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STEP 1 > ID/Immuno > Flashcards

ID/Immuno Flashcards

1
Q

what is one of the most important cytokines in sepsis? list some other imp cytokines

A

TNF-alpha

IL1, IL6

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2
Q

IL3 produced by ___.

-function?

A

activated T cells

stim growth and differentiation of stem cells in bone marrow

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3
Q

IL4 made by ___.

-function?

A

TH2 T-helper cells

stimulates growth of B cells and increases number of TH2 T-helper cells at site of inflammation

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4
Q

IL10 made by ___. function?

A

antiinflamm cytokine made by macrophages and TH2 T-helper cells

limits the production of proinflamm cytokines (eg interferon gamma, IL2, IL3, TNFa)

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5
Q

function of leukotriene B4

A

stimulate neutrophil migration to site of inflammation

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6
Q

transforming growth factor-beta made by __.

-function?

A

released by macrophages

anti-inflamm roles in sepsis incl suppressing release of IL1 and TNFa, and inhibiting lymphocyte proliferation

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7
Q

deficiency of ___ results in recurrent Neisseria infections

A

MAC attack complex (C5b-C9)

Terminal complement deficiency- any of C5-C9

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8
Q

prophylaxis for Mycobacterium avium complex infections

A

azithromycin

for AIDS pts CD4 <50

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9
Q

describe the process by which neutrophils go from bloodstream to site of inflammation

A

rolling

crawling

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10
Q

azole MOA

A

inhibit synthesis of ergosterol by fungal cytochrome p450

they also suppress human P450 system = many drug interactions (increae levels of drugs metabolize by liver P450- eg warfarin, cyclosporine, tacrolimus, oral hypoglycemiscs)

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11
Q

what is the most common cause of hydatid cysts?

what can happen when cyst spills?

where do most cases occur?

A

echinococcus granulosus

spill can => anaphylactic shock (perform surgery with caution)

endemic areas (eh easter Meditt, middle east, south am, subsaharan africa, former soviet union, western china) OR ppl in SW US with sheep or dogs

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12
Q

unilocular hydatid cysts seen in what infection?

multilocular?

A

unilocular- E granulosus

multi- E. mulilocularus

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13
Q

purpose of adding clavulanic acid to amoxicillin?

A

is a beta-lactamase inhibitor ->decrease amoxicillin cleavage by bacterial cells

-some bact make beta-lactamase which hydrolyzes the beta-lactam ring of penicllin family

adding beta lactamase inhibitor expands amoxicillin’s spectrum of activity to include strains of beta-lactamase syntheszing bacteria that are resistant to amoxicillin alone

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14
Q

HLA-B*57:01 allele associated with what

A

Abacavir hypersensitivity
(a nucleoside reverse transcriptase ihibitor NRTI used to treat HIV/AIDS)

abacavir directly binds to a segment on the HLAB*57:01 molecule, altering presentation of slef-peptides to immune system resulting in a delayed hypersens reaction (type IV)

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15
Q

most common bacterial cause of acute parotitis

what are risk factors for suppurative parotitis

how diagnosed

A

staph aureus

risk factors = decreased salivary flow

  • meds (eg anticholinergics)
  • obstruction (eg calculi, neoplasm)
  • dehydration, postsurg/intubation)

duagbosis = elevated amylase without elevated lipase

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16
Q

malaria is caused by what species?

what does it look like on blood smear

A

Plasmodium (there are four species)

trophozoites w/ diamond ring appearance in RBC

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17
Q

describe life cycle of parasite transmission

A

transmitted by female Anopheles mosquito during blood feed

goes to liver to infect hepatocytes

undergoes asexual repr which makes hepatic schizonts with thousands ot daugther cells (merozoites)

rupture of schizont into circulatory system–> erythrocyte infection and cycles of intraerythrocytic reproduction

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18
Q

paranasal sinus complaints
DM/immunosuppression

non septate hyphae branching at right angles

this is most likely?

A

mucormycosis

an opportunistic infection caused by rhizopups, mucor, and absidia species

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19
Q

what binding interactions are needed in activation of B cells?

A

MHCII (B) binds T-cell receptor
CD40(B) binds CD40-ligand on T cell
B7 (B) binds CD28 (T)

20
Q

when do maternal Ab fade

A

after 6 months

21
Q

Wiskott-Aldrich syndrome

  • cause
  • inheritance, mutation
  • symptoms
  • treatment
A

X-linked recessive
mutation in WASp gene imp for cytoskeleton rearrangement -> defective antigen presentation

is a combined B and T cell disorder

Wiskott
Aldrich
Thrombocytopenia
Eczema
Recurrent infections

infections worsen as patient ages, apparent after maternal IgG and mucosal IgA from breast milk are degraded at 6months

HLA-matched bone marrow transplant

22
Q

Chediak-Higashi syndrome

  • gemetics
  • cause
  • signs/symptoms
A

defective lysosomal trafficking regulator gene (LYST)
microtubule dysfunction in phagosome-lysosome fusion
AR

Progressive neurodegen
Lymphohistocytosis
Albinism
Infections
Neuropathy
23
Q

list 5 chemotactic agents that stimulate neutrophil migration to site of inflammatoin

A 
IL-8
n-formylated peptides
leukotriene B4
5-HETE (the leukotrient precursors)
C5a
24
Q

erythroblastosis fetalis and hemolytic disease of the newborn do not occur in what blood type(s) / do occur in what blood type(s)?

why?

A

does NOT occur in maternal blood types A and B as the anti-A and anto-B Ab are IgM type and can’t cross the placenta

occurs in type O mothers as antibodies are predominantly IgG and can cross placenta to case fetal hemolysis

25
Q

SCID

  • what two inheritance patterns/causes
  • signs and symptoms
  • treatment
A

XLR defective IL-2R gamma chain
AR adenosine deaminase deficiency

  • present in infancy w/ recurrent bacterial, viral, fungal, and opportunistic infections
  • failure to thrive
  • chronic diarrhea

decr T-cell receptor excision circles (TRECs), absent thymic shadown, germinal centers, and T cells

bone marrow treatment

26
Q

chronic granulomatous disease

  • cause
  • lab signs
A

NADPH oxidase defect (can’t make superoxide, hydrogen peroxide for resp burst)

X-linked most common

incr susceptibility to catalase+

nitroblue tetrazolium die reduction test fails to turn blue

27
Q

what cytokin stimulates antibody isotype switching

A

IL-4

esp swtiching to IgE

28
Q

thymus and ___ develop from ___ pharyngeal pouch

A

inferior parathyroid

3rd

29
Q

what is rheumatoid factor

A

IgM antibody specific for the Fc component of IgG

infiltrating CD4 cell secrete cytokines that stim B cells to make rhyematoid factor and anti-CCP antodies –> RA

30
Q

pubic louse

-treatment MOA

A

topical permethrin cream blocks parasite’s sodium ion conduction in nerve cell channels –> paralysis and death

31
Q

most common cause of hematogenous osteomyelitis

A

staph aureus

is predom a disease of children, freq affects long bones

strep pyogens (group a strep) is second most common cause

32
Q

widespread epidermal sloughing, esp with gentle pressure

  • what is this caused by and MOA
  • what is this sign called
A

staphylococcal scalded skin syndrome–due to production of the extoxin exfoliatin

blistering only in the superficial epidermis. the toxins act as proteases and cleave desmoglein in desmosomes

Nikolsky’s sign

33
Q

what can trigger IgE INdependent mast cell degranulation?

A

does so by activation of PKA and PI3 kinase

medications including

  • opioids
  • radiocontrast agents
  • some antibiotics eg vancomycin

diffuse itching and pain, bronchospasm, localized swelling

34
Q

what can cause IgE-DEpendent degranulation

A

usu a/w environmental exposures like foods or stings

or meds like beta-lactam and sulfonamide abxs

35
Q

Terbinafine

  • moa
  • usage
A

treat dermatophytosis (ringworm)

inhibits fungal membrane ergosterol by suppressing the enzyme squalen epoxidase

36
Q

caspofungin moa

A

blocks beta(1,3)-D-glucan which is a main component of Candida and Aspergillus cell walls

37
Q

Griseofulvin moa and use

A

binds polymerized microtubules and disrupts fungal mitotic spindle

accumulates in the skin, only effective for dermatophytosis

38
Q

what does IL-12 do

A

triggers differentiation of T-cells to Th1 cells

39
Q

Nystatin

  • moa
  • usage
A

polyene antifungal
binds ergosterol in fungal cell membrane, causing formation of pores and leakage of fungal cell contents

is not absorbed from GI tract and is given as an oral swish and swallow agent

DOC for oral candidiasis in pts without advanced immundeficiecny

40
Q

cause of hereditary angioedema

what drug should NOT be given to them

A

low C1 esterase inhibitor, which normally suppresses activation of C1 complement (this rest of cascade) and inactivates kallikrein which converts kinongen to bradykinin

= increase bradykinin

bradykinin, C3a, and C5a mediate angioedema by increasing vasodilation and vascular permeability

41
Q

what are the two most imp opsonins

A

IgG

C3b
which can also bind C3b convertase and form C5 convertase, ult triggering MAC

42
Q

what are the two mos common causes of SCID

A

X-linked

Adenosine deamine deficiency (AR) –> adenosine accumulation is toxic to lymphocytes

43
Q

what interferons do most human cells make in response to viral infection? what do they do?

A

interferons alpha and beta

help suppress viral refplic by halting protein synth and promoting apoptosis of infected cells –> limits virus ability to spread

44
Q

cause of green sputum / pus in bact infections

A

myeloperoxidase, which is a blue-green heme-based enzyme released from neutrophil azurophilic granules and makes hyypochlorous acid (Bleach)

45
Q

best time and agent to give pregnant woman to protect baby against Group B strep

A

35-37 weeks gestation

first choice penicillin

46
Q

name and explain a major virulence factor of M. tuberculosis

A

cord factor - a hydrophobic surface glycolipid

forms cylindrical micelles around M. tuberculosis to prevent macrophage destruction within the phagolysosome

forms toxic crystalline monolayer hydrophobic surface that drive formation of caseating granulomas

STEP 1 (12 decks)

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