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My step 1 mnemonics > Immunology and basic Microbiology > Flashcards

Immunology and basic Microbiology Flashcards

1
Q

Immune system

organs (2nd)

A

2° organs: Allow immune cells to interact with antigen

P - Peyer patches
L - lymph nodes
a
T - tonsils
S - Spleen
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2
Q

Lymph node Medulla Consists of

A
  • medullary cords (closely packed lymphocytes and plasma cells) and medullary sinuses.
  • Medullary sinuses communicate with efferent lymphatics and contain reticular cells and macrophages.
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3
Q

Internal iliac nodes drain the…

A

Lower rectum to anal canal (above pectinate line), vagina (middle third), prostate.

(bladder, cervix- both)

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4
Q

External iliac drain the…

A

body of uterus

cervix, bladder in both Internal iliac and External iliac

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5
Q

Both Internal iliac and External iliac. drain the…

A

cervix, bladder in both Internal iliac and External iliac

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6
Q

Cervical supraclavicular drain the…

A

Head and neck (URI, Mono, Kawasaki - KUM)

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7
Q

Mediastinal drain the…

A

Trachea and esophagus

Primary lung cancer
Granulomatous disease

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8
Q

Hilar drain the…

A

Lungs

Granulomatous disease

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9
Q

Para-aortic drain the…

A

Testes. ovaries. kidneys. uterus -> Metastasis

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10
Q

Popliteal nodes drain the:

A

Dorsolateral foot posterior calf -> Lateral foot/ leg cellulitis

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11
Q

Superficial inguinal nodes drain the_____

A 
Anal canal (below pectinate fine skin below), umbilicus (except
popliteal area). scrotum. vulva
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12
Q

Hassal corpuscules are part of…

and contain

A

Hassal corpuscules are located in the thymus medulla along with mature t-cells and reticular cells.

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13
Q

Thymoma- neoplasm of the thymus.

associated with

A

myasthenia gravis, superior vena cava
syndrome, pure red cell aplasia, Good
syndrome.
MS Pure & Good

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14
Q

PAMPS are..

A

LPS
N.A. (Virus)
Flagellin

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15
Q

Spleen white pulp has

A

Follicules (B cells)

PALS (T cells)

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16
Q

Spleen red pulp has

A

Sinusoids - long, vascular channels in reed pulp with fenestrated “barrel hoop” basement membrane.

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17
Q

Spleen marginal zone has

A

BAM! presentation!
B cells
APC
Macrophages

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18
Q

Postsplenectomy blood findings:

A
  • Howell-Jolly bodies (nuclear remnants)
  • Target cells
  • Thrombocytosis (loss of sequestration and removal)
  • Lymphocytosis (loss of sequestration)
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19
Q

HLA SUBTYPE A3

DISEASE

A

Hemochromatosis

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20
Q

HLA SUBTYPE B8

DISEASE

A

Addison disease, myasthenia gravis, Graves
disease
Bate (B8) Addison to Graves(2)

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21
Q

HLA SUBTYPE B27

DISEASE

A

Psoriatic arthritis, Ankylosing spondylitis,
IBD-associated arthritis, Reactive arthritis

PAIR

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22
Q

HLA SUBTYPE C

DISEASE

A

Psoriasis

P”C”riasis

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23
Q

HLA SUBTYPE DQ2/DQ8

DISEASE

A

Celiac disease

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24
Q

HLA SUBTYPE DR2/3

DISEASE

A

SLE

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25
Q

HLA SUBTYPE DR2

DISEASE

A

Multiple sclerosis, hay fever, SLE,
Goodpasture syndrome

Multiple hay pastures are dirty (DR2).

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26
Q

HLA SUBTYPE DR3/5

DISEASE

A

Hashimoto

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27
Q

HLA SUBTYPE DR3

DISEASE

A

DM type I, SLE, Graves disease, Addison disease

Addison in front of 1 grave

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28
Q

HLA SUBTYPE DR4

DISEASE

A

Rheumatoid arthritis, DM type 1, Addison
disease

Addison in 1 room

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29
Q

Natural killer cells Activity enhanced

A

by IL-2, IL-12, IFN-alfa , and IFN-beta.

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30
Q

T -cell subset Th1

secrets

A

IL 2

IFN gamma

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31
Q

T -cell subset Th2

secrets

A

IL 4,5,6,10,13

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32
Q

T -cell subset Th17

secrets

A

IL 17, 21, 22

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33
Q

T -cell subset Treg

secrets

A

TGF beta

IL 10, 35

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34
Q

T -cell subset Th1

induced by

A

IL 12

IFN gamma

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35
Q

T -cell subset Th2

induced by

A

IL 2,4

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36
Q

T -cell subset Treg

induced by

A

TGF beta

IL2

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37
Q

T -cell subset Th17

induced by

A

TGF-beta

IL 6, 1

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38
Q

T -cell subset Th1

inhibited by

A

IL 4

IL 10

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39
Q

T -cell subset Th2

inhibited by

A

IFN gamma

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40
Q

T -cell subset Th17

inhibited by

A

IL 4

IFN gamma

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41
Q

T -cell subset Treg

inhibited by

A

IL-6

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42
Q

Important cytokines

SECRETED BY MACROPHAGES

A

Acute (IL- I, IL-6, TNF-a), then recruit (IL-8, IL-12).

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43
Q

interleukin-1

A

F - fever

A - acute inflammation.

C - chemokine secretion - recruit WBCs.

E - endothelium activation - express adhesion molecules.

Also known as an osteoclast-activating factor.

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44
Q

interleukin-6

A

Causes fever and stimulates the production of acute-phase

proteins.

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45
Q

Tumor necrosis

factor-a

A

W - WBC recruitment
E - endothelium( Activation)
L - leak (vascular)

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46
Q

lnterleukin-8

A

Major chemotactic factor for neutrophils.

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47
Q

lnterleukin-12

A

Induces differentiation ofT cells into Th I cells.

Activates NK cells.

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48
Q

Important cytokines

SECRETED BY ALL T CELLS

A

lnterleukin-2

lnterleukin-3

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49
Q

lnterleukin-2

A

Stimulates growth of helper, cytotoxic, and

regulatory T cells, and NK cells.

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50
Q

nterleukin-3

A

Supports growth and differentiation of bone

marrow stem cells. Functions like CM-CSF.

51
Q

Cell surface proteins

T cells

A

TCR (binds antigen-Ml IC complex)
CD3 (associated with TCR for signal transduction)
CD28 (binds B7 on APC)

52
Q

Cell surface proteins

Helper T cells

A

CD4, CD40L, CXCR4/CCR5 (co-receptors for HIV)

53
Q

Cell surface proteins

Cytotoxic T cells

A

CD8

54
Q

Cell surface proteins

Regulatory T cells

A

CD4,CD25

55
Q

Cell surface proteins B cells

A

lg (binds antigen)
CDl9, CD20, CD21 (receptor for Epstein-Barr virus), CD40
MHC II, B7

56
Q

Cell surface proteins

Macrophages

A

CDl4 (receptor for PAMPs, eg, LPS), CD40
CCR5
MHC II, B7 (CD80/86)
Fc and C3b receptors (enhanced phagocytosis)

57
Q

Cell surface proteins

NK cells

A

CDl6 (binds Fe of lgG), CD56 (suggestive

marker for NK)

58
Q

Cell surface proteins

Hematopoietic stem cells

A

CD 34

59
Q

Passive immunity for

A

After exposure to Tetanus toxin, Botulinum
toxin, IIBV, Varicella, Rabies virus, or
Diphtheria toxin, unvaccinated patients are
given preformed antibodies (passive)- “To Be
Healed Very Rapidly Before Dying”

60
Q

live attenuated

vaccine

A 
Adenovirus (nonattenuated,
given to military recruits},
Typhoid (Ty21a, oral},
Polio (Sabin}, Varicella
(chickenpox}, Smallpox,
BCC, Yellow fever, Influenza
(intranasal}, MMR, Rotavirus
"Attention Teachers! Please
Vaccinate Small, Beautiful
Young Infants with MMR
Regularly!"
61
Q

Killed or inactivated

vaccine

A 
Rabies, influenza (injection),
Polio (Salk}, hepatitis A,
typhoid (Vi polysaccharide,
intramuscular)
Sa lK = Killed
RIP At Times
62
Q

Subunit vaccine

A 
HBV (antigen = HBsAg),
HPV (types 6, 11, 16, and
18), acellular pertussis
(aP}, Neisseria meningitidis
(various stra ins), Streptococcus
pneumoniae, Haemophilus
influenza type b.
Be PP SHIN
63
Q

Arthus reaction

A

a local subacute immune
complex-mediated hypersensitivity reaction.
intradermal injection of antigen into a
pre-sensitized (has circulating IgG) individual
leads to the immune complex formation in the
skin. Characterized by edema, necrosis, and
activation of complement.

64
Q

Type I

hypersensitivity Phases

A

Anaphylactic and atopic-two phases:
• Immediate (minutes)
• Late (hours)

65
Q

Type I
hypersensitivity
Immediate (minutes):

A

antigen crosslinks
preformed lgE on presensitized mast cells
- immediate degranulation - release of
histamine (a vasoactive amine} and tryptase
(a marker of mast cell activation}.

66
Q

Type I
hypersensitivity
ILate (hours}:

A

chemokines (attract inflammatory cells, eg, eosinophils) and
other mediators (eg, leukotrienes} from mast
cells - inflammation and tissue damage.

67
Q

Common variable
immunodeficiency
PRESENTATION

A

Usually presents after age 2 and may be considerably delayed;

dec. Plasma cells, dec. Igs

LABS
L - Lymphoma,
A - Autoimmune disease
B -  Bronchiectasis
S - Sinopulmonary infections
68
Q

Autosomal dominant
hyper-lgE syndrome
(Job syndrome)
PRESENTATION

A 
FATED
Facies/Fractures
Abscesses (cold)
Teeth (baby)
Eosinophils/IgE
Dermatologic eczema/dominant.
69
Q

Ataxia-telangiectasia

PRESENTATION

A 
Lymphoma and leukemia.
AFP inc. 
Lymphopenia, cerebellar atrophy.
IgA dec
LALA
70
Q

Hyper-lgM syndrome

A

X-linked recessive.
Failure to make gerMinal
centers.

71
Q

Wiskott-Aldrich

syndrome findings

A

gAmE (Ig- caps inc, lower case dec.)
WATER: Wiskott-Aldrich:
thrombocytopenia, Eczema, Recurrent (pyogenic) infections.

72
Q

Chediak-Higashi

syndrome

A

PLAIN: Progressive neurodegeneration,Lymphohistiocytosis, Albinism (partial), recurrent pyogenic Infections, peripheral Neuropathy.

73
Q

Infections in immunodeficiency

- Bacteria (no T-cells)

A

Sepsis

74
Q

Infections in immunodeficiency

- Viruses (no T-cells)

A

CMV, EBV, JC
virus, VZV, chronic
infection with
respiratory/GI viruses

75
Q

Infections in immunodeficiency

- Fungi/parasites (no T cells)

A

Candida (local), PCP, Cryptococcus

76
Q

Infections in immunodeficiency - Bacteria (no B-cells)

A 
Encapsulated (Please
SHINE my SKiS):
Pseudomonas
aeruginosa,
Streptococcus
pneumonia,
Haemophilus
Influenzae type b,
Neisseria
meningitis,
Escherichia coli,
Salmonella,
Klebsiella
pneumoniae,
Group B
Streptococcus
77
Q

Infections in immunodeficiency - Viruses (no B-cells)

A 
Enteroviral
encephalitis,
poliovirus
(live vaccine
contraindicated)
78
Q

Infections in immunodeficiency - Fungi/parasites (no B-cells)

A

GIgiardiasis (no IgA)

79
Q

Infections in immunodeficiency - Bacteria (no GRANULOCYTES)

A 
Staff Break Pseudo! Not serious:
Staphylococcus,
Burkholderia cepacia,
Pseudomonas
aeruginosa, Nocardia,
Serratia
80
Q

Infections in immunodeficiency - Fungi/parasites (no GRANULOCYTES)

A

Candida (systemic),
Cryptococcus
Aspergillus
Mucor

81
Q

infections in immunodeficiency - Bacteria (no complement)

A 
Encapsulated
species with early
complement
deficiencies
Neisseria with late
complement (C5-
C9) deficiencies
82
Q

Alemtuzumab
TARGET
CLINICAL USE

A

CD52

CLL, MS

83
Q

Bevacizumab
TARGET
CLINICAL USE

A

VEGF

Colorectal cancer, renal cell
carcinoma, non-small cell
lung cancer

Also used for neovascular age-related
macular degeneration,
proliferative diabetic
retinopathy, and macular
edema

CoLoREtaL

84
Q

Rituximab
TARGET
CLINICAL USE

A 
CD20
CRIB =B-cell non-Hodgkin
lymphoma, CLL, rheumatoid
arthritis, ITP, MS
Risk of PML in patients with
JC virus
85
Q

Trastuzumab
TARGET
CLINICAL USE

A

HER2

Breast cancer, gastric cancer

86
Q

Adalimumab,
infliximab
TARGET
CLINICAL USE

A

Soluble TNF-a
PAIR=IBO, rheumatoid arthritis,
ankylosing spondylitis,
psoriasis

87
Q

Etanercept is a

A

decoy TNF-a receptor and not a

monoclonal antibody

88
Q

Eculizumab
TARGET
CLINICAL USE

A

Complement protein C5
Paroxysmal nocturnal
hemoglobinuria

89
Q

Natalizumab
TARGET
CLINICAL USE

A 
a4-integrin
MS, Crohn disease
a4-integrin: WBC adhesion
Risk of PML in patients with
JC virus
90
Q

Denosumab
TARGET
CLINICAL USE

A

RANKL
Osteoporosis; inhibits osteoclast maturation
(mimics osteoprotegerin)

91
Q

Omalizumab
TARGET
CLINICAL USE

A

IgE
Refractory allergic asthma;
prevents IgE binding to FceRI

92
Q

Palivizumab
TARGET
CLINICAL USE

A

RSV F protein

RSV prophylaxis for high-risk infants

93
Q

Ustekinumab
TARGET
CLINICAL USE

A

IL-12/IL-23

Psoriasis, psoriatic arthritis

94
Q

Periplasm location and significance

A

Space between the cytoplasmic membrane
and outer membrane in gram neg bacteria.
(Peptidoglycan in middle.)

Accumulates components exiting gram
neg cells, including hydrolytic enzymes
(eg, beta-lactamases).

95
Q

Pleomorphic bacteria

A

Have no rigid cell walls.
Examples include Anaplasma, Ehrlichia, Chlamydiae, Rickettsiae, Mycoplasma, Ureaplasma.
U-CREAM

96
Q

These bugs do not Cram stain well…

A

Treponema, Leptospira,Mycobacteria, Mycoplasma, Ureaplasma, Legionella, Rickettsia, Chlamydia, Bartonella, Anaplasma, Ehrlichia
TeLL MUM B CLEAR

97
Q

Giemsa stain bugs

A

Rickettsia, Chlamydia, Trypanosomes,
Plasmodium, Borrelia, Helicobacter pylori
Ricky got Chlamydia as he Tried to Please the
Bored Ilot “Geisha.”

98
Q

Periodic a cid- Schiff

stain

A

Stains glycogen, mucopolysaccharides; used
to diagnose Whipple disease (Tropheryma
Whipple

99
Q

Ziehl-Neelsen stain

carbol fuchsin

A

Acid-fast bacteria (eg, Mycobacteria,
Nocardia; stains mycolic acid in the cell wall);
protozoa (eg, Cryptosporidium oocysts)

Auramine-rhodamine stain is more often used
for screening (inexpensive, more sensitive).
100
Q

India ink stain

A

Cryptococcus neoformans; mucicarmine
can also be used to stain thick polysaccharide
capsule red

101
Q

Silver stain

A

Fungi (eg, Coccidioides, Pneumocystis
Jiirovecii), Legionella, helicobacter pylori
F His Life

102
Q

Fluorescent antibody stain

A

Used to identify many bacteria, viruses,
Pneumocystis Jirovecii, Giardia, and
Cryptosporidium.

103
Q

Thayer-Martin agar has

A

Selective ly favors growth of Neisseria by
inhibiting the growth of gram (+) organisms
with Vancomycin, gram (-) organisms except
Neisseria with Trimethoprim and Colistin,
and fungi with Nystatin
Vice City News Team

104
Q

Aerobes

A

Nocardia, Pseudomonas
aeruginosa, Mycobacterium tuberculosis, and
Bordetella pertussis.

105
Q

Anaerobes

A

Clostridium, Bacteroides,
Fusobacterium, and Actinomyces israelii

AminO2glycosides are
ineffective against anaerobes because these
antibiotics require O2 to enter into bacterial
cell.

106
Q

Facultative anaerobes

A

Streptococci, staphylococci, and enteric gram (-)

bacteria.

107
Q

Obligate intracellular bacteria

A

Rickettsia, Chlamydia, Coxiella. Rely on host
ATP.
Stay inside (cells) when it is Really Chi lly and
Cold.

108
Q

Facultative
intracellular
bacteria

A

Salmonella, Neisseria, Bruce/la, Mycobacterium,
Listeria, Francisella, Legionella, Yersinia pestis

Bruces List SNM FacultativeLY.

109
Q

Urease-positive organisms

A

Proteus, Cryptococcus, H pylori, Ureaplasma, Nocardia, Klebsiella, S epidermidis, S saprophyticus. Urease hydrolyzes urea to release ammonia and C02 - inc. pH

Predisposes to struvite (ammonium magnesium phosphate) stones, particularly Proteus.

Pro CHUNKSS.

110
Q

Catalase-positive

organisms

A

Nocardia, Pseudomonas, Listeria,
Aspergillus, Candida, E coli, Staphylococci,
Serratia, B cepacia, H pylori.

PS BLANCHES

111
Q

Type Ill secretion

system

A

Needle-like protein appendage fac ilitating d irect delivery of toxins
(eg, Pseudomonas, Salmonella, Shigella, E coli)
PuShES

112
Q

Sporicidal Disinfection & sterilization

A 
Chlorine
Autoclave
Ethylene oxide
Hydrogen peroxide
Iodine and iodophors (maybe)
EACH I
113
Q

Non-Sporicidal Disinfection & sterilization

A

Quaternary amines
Chlorhexidine
Alcohols
Quarters Are Cool

114
Q

Early complement

deficiencies (C1-C4)

A

Increased risk of severe, recurrent pyogenic sinus and respiratory tract infections.

Increased risk of
SLE.

115
Q

Oxidative burst also leads to…

A

K+ influx, which releases lysosomal enzymes.

116
Q

Pyocyanin of P aeruginosa generates…

A

ROS to kill competing pathogens.

117
Q

Lactoferrin is a protein found in_____(2) that inhibit microbial growth via______

A

secretory fluids and
neutrophils

iron chelation.

118
Q

Combined passive and active immunizations

can be given for… (2)

A

hepatitis B or rabies exposure

119
Q

AUTOANTIBODIES for Polymyositis, dermatomyositis

A

Antisynthetase (eg, anti-Jo-I)
anti-SRP
antihelicase (anti-Mi-2)

120
Q

AUTOANTIBODIES for SLE

A 
Anticardiolipin
lupus anticoagulant
Antinuclear (ANA)
Anti-dsDNA
anti-Smith
121
Q

AUTOANTIBODIES for Antiphospholipid syndrome

A

Anticardiolipin
lupus anticoagulant
Anti-beta 2 glycoprotein I

122
Q

Endotoxin

A 
ENDOTOXINS:
Edema
Nitric oxide
DIC/Death
Outer membrane
TNF-a
O -antigen + core polysaccharide + lipid A
eXtreme ly heat stable
IL-I and IL-6
Neutrophil chemotaxis
Shock

Three main effects: macrophage activation
(TLR4/CDl4), complement activation, and
tissue factor activation.

123
Q

Pseudomonas aeruginosa Produces

A

Produces PEEP:

Phospholipase C (degrades cell membranes); 
Endotoxin (fever, shock);
Exotoxin A (inactivates EF-2);
Pigments: pyoverdine and pyocyanin (blue-green pigment)
124
Q

False-Positive results on VDRL with:

A

Pregnancy

Viral infection (eg, EBV, hepatitis}
Drugs
Rheumatic fever
Lupus and leprosy

My step 1 mnemonics (19 decks)

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