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Host Defense Flashcards

1
Q

Glucocorticoids inhibit _______

A

mRNAs, IL-1, IL-2

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2
Q

Most common cause of edema

A

Increased hydrostatic pressure

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3
Q

What stains Congo Red with polarizing birefrengence?

A

amyloid fibers (A & B) comes from Beta sheets

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4
Q

What is the embryologic origin of the thymus?

A

The thymus develops from cranial ectomesenchyme (mixed neural ectoderm and neural crest), hematopoietic cells (para-aortic lateral plate
splanchnic mesoderm via the liver, spleen, and bone marrow), and endoderm lining the 3rd (III)
pharyngeal pouches

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5
Q

What is the function of CD2 and LFA3(CD58)?

A

costim recept of T cells (and NK) - adhesion and signaling

Tcells express CD2
Dendritic cells express LFA3

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6
Q

What are the hallmark symptoms of EBV (mono)?

A

lymphadenopathy, pharyngitis, and splenomegaly

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7
Q

Why do you get vaccinated for the togavirus?

A

To prevent teratogenic effects on the fetus of nonimmune mothers.

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8
Q

What are the teratogenic effects of rubella?

A

hepatosplenomegaly

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9
Q

What is herd immunity?

A

If everyone is vaccinated, least likely for that disease to continue on through that group

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10
Q

Describe histamine synthesis

A

histidine > histamine

This reaction is catalyzed by histidine decarboxylase.

Histidine decarboxylase requires pyridoxal phosphate (PLP) which is derived from vitamin B6.

This reaction also gives off CO2

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11
Q

What is the precursor to arachidonic acid?

A

linoleic acid

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12
Q

Why do you eat fish for heart problems?

A

Omega 3s and EPA

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13
Q

bronchoconstrictors and in relation to asthma

A

LTB, C, and D

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14
Q

What stain is used to diagnose Cryptococcus neoformans as the culprit for meningitis?

A

India Ink

Confirm with a cryptococcal antigen test

Gram stain (gram positive)

Shows up in AIDS when CD4+ count less than 100

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15
Q

What is the dermatome associated with Herpes Zoster?

A

T7

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16
Q

What is slap cheek indicative of?

A

Parvovirus (B19)

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17
Q

What kinds of granulomas are caseating?

A

those caused by microbial infection. Foreign bodies will cause non-caseating granulomas.

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18
Q

What cytokine is essential for maintaining memory T-cells?

A

IL-7

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19
Q

What cytokine maintains memory CD8 cells specifically?

A

IL-15

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20
Q

Marker for memory T cells.

A

CD45RO

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21
Q

Marker for naive T cells.

A

CD45RA

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22
Q

Mechanism of vancomycin resistance

A

“vanA type resistance” leads to the expression of enzymes that modify cell wall precursors by substituting a D-lactate for D-alanine.

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23
Q

Types of synergistic antimicrobial combinations

A
  1. Blockade of sequential steps in a metabolic sequence
  2. Inhibition of enzymatic inactivation
  3. Enhancement of antimicrobial agent uptake
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24
Q

Examples of synergistic antimicrobial combinations via the blockade of sequential steps in a metabolic sequence

A

Trimethoprim-sulfamethoxazole

Blocks two steps in the production of tetrahydrofolic acid from paraminobenzoic acid in microorganisms

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25
Examples of synergistic antimicrobial combinations via the inhibition of enzymatic inactivation
β-Lactamase inhibitors (clavulanate, sulbactam, tazobactam) enhances the antibacterial activity of β-Lactam agents (penicillins, cephalosporins).
26
Examples of synergistic antimicrobial combinations via the enhancement of antimicrobial agent uptake
Penicillins and other cell wall-active agents increase the uptake of aminoglycosides. Amphotericin B creates pores in the fungal cell membrane to enhance the uptake of flucytosine
27
MOA of Trimethoprim-sulfamethoxazole
Sulfonamides compete with PABA and block Dihydropteroate synthase Trimethoprim blocks DHFR
28
Treatment for pneumocystis jirovecii in immunocompromised host.
TMP-SMZ
29
MOA of erythromycin
Macrolide antibiotics are bacteriostatic agents that inhibit protein synthesis by binding reversibly to the 50S ribosomal subunits of sensitive organisms and inhibiting the translocation step
30
What do you use to treat impetigo?
macrolides (erythromycin being one of them)
31
What do you use to treat candidiasis?
1st: fluconazole, clotrimazole, or nystatin 2nd: Itraconazole
32
What do you use to treat dermatophytes on skin, hair, and nails
Griseofulvin (orally administered, induces CYP450, dangerous for patients on warfarin)
33
MOA of enfuvirtide
aka Fuzeon Enfuvirtide binds to the gp41 subunit of the viral envelope glycoprotein and prevents the conformational changes required for the fusion of viral and cellular membranes
34
What does a Western Blot for HIV test for?
p24 that is present inside of the capsid. Starts to show up after 6 weeks.
35
MOA of maraviroc
chemokine receptor antagonist that acts as an entry inhibitor. It blocks the binding of the HIV outer envelope protein gp120 to the CCR5 chemokine receptor Maraviroc is active only against CCR5-tropic strains of HIV. Resistance- shift in HIV tropism to CXCR4 or dual/mixed tropism.
36
Gancyclovir
Monophosphorylated by viral thymidine kinase during HSV infections Monophosphorylated by viral phosphotransferase encoded by UL97 in CMV infections Ganciclovir di- and triphosphates made by cellular enzymes. Triphosphate form preferentially inhibits viral DNA polymerases Used in combo with foscarnet sodium for CMV Resistance: mutations of UL97 gene and viral polymerases Toxicity: neutropenia
37
Foscarnet Sodium
Stalls primer template extension by preventing cleavage of pyrophosphate from nucleoside triphosphates. Used in combo with gancyclovir for CMV Toxicity: nephrotoxicity and hypocalcemia
38
Sargeamostim
GM-CSF For patients who have undergone autologous bone marrow transplantation Stimulates growth of a wide range of myeloid cells Never used for high dose chemo Not much toxicity
39
Figrastim
G-CSF Used for severe neutropenia after high dose chemo Only stimulates production of neutrophils Short lived Monomer
40
pegfilgrastim
Pegylated G-CSF Longer lasting version of filgrastim Attached to a big protein that blocks secretion
41
What can you give a patient who needs a non-sedating antihistamine?
``` loratadine terfenadine astemizole fexofenadine cetirizine desloratadine acrivastine, ebastine, mizolastine ```
42
General structure of leukotrienes
3 C-C double bonds in a row. LTA4 > LTB4 LTA4 > LTC4 > LTD4 > LTE4
43
Cyclosporine
Glucocorticoid that inhibits calcineurin phosphatase activity Decreases dephosphorylation of NFAT T-cell selective renal toxicity hyperglycemia with tacrolimus
44
methotrexate
Inhibits DHFR psoriasis
45
Basiliximab
Monoclonal antibodies against IL-2 receptor Blocks IL-2 mediated T-cell activation Potential anaphylactic reactions
46
Etanercept
Used in IBS and arthritis Anti TNF-alpha drug recombinant fusion protein consisting of two soluble TNF receptor regions linked to Fc portion of human IgG
47
Levamisole
Synthesized as antihelminth agent “Restores” depressed B- and T-cell function, moncytes, macrophages use as adjunct in colon cancer therapy
48
Thalidomide
Associated with severe birth defects Potential anti-TNF effect May be anti-angiogenic Increase NK cell activity Used in treatment of multiple myeloma
49
Viral routes of transmission
Skin Mucosal membranes Alimentary canal Respiratory tract
50
Viruses associated with entry through the skin
HSV papilloma probably need some break in the barrier to cause infection
51
Viruses associated with entry through the mucosal membrane
Eye and genitourinary tract HSV, HIV, and other STDs
52
Viruses associated with entry through the alimentary canal
nonenveloped viruses Enteroviruses (polio, coxsackie B) Rotaviruses (diarrhea)
53
Viruses associated with entry through the respiratory tract
Influenza Measles rhinoviruses (colds) most common route of entry infection caused by contact with aerosols
54
SARS
Sever Acute Respiratory Syndrome Type of viral pneumonia novel coronavirus (SARS-CoV) contracted by people who were handling and slaughtering civets (not people who were eating them)
55
Zoonoses
Sandfly fever Dengue Rabies Cowpox
56
NK cell activation (cytokines involved)
IFN-alpha/beta IL-12 and TNF-alpha also rise with IFN-alpha/beta in the early stages of infection (according to graph on Dr. Visalli's slide)
57
Antibody response to viral infection
IgG lasts for up to 28 days. Most important response. Drastic increase in magnitude of response after repeat exposure. IgA lasts 3 days. Important for mucosal immunity and preventing infection from occurring. IgM lasts 3 days. More important for bacterial infections. Magnitude of response to repeat exposure is the same as the first exposure
58
Three contributing factors of damage during virus infection
1. Direct cell damage resulting from virus replication 2. Damage resulting from immune activation or suppression 3. Cell transformation caused by viruses
59
Rash in Rubeola vs. Rubella
Rubeola: T-Cell mediated | Rubella (German measles): immune complex mediated (Ab). Joint pain is diagnostic
60
Rash in VZV
due to viral replication
61
Koplik's spots
indicative of measles
62
Causes of vasodilation
NO | PGD2,PGI2 (prostacyclin2), PGE2
63
Chemotactants
IL-8 N-formylmethionine LTB4 C5a
64
Hassels corpuscles
Found in medulla of thymus contain type 6 epithelialreticular cells undergo keratinization stains eosinophilic (negatively charged)
65
SCID
Type 1: Common gamma chain mutation. X-linked. Dicks up IL-2, 4, 7, 9, 15, and 21 Type 2: adenosine deaminase deficiency.
66
Ciperoheptadine
2nd generation antihistamine antiserotonin treating cold weather induced allergic reactions
67
Where is psoriasis common?
elbows torso crotch hairline?
68
Pimphigus vulgaris
desmoglein 1: at surface Desmoglein 3: at basal layer Type 2 hypersensitivity MHCs don't hold desmogleins tight enough in thymic maturation so self reactive T cells survive.
69
Bullous pimphigoid
similar to pimphigus vulgaris but hemidesmosomes instead of desmogleins
70
Cytokine for survival of memory B cells
BAFF and APRIL from follicular dendritic cells
71
Interleukins signal through ______
JAK STAT
72
TLRs signal through ________
MyD88 (bacteria or fungi) TRIF (viruses, TLRs 3,7,8,9)
73
chemotaxis signalled through
G proteins
74
Raltegravir
integrase inhibitor
75
Bradykinin
acts on nociceptors and causes pain proinflammatory broken down by kininase II (aka ACE inhibitors)
76
Functions of reverse transcriptase
builds DNA strands based on an RNA template after building the DNA strand, the enzyme removes the original RNA builds second DNA strand matched to the one that was just created
77
Smallpox
effects palms and soles macupapules all at same phase
78
Chickenpox
macupapules on scalp is diagnostic macupapules at different phases
79
F. Tularensis requires ________ to grow
cysteine
80
Type I collagen
CT associated with type XII in skin and placenta
81
Type II collagen
cartilage associated with Type IX
82
Type III collagen
Reticular tissue
83
Type IV collagen
basal lamina
84
Treatment for CMV
Normal host: none needed | Immunocompromised host: ganciclovir and foscarnet sodium
85
Stain used to detect fungi
Lactophenol cotton blue
86
Substance used to culture fungi
Sabouraud agar

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