilis
primary or 1st
secondary or 2nd
latent
tertiary or third
Symptoms of the secondary stage include
generalized lymphadenopathy,
or enlargement of the lymph nodes;
malaise, fever, pharyngitis,
and a rash on the skin and mucous membranes.
this stage still has chancre and dessimination of microorganism
secondar or 2nd stage
what stage of syphilis wherein
Patients are noninfectious at this time, with the exception of pregnant
women, who can pass the disease on to the fetus even if they exhibit
no symptoms.
latent stage/period
Vertical transmission of the disease (syphilis)
latent stage
a stage of syphilis wherein there’s Disappearance of the clinical signs and symptoms
latent stage
This range appears anywhere from months to years after secondary
infection of syphilis
third stage
Typically, this occurs most often between 10 and 30 years following
the secondary stage.
third stage
Super payat na ng patients, sugat sugat na ang katawan within the
bones and subcutaneous tissues. Dito na lumalabas ang clinical
manifestations of syphilis
third stage
Tertiary syphilis has three major manifestions:
Gummas syphilis or gummatous syphilis
Cardiovascular disease
Neurosyphilis
granulomatous within the tissue. Can be found in the bones
and subcutaneous tissues. May scales na sa balat.
gummas syphilis or gummatous syphilis
Traditional laboratory tests for syphilis can be classified into three main types:
Direct detection of Spirochetes:
nontreponemal serological test:
Treponemal serological test:
what is under the Direct detection of Spirochetes:
o Darkfield microscope
o Direct immunofluorescence assay
Nontreponemal serological test: which detect antibody to ____
cardiolipin
which detect antibody to
cardiolipin, have traditionally been used to screen for syphilis
because of their high sensitivity and ease of performance.
Nontreponemal serological test:
Specific type of precipitation that
occurs over a narrow range of antigen concentrations.
flocculation
non treponemal serological test is based on what type of precipitation reactio
flocculation
Examples of Non-Treponemal Test:
VDRL (Venereal Disease Research Laboratory), RPR (Rapid Plasma Reagin),
TRUST (Toluidine Red Unheated Serum Test),
USR (Unheated Serum Reagin Test),
RST (Reagin Screen Test).
Nontreponemal serological test:
prone for ___ reaction
false positive reaction
most used non treponemal test
VDRL and RPR
is an antibody substances which are primarily
produced by the spirochetes within the serum or plasma of
the individual.
Reagin
Treponemal Serological Test
FTA-ABS (Fluorescent Treponemal Antibody Absorption Test
Manner of reporting of non treponemal test
reactive and non-reactive.
Is both a qualitative and quantitative slide flocculation test for serum and spinal
fluid
VDRL - Venereal
Disease Research Laboratory
for vdrl
The reagent (antigen) is consists of:
___
0.03% cardiolipin,
0.9% cholesterol, and
0.21% lecithin
how to process vdrl
VDRL antigen via a dropper to a buffered saline solution while continuously
rotating on a flat surface
vdrl
it is sensitive so __ and ___of the mechanical rotator should be considered
timing and speed
For serum vdrl
speed
time
speed - 180 rpm
time - 4 mns
read microscopically (LPO) for flocculation
For csf vdrl
speed
time
For csf vdrl
speed - 180 rpm
time - 8 mns
then read microscopically (LPO) for flocculation
vdrl - Venereal
Disease Research Laboratory
Tests must be performed at a room temperature within the range of ___
23°C at 29°C.
Recommended volume of serum:___ for VDRL
0.05 mL or 50 uL
Diameter if positive in VDRL: ___ in diameter
14 mm
In vdrl - Venereal
Disease Research Laboratory
Serum must be inactivated, the serum heating is about ____ * C for ___ minutes.
56°C for 30
All sera with reactive or weakly reactive results must be tested using the
quantitative slide test, in which two-fold dilutions of serum ranging from ___
1-2 to 1:32 are initially used.
Highest dilution should be reported in VDRL (Venereal disease research laboratory)
true or false
true
a syringe which has a polymer tip that creates a leak-free seal for both liquids and gases
hamilton syringe
Qualitative Serum VDRL: uses ___ gauge needle without bevel.
18
Qualitative Serum VDRL: uses 18 gauge needle without bevel.
It can deliver ___ drops per mL of the antigen suspension.
1 out of 60
Quantitative Serum VDRL: uses ___ gauge needle without bevel
19
Quantitative Serum VDRL: uses 19 gauge needle without bevel.
___ drops per mL
7
CSF VDRL: uses ____ gauge needle
21 or 22
CSF VDRL: uses 21 or 22 gauge needle.
___ drops per mL would be delivered.
100
grading of flocculation
reactive
weakly reactive
non reactive
describe the flocculation for REACTIVE VDRL
medium to large clumps
describe the flocculation for WEAKLY REACTIVE VDRL
small clumps
describe the flocculation for NON REACTIVE VDRL
No clumps or slight roughness
Modification of VDRL which involves macroscopic agglutination.
RPR - Rapid Plasma Reagin
The cardiolipin-containing antigen suspension is bound to charcoal particles,
which make the test easier to read.
RPR - Rapid Plasma Reagin
describe the flocculation of RPR
RPR - Rapid Plasma Reagin
Visible black floccules.
Do we still need to heat or activate serum in - RPR - Rapid Plasma Reagin
Nope
RPR - Rapid Plasma Reagin
We have to take note the
inactivation of the complement by ___
adding EDTA, thimerosal, and choline
chloride.
amount of sample for RPR - rapid plasma reagin
0.05 ml or 50ul
syringe used for RPR - rapid plasma reagin
20 gauge needle without the bevel is used.
60 drops per mL
time and speed for RPR - rapid plasma reagin
speed - 100 rpm
time - 8 mns
an indirect fluorescent antibody test.
FTA-ABS
Fluorescent Treponemal Antibody Absorption
Test
type of serum used for treponemal serologic test
Inactivated serum is used
a dilution of heat inactivated patient serum in incubated with a sorbent consisting of an extract of nonpathogenic treponemes
(Reiter strain)
FTA-ABS
Fluorescent Treponemal Antibody Absorption
Test
a non pathogenic treponemes is used for
FTA-ABS
Fluorescent Treponemal Antibody Absorption
Test
Reiter strain
Reiter strain is used to ____
to prevent cross reaction with treponema pallidum subspecie pallidum
slides used for FTA- ABS have ____
Fluorescent Treponemal Antibody Absorption
Test
Nichols strain of T. pallidum
FTA - ABS
do we need to perform washing for the mixture?
yes
in fta - abs
___ is added to each well.
Antibody conjugate (antihuman immunoglobulin conjugated with
fluorescein)
in fta abs
___ is applied, and coverslips are placed on the slides
Mounting medium
fta abs is Read on ___ microscope.
fluorescence
agglutination test for FTA ABS is based on what principle
passive hemagglutination test
short rode, or coccobacilli, that are obligate,
intracellular, gram-negative bacteria.
Rickettsiae and Coxiella
Rickettsiae and Coxiella
Considered as vector borne disease
except for ____
Coxiella burnetii
Coxiella burnetii MOT
inhalation and ingestion of contaminated
milk)
Rickettsiae has two distinct groups
spotted fever group (SFG)
and
Typhus group (TG) live
RICKETTSIAL INFECTIONS
Vector Borne Disease - transmitted through a ___.
fleas/lice/mites/tick bite
members of spotted fever group
Rickettsia rickettsii
Rickettsia japonica
Rickettsia felis
Rickettsia akari
members of Typhus group
Rickettsia typhi
Rickettsia prowazekii
the typhus group’s geographical distribution
worldwide
disease association of Rickettsia rickettsii
rocky mountain spotted fever
rocky mountain spootted fever is transmitted tru
tick bite
Rickettsia japonica’s disease association
japanese spotted fever
MOT of japanese spotted fever
tick bite
Rickettsia felis disease
flea borne spotted fever
Rickettsia felis MOT
unknown
Rickettsia akari disease
Rickettsial pox
Rickettsia akari MOT
mite bite
Rickettsia typhi disease
endemic typhus
Rickettsia typhi MOT
flea
Rickettsia prowazekii disease
epidemic typhus
Rickettsia prowazekii MOT
louse feces
Rickettsia prowazekii another disease
recrudescent typhus
MOT of recrudescent typhus
years after epidemic typhus
R. prowazekii – Louse borne typhus. There is a reactivation from the original infection
this would be ___
Brill-Zinsser disease
Serological Diagnosis for ricketssia
Weil-Felix Agglutination test
a non-specific test. An agglutination test
based on cross-reactivity of Rickettsial antibodies
Weil-Felix Agglutination test
“O”
antigens of the OX-19 and OX-2 strains of Proteus ___
vulgaris
o “O”
antigens of the OX-K strain of Proteus ___
mirabilis
Proteus ang antigen suspension because of the cross-reactive
mechanism and the same ___
antigen determinants
More sensitive and specific test for rickettsia
IFA,
micro immunofluorescent assay (micro-IFA),
immunoperoxidase assays (IPA),
ELISA and Immunoblot assays (IBA).
Weil-Felix Agglutination test
1 is to ___ is the titer.
160
