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High Yield > Host Defense > Flashcards

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
Q

Examples of synergistic antimicrobial combinations via the inhibition of enzymatic inactivation

A

β-Lactamase inhibitors (clavulanate, sulbactam, tazobactam) enhances the antibacterial activity of β-Lactam agents (penicillins, cephalosporins).

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26
Q

Examples of synergistic antimicrobial combinations via the enhancement of antimicrobial agent uptake

A

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

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27
Q

MOA of Trimethoprim-sulfamethoxazole

A

Sulfonamides compete with PABA and block Dihydropteroate synthase

Trimethoprim blocks DHFR

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28
Q

Treatment for pneumocystis jirovecii in immunocompromised host.

A

TMP-SMZ

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29
Q

MOA of erythromycin

A

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

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30
Q

What do you use to treat impetigo?

A

macrolides (erythromycin being one of them)

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31
Q

What do you use to treat candidiasis?

A

1st: fluconazole, clotrimazole, or nystatin
2nd: Itraconazole

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32
Q

What do you use to treat dermatophytes on skin, hair, and nails

A

Griseofulvin (orally administered, induces CYP450, dangerous for patients on warfarin)

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33
Q

MOA of enfuvirtide

A

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

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34
Q

What does a Western Blot for HIV test for?

A

p24 that is present inside of the capsid. Starts to show up after 6 weeks.

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35
Q

MOA of maraviroc

A

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
Q

Gancyclovir

A

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
Q

Foscarnet Sodium

A

Stalls primer template extension by preventing cleavage of pyrophosphate from nucleoside triphosphates.

Used in combo with gancyclovir for CMV

Toxicity: nephrotoxicity and hypocalcemia

38
Q

Sargeamostim

A

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
Q

Figrastim

A

G-CSF

Used for severe neutropenia after high dose chemo

Only stimulates production of neutrophils

Short lived

Monomer

40
Q

pegfilgrastim

A

Pegylated G-CSF

Longer lasting version of filgrastim

Attached to a big protein that blocks secretion

41
Q

What can you give a patient who needs a non-sedating antihistamine?

A 
loratadine
terfenadine
astemizole
fexofenadine
cetirizine
desloratadine
acrivastine, ebastine, mizolastine
42
Q

General structure of leukotrienes

A

3 C-C double bonds in a row.

LTA4 > LTB4

LTA4 > LTC4 > LTD4 > LTE4

43
Q

Cyclosporine

A

Glucocorticoid that inhibits calcineurin phosphatase activity

Decreases dephosphorylation of NFAT

T-cell selective

renal toxicity

hyperglycemia with tacrolimus

44
Q

methotrexate

A

Inhibits DHFR

psoriasis

45
Q

Basiliximab

A

Monoclonal antibodies against IL-2 receptor
Blocks IL-2 mediated T-cell activation
Potential anaphylactic reactions

46
Q

Etanercept

A

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
Q

Levamisole

A

Synthesized as antihelminth agent

“Restores” depressed B- and T-cell function, moncytes, macrophages

use as adjunct in colon cancer therapy

48
Q

Thalidomide

A

Associated with severe birth defects

Potential anti-TNF effect
May be anti-angiogenic
Increase NK cell activity
Used in treatment of multiple myeloma

49
Q

Viral routes of transmission

A

Skin

Mucosal membranes

Alimentary canal

Respiratory tract

50
Q

Viruses associated with entry through the skin

A

HSV

papilloma

probably need some break in the barrier to cause infection

51
Q

Viruses associated with entry through the mucosal membrane

A

Eye and genitourinary tract

HSV, HIV, and other STDs

52
Q

Viruses associated with entry through the alimentary canal

A

nonenveloped viruses

Enteroviruses (polio, coxsackie B)

Rotaviruses (diarrhea)

53
Q

Viruses associated with entry through the respiratory tract

A

Influenza

Measles

rhinoviruses (colds)

most common route of entry

infection caused by contact with aerosols

54
Q

SARS

A

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
Q

Zoonoses

A

Sandfly fever

Dengue

Rabies

Cowpox

56
Q

NK cell activation (cytokines involved)

A

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
Q

Antibody response to viral infection

A

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
Q

Three contributing factors of damage during virus infection

A
  1. Direct cell damage resulting from virus replication
  2. Damage resulting from immune activation or suppression
  3. Cell transformation caused by viruses
59
Q

Rash in Rubeola vs. Rubella

A

Rubeola: T-Cell mediated

Rubella (German measles): immune complex mediated (Ab). Joint pain is diagnostic

60
Q

Rash in VZV

A

due to viral replication

61
Q

Koplik’s spots

A

indicative of measles

62
Q

Causes of vasodilation

A

NO

PGD2,PGI2 (prostacyclin2), PGE2

63
Q

Chemotactants

A

IL-8
N-formylmethionine
LTB4
C5a

64
Q

Hassels corpuscles

A

Found in medulla of thymus

contain type 6 epithelialreticular cells

undergo keratinization

stains eosinophilic (negatively charged)

65
Q

SCID

A

Type 1: Common gamma chain mutation. X-linked. Dicks up IL-2, 4, 7, 9, 15, and 21

Type 2: adenosine deaminase deficiency.

66
Q

Ciperoheptadine

A

2nd generation antihistamine

antiserotonin

treating cold weather induced allergic reactions

67
Q

Where is psoriasis common?

A

elbows

torso

crotch

hairline?

68
Q

Pimphigus vulgaris

A

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
Q

Bullous pimphigoid

A

similar to pimphigus vulgaris but hemidesmosomes instead of desmogleins

70
Q

Cytokine for survival of memory B cells

A

BAFF and APRIL from follicular dendritic cells

71
Q

Interleukins signal through ______

A

JAK STAT

72
Q

TLRs signal through ________

A

MyD88 (bacteria or fungi)

TRIF (viruses, TLRs 3,7,8,9)

73
Q

chemotaxis signalled through

A

G proteins

74
Q

Raltegravir

A

integrase inhibitor

75
Q

Bradykinin

A

acts on nociceptors and causes pain

proinflammatory

broken down by kininase II (aka ACE inhibitors)

76
Q

Functions of reverse transcriptase

A

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
Q

Smallpox

A

effects palms and soles

macupapules all at same phase

78
Q

Chickenpox

A

macupapules on scalp is diagnostic

macupapules at different phases

79
Q

F. Tularensis requires ________ to grow

A

cysteine

80
Q

Type I collagen

A

CT associated with type XII in skin and placenta

81
Q

Type II collagen

A

cartilage associated with Type IX

82
Q

Type III collagen

A

Reticular tissue

83
Q

Type IV collagen

A

basal lamina

84
Q

Treatment for CMV

A

Normal host: none needed

Immunocompromised host: ganciclovir and foscarnet sodium

85
Q

Stain used to detect fungi

A

Lactophenol cotton blue

86
Q

Substance used to culture fungi

A

Sabouraud agar

High Yield (1 decks)

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