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PPE > I&I > Flashcards

I&I Flashcards

1
Q

State cytokines released by Th1 and Th2

A

Th1 - TNF alpha, IFN-gamma

Th2 - IL 4, 5, 10

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2
Q

characteristics of HIV? pathology and acute symptoms?

A

pathogen - SS+ RNA
Binds to GP120 on cell –> reverse transcriptase + integrase then incubation for 1-3 weeks
acute - fever, rash, myalgia

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3
Q

detection and treatment of HIV?

A

Detect - PCR, p24 antigen via ELISA. All after 6 months

Treatment - HAART therapy - 2NRT inhibitors, integrase inhibitor, fusion inhibitor, protease inhibitor, NNRTI

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4
Q

Acute and chronic symptoms of Hep B?

A

acute - after 1-6 mths fever, malaise, jaundice

Chronic - jaundice, liver failrue, cirrhosis,, liver cancer

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5
Q

define microbiota

A

commensal bacteria both pathogenic and symbiotic that live on a body surface

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6
Q

Give examples of microbiota

A

HPV, herpes simplex
Gram + - s aureus, strep viridans, cornyebacterium
gram - - enterobacteriacae
dermatophytes

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7
Q

what are the gram positive bacteria?

A

Strange, staphys act list entered my new carrier bag

streptococcus, staphylococcus, actinomyces, listeria, enterococcus, mycobacteria, pneumonia, cornyebacteria, bacillus

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8
Q

mechanism of infection of a surface/

A

adherence via fimbriae > invasion + multiplication > biofilm > quorum sensing > host response of fever and granuloma

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9
Q

what bacteria infect heart valves?

A

native + >1yr prosthetic - HACEK group, strep viridans, candida, staph aureus

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10
Q

how do you diagnose and treat infected surfaces?

A

blood culture + sonication

treat with antibiotics or surgery

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11
Q

Explain the sensitisation and effector phase of type 1 hypersensitivity reactions

A

sensitisation - antigen contact –> IgE produced
effector - antigen binds to IgE on mast cell –> release of chemoattractants, cytokines, histamines –> effects depend on location

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12
Q

treat and manage anaphylaxis?

A

treat - adrenaline, monitor pulse oximetry, BP

manage - steroids, antihistamines, anti-ige

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13
Q

give examples of hospital acquired infections

A

pneumonia, UTI, legionella, MRSA, c diff

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14
Q

how do you diagnose and treat c diff

A

stool and elisa diagnose

treat - metronidazole or vancomycin

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15
Q

treat mrsa?

A

vancomycin

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16
Q

norovirus characteristics?

A

ss+ rna

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17
Q

define basic reproductive number

A

no of cases 1 case generates on average over the course of the infectiuous period
1 - infection will spread

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18
Q

what are the principles of antimicrobial stewardship

A

prevent inappropriate use of antibiotcs and resistance, minimise adverse effects, reduce cost of infection

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19
Q

what are some possible causes of chronic infections?

A

VITAMIN DEI

vascular, infection, trauma, autoimmune, metabollic, idiopathic, neoplasia, degenerative, environmental, inflammation

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20
Q

what is the pattern of inheritance of cf? what organisms infect a cf patient? what disease can cf progress to?

A

autosomal recessive
h influenzae –> staph aureus –> atypical mycobacteria –> pseudomonas aeroginosa
can become COPD

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21
Q

why does DM lead to increased risk of infection?

A

hyperglycaemia and acidosis results in reduced humoral immunity (antibodies) and decreased neutrophil and lymphocyte function

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22
Q

what diseases are DM patients at higher risk of?

A

otitis externa - pain and discharge of external ear and meatus
rhinocerebral mucormycosis - mould infection of sinuses due to DKA resulting in soft tissue and bony necrosis
UTIs

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23
Q

what symptoms does a immunocompromised patient have?

A

SPUR - severe, persistent, unusual, recurrent

24
Q

Give example b cell deficiencies

A

CVID - b cells dont mature
IgA or IgG deficiency
Brutons - X linked
Hyper IgM syndrome - cant switch to IgG

25
Q

what cell secretes antiobides? what are the types of antibodies and what is their funciton?

A

B cell secretes. MAGED
IgA - mucosal areas + saliva, sweat, tears, breast milk
IgD - immature b cells
IgE - allergies and parasitic worms
IgG - majority of antibody immunity against pathogens. Only ab that can cross placenta
IgM - eliminates pathogens in early stages of humoral immunity

26
Q

give examples of phagocyte deficiencies -

A

cyclic neutropenia, leukocyte adhesion deficiencym chronic granulomatous disease

27
Q

give example t cell deficiencies. How do you treat

A

digeorge syndrome, SCID
CATCH 22
Dg treat - antibiotics, correct calcium and heart, no live vaccines, X irradiated and CMV -ve blood, BM transplant

28
Q

give examples of secondary immunodeficiency

A

HIV, malnutrition, liver disease, drug induced, splenectomy

29
Q

give examples of encapsulated bacteria

A

strep pneumoniae, n mengitidis

30
Q

how do you manage asplenic patients

A

penicillin prophylaxis, immunisation, medic bracelet

31
Q

function of spleen?

A

removes opsonised and encapsulated bacteria, synthesis Antibodies

32
Q

how do b cell deficiencies present? manage?

A

resp infections, gi complications,

manage - prophylaxis, immunoglobin replacement, avoid radiation

33
Q

how do phagocyte deficiencis present? manage?

A

ulcer, osteomyeleitis, abscesses

manage - prophylaxis, stem cell transplant

34
Q

how does SCID present?

A

failure to thrive, deep abscesses, decreased lymphocyte, viral + fungal infection

35
Q

how do organisms cause disease?

A

exposure –> adherence –> invasion –> multiplication –> dissemination

36
Q

antibiotics in the beta lactam group?

A

MCCP

monobactams, carbapenems, cephalosporins, penicillin

37
Q

what are the resistance mechanisms in bacteria/

A

vertical (reproduction), horizontal (transformation (from environment), transduction (bateriophage), conjugation)

38
Q

sepsis commonest pathogen?

A

n meningitidis

39
Q

SIRS diagnoses?

A

2+ from

RR > 20, HR >90, temp >38, WBC 12x10(9)

40
Q

what is sepsis and severe sepsis?

A

sepsis - sirs + infection

severe sepsis - sepsis + organ hypoperfusion or failure

41
Q

how do you manage sepsis ASAP/

A

sepsis 6 within 1 hr

IV fluids and antibiotics, blood culture, serum lactate, urine output measured, oxygen

42
Q

what is the characteristics of innate and adaptive immunity?

A

innate - fast, non specific, no memory

adaptive - slow, specific, memory

43
Q

what structures and cells involved in innate and adaptiv eimmunity?

A

innate - WBCs, anatomical barriers, inflammation, complement proteins
adaptive - b and t lymphocytes

44
Q

how do macrophages recognise pathogens?

A

have Pathogen recognition receptors (PRRs) to recognise PAMPs + phagocytose

45
Q

how do macrophages kill?

A

oxygen dependent - superoxide

oxygen independent - lactoferrins, proteases, lysozyme

46
Q

what complement proteins do you know nad their functions

A

c3a and 5a - chemoattractants for phagocytes
c3b and 4b - opsonise
c5-9 - membrane attack complex

47
Q

How do you treat malaria

A

falcifiparum - quinine / artemesinin

other species - chloroquine

48
Q

pathology of enteric fever and symptoms?

A

caused by salmonella enterica, adheres to ileal lymphoid tissue called peyers patches.
symptoms - fever, malaise, abdo pain, consitpation, hepatosplenomegaly, dry cough, intestinal hemorrhage

49
Q

how do you investigate and treat enteric fever?

A

investigate - blood culture, raised LFTs, lymphopenia

treat - typhoid vaccine, ceftriaxone

50
Q

symptoms of brucellosis and treatment/

A

symptoms - fever, myalgia (most important), arthralgia

doxycycline

51
Q

characteristics of flu A

A

-ss RNA

52
Q

legionella symptoms?

A

fever, diarrhoea, chils, myalgia, tiredness

53
Q

what is antigenic drift and shift?

A

drift - mutation

shift - combo of different strains

54
Q

how are extracellular PAMPs targetted?

A

phagocytosed by antigen presenting cells (APCs) –> MHS class 2 binds to PAMP –> activates CD4 cell –> activates B cells, eosinophils, mast cells

55
Q

how are intracellular PAMPs targetted

A

antigen enters ER –> Binds to MHC1 –> activates CD8 –> activates killer t cells –> release perforins and granzymes

56
Q

why does organ rejection occur?

A

MHC incompatability

PPE (18 decks)

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