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BDS 1 > Immunology and Pathology > Flashcards

Immunology and Pathology Flashcards

1
Q

What are extremophiles?

A

Microorganisms adapted to live in harsh and extreme environments

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2
Q

What are thermophiles?

A

Bacteria with optimum growth temp >45

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3
Q

What are psychrophiles?

A

Bacteria with optimum growth temp below 20

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4
Q

What are bacteria that withstand high osmotic pressure environments called?

A

Halophiles - high salt environments and spoilage of salted foods

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5
Q

What are bacteria that live in acidic and alkaline environments called?

A

Acidophiles

Basophiles

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6
Q

What are the 7 beneficial activities of microorganisms?

A
  1. Environmental cycles: C, N, O, S
  2. Agriculture and horticulture
  3. Food and drink: brewing, wine-making, baking, cheese
  4. Medicine: insulin, antibiotics
  5. Energy production: ethanol, methane, H2
  6. Solvent production: acetone, butanol
  7. Nutritional benefits and protective in man and animal
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7
Q

What are the 7 mechanical antimicrobial factors which microbiota must contend with in healthy host?

A
  1. Flushing action of liquids: saliva, urine
  2. Peristalsis of gut
  3. Skin: impermeable barrier
  4. Cough/sneeze reflex
  5. Mucus
  6. Cilia
  7. Shedding of epithelial cells
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8
Q

What are the 8 biochemical antimicrobial factors in health?

A
  1. Anaerobicity
  2. Acidity
  3. Sebaceous secretions
  4. Sweat: high salt
  5. Lysozyme: antibacterial enzyme
  6. Digestive enzymes
  7. Bile: detergent action
  8. Colonisation resistance
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9
Q

What are the 6 immunological antimicrobial factors in health?

A
  1. Complement
  2. Phagocytosis
  3. Inflammation
  4. Acute phase response
  5. Antibodies
  6. Cell-mediated responses
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10
Q

Why is infection control important?

A

Body surfaces are heavily colonised
Inanimate surfaces, instruments, H2O, air contaminated
Patients and staff may be carrying infections
Need to protect patients and staff from risk of infection
Dentists have responsibility for ensuring safety

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11
Q

What are some of the infection control procedures?

A 
Hep B immunisation
Sterile instruments/equipment 
Proper aseptic techniques
Safe disposal of waste
PPE
General hygiene and cleanliness
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12
Q

What dental diseases are caused by microorganisms?

A

Dental plaque related disease: caries, periodontal disease
Other oral infections: abscess, mucosal infections, bone and sinus infections
Systemic disease: infective endocarditis, brain abscess

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13
Q

What are the 5 infectious agents in inc. complexity?

A
  1. Prions: infectious proteins
  2. Viruses: non-living, obligate intra-cellular parasites
  3. Bacteria: prokaryote
  4. Fungi: eukaryote
  5. Protozoa: eukaryote
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14
Q

What are prokaryotes?

A

Single-celled, contain RNA and DNA
Lack membrane bound nucleus
Single, circular DNA molecule as chromosome

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15
Q

Describe eukaryotes

A

Truly nucleated: uni/multicellular containing both RNA and DNA
Membrane bound nucleus and other organelles

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16
Q

What are prokaryotes and eukaryotes but viruses not?

A

Defined as living organisms

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17
Q

What are parasites?

A

Organism that lives in/on 2nd organism (host)

May have little/no harmful affect, in apparent or bring about damage/harm (pathogen)

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18
Q

What are commensals?

A

Microbes found colonising host that benefit or are essential to them

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19
Q

Describe bacteria

A

Unicellular
Reproduce asexually by binary fission

V small, v diverse (aerobes, anaerobes, microaerophilic, capnophilic)
Low generation time (mins)

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20
Q

What are the 2 important structural features of bacteria essential for their survival?

A
  1. Fimbriae: on surface; protect against phagocytosis, aid adherence to target
  2. Pilus: share genetic material; antibiotic resistance
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21
Q

What are the 6 main bacteria types that interact with man?

A
  1. Gram +ve
  2. Gram -ve
  3. Acid-fast
  4. Mycoplasma, ureaplasma
  5. Rickettsiae
  6. Chlamydia
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22
Q

Describe gram +ve bacteria

A

Thick peptidoglycan cell wall, possible protein layers, stain purple

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23
Q

Describe gram -ve bacteria

A

Thin peptidoglycan layer, 2nd membrane, periplasm (space), lipid rich, fragile, stain pink

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24
Q

What are acid-fast bacteria?

A

Bacteria with mycolic acids (waxy lipid) attached to peptidoglycan
Cross linking with arabinose and galactose
Does not stain by normal procedure

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25
Q

What is special about mycoplasma and ureaplasma?

A

Cytoplasmic contents surrounded by well developed PM thus resistance to antibiotics that target cell wall e.g. penicillins

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26
Q

How do viruses replicate?

A 
Depend on host
Adsorption
Penetration
Assembly
Reslease
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27
Q

How do fungi reproduce?

A

Asexual - most freq. in good conditions

Sexual - fusion of gametes or gametangia

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28
Q

How do yeasts reproduce?

A

By budding

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29
Q

What is an important yeast in oral biology?

A

Candida albicans

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30
Q

When are the body surfaces sterile?

A

Immediately before birth, rapidly colonised after birth

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31
Q

What body surfaces are normally non-sterile?

A

Skin, mouth, upper respiratory tract, GIT, genitourinary tract
Acquire from environment and contact with other people

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32
Q

What body surfaces are usually sterile?

A

Blood, CSF, lymph, bones, joints, internal organs

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33
Q

What secretions are contaminated?

A

Faeces heavily

Saliva, tears, sebum sterile within glands, contaminated as soon as reach mucous membrane/skin

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34
Q

What 5 factors effect establishment of microorganisms?

A
  1. Exposure of site to potential organism
  2. Availability of suitable receptor sites
  3. Ability of organism to adhere to receptors
  4. Ability of organism to compete for nutrients
  5. Ability to evade/withstand host defence mechanisms
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35
Q

Compare resident and transient microflora

A

Resident: commensal organisms regularly present at different sites
Transient: colonise body for short periods of time, w/o causing disease

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36
Q

Define commensal

A

Organism that benefits from relationship with host but is neither directly benefits or harms host

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37
Q

Define opportunistic pathogen

A

Organism that only causes disease when host is immunocompromised or is transferred to unusual site

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38
Q

Define carriage

A

Person asymptomatically carries pathogen which can be transferred to others

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39
Q

Define colonisation resistance

A

Mechanism by which resident microflora act as barrier against colonisation by undesirable, exogenous organisms

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40
Q

Define pathogen

A

Microorganism that is capable of causing disease

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41
Q

Define virulence

A

Quantitative ability of a pathogen to cause disease - measure of degree of pathogenicity

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42
Q

Describe the possible consequences of resident microflora being absent

A 
Poor physical development of gut
Poor nutrient absorption in gut
Vit. deficiencies 
Reduced host immune defences
Susceptibility to colonisation by pathogens
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43
Q

Describe the consequences of resident microflora being suppressed

A

Overgrowth by antibiotic-resistant microorganisms

Colonisation by pathogens

44
Q

What are the 4 possible mechanisms for colonisation resistance?

A
  1. Competition for receptor sites
  2. Competition for nutrients
  3. Creation of unfavourable micro-environments that discourage colonisation
  4. Production of inhibitory substances
45
Q

Describe the advantageous metabolic activities of microflora of the vagina

A

Lactobacilli produce acid from glycogen, maintain low pH which is unsuitable for many exogenous bacteria

46
Q

Describe advantageous activities of skin microflora

A
  1. Propionibacteria breakdown sebum, release FAs - inhibit some potential pathogens
  2. Some staphylococci produce peptide antibiotics which inhibit other bacteria
47
Q

Describe advantageous activities of mouth and GIT microflora

A

Some bacteria produce bacteriocins which inhibit other organisms

48
Q

What are 4 important gram +ve mouth microflora?

A
  1. Streptococci
  2. Actinomyces
  3. Bifidibacterium
  4. Lactobacillus
49
Q

What are 4 important gram -ve oral bacteria?

A
  1. Aggregatibacter
  2. Porphyromonas
  3. Fusobacterium
  4. Prevotella
50
Q

What 4 factors can disrupt normal flora at all sites?

A
  1. Suppression by antimicrobial agents allowing overgrowth of resistant organisms
  2. Changes in general health or immunological status
  3. Hormonal changes
  4. Local trauma
51
Q

What 5 factors can disrupt normal flora of the mouth?

A
  1. Changes in diet
  2. Reduction in salivary production
  3. Dental disease
  4. Dental treatment
  5. Oral hygiene
52
Q

What 3 factors can disrupt GIT flora?

A
  1. Changes in diet
  2. Functional disorders of gut
  3. Localised pathological lesion in gut
53
Q

What 2 factors can disrupt female genital tract flora?

A
  1. Menstrual cycle, pregnancy

2. Infra-urine contraceptive device

54
Q

What 2 factors can disrupt skin flora?

A
  1. Use of soaps, cosmetics, antiseptics

2. Wetness, dryness

55
Q

What 2 factors can disrupt respiratory tract flora?

A
  1. Viral infections

2. Damage to ciliated epithelial cell function

56
Q

What are viruses?

A

‘Non-living’, obligate intracellular parasites

57
Q

What are the 4 distinguishable features of viruses?

A
  1. V small size
  2. Genome: DNA/RNA
  3. Metabolically inert: some have polymerases
  4. Replication: not true reproduction
58
Q

Describe the structure of viruses

A

Capsid: protein coat made of capsomeres
Nucleic acid in capsid
Some have membrane derived from host cell
Receptor binding protein

59
Q

On what 5 characteristics are viruses classified?

A 
1. Virus particle morphology 
Type of nucleic acid:
2. DNA OR RNA
3. Intact or segmented
4. Single or double stranded 
5. Linear or segmented
60
Q

Differentiate between positive and negative RNA viruses

A

+ve: act directly as mRNA

-ve: transcribed by virus-associated RNA transcriptase to mirror-image +ve copy which then acts as mRNA

61
Q

What 4 factors allow viral evolution to be so rapid?

A
  1. Genome duplication v quick
  2. No proof reading or error correction
  3. RNA viruses: nucleotide divergence 2%/yr
  4. Polymerases v high freq. of error
62
Q

What are the 6 stages of the viral life cycle?

A
  1. Attachment
  2. Entry
  3. Uncoating
  4. Synthesis (of viral components)
  5. Assembly
  6. Release
63
Q

Define episomal and proviral

A

Episomes: viral genomes free in cytoplasm or nucleus
Proviral: integrate into host genome

64
Q

What is amantadine? How does it work?

A

Antiviral agent
1-aminoadamantane
Interferes with uncoating of virus

65
Q

What is acyclovar and how does it work?

A

Antiviral

Inhibits viral reverse transcriptase

66
Q

How do proteases inhibit viruses?

A

Prevent cutting up of viral proteins for assembly into capsid

67
Q

How does ribavirin inhibit viruses?

A

Unknown
Ribonucleoside analogue
Prevents RNA synthesis and mRNA capping

68
Q

What are the 5 leukocytes in order from most numerous to least?

A
  1. Neutrophils: 40-70%
  2. Lymphocytes: 20-45%
  3. Monocytes: 4-8%
  4. Eosinophils: 1-4%
  5. Basophils: <1%
69
Q

What are the 2 types of leukocytes?

A
  1. Granulocytes

2. Agranulocytes

70
Q

Which leukocytes are granulocytes and which are agranulocytes?

A

Granulocytes: neutrophils, eosinophils, basophils
Agranulocytes: lymphocytes, monocytes

71
Q

Describe neutrophils

A

Multilobed nucleus: 2-6 interconnected lobes
Blue granules, pick up acid and base stains

Phagocytise and destroy bacteria

72
Q

Describe eosinophils

A

Bilobed nucleus
Red/yellow granules

Role in ending allergic reactions and parasitic infections

73
Q

Describe basophils

A

Bilobed nucleic hidden by large purple granules

Role in inflammation mediator
Granules secrete histamine

74
Q

Describe lymphocytes

A

Round nuclei
Dense, purple staining, little cytoplasm

Immune response; act against specific antigens and infectious agents

75
Q

Describe monocytes

A

Kidney shaped nuclei
Larges leukocyte

Transform into macrophages; phagocytic cells

76
Q

What are the 2 types of lymphocytes?

A
  1. T cells: attack antigen directly

2. B cells: multiply to become antibody secreting plasma cells

77
Q

What are the 3 basic functions of myeloid cells (WBCs)?

A
  1. Migration: move to site of infection
  2. Phagocytosis: engulf bacteria in vacuole
  3. Granule-release: different cells have different granules and purposes
78
Q

What are the 4 functions of granule release from myeloid cells?

A
  1. Degradation of pathogens
  2. Chemotactic factors: cytokines that stim. release of more WBCs from bone marrow
  3. Activators of clotting and clot dissolution
  4. Factors that allow permeability
79
Q

What is the overall affect of granule release?

A

Trigger and sustain inflammatory response

80
Q

What is neutrophilia? When is it seen?

A

Inc. in number of neutrophils

  1. Infection
  2. Inflammation
  3. Tissue damage
  4. Myeloproliferative disorders
81
Q

What 6 disorders can lead to eosinophilia?

A
  1. Allergic: asthma
  2. Skin: eczema, psoriasis
  3. Gut: ulcerative colitis
  4. Parasitic: Protozoa, metazoa
  5. Malignancies: Hodgkin’s disease, myeloproliferative
  6. Lung eosinophilia: tuberculosis
82
Q

What conditions can lead to basophilia?

A
  1. Myeloproliferative: chronic leukaemia
  2. Occasionally chronic infections
  3. Severe hypothyroidism
83
Q

In what situations does monocytosis arise?

A
  1. Recovery from acute infection
  2. Some chronic bacterial infection: tuberculosis
  3. Viral infections
  4. Collagen disease
  5. Monocytic leukaemia
84
Q

In what 4 conditions can lymphocytosis arise?

A
  1. Viral infections: glandular fever
  2. Infections in children: whooping cough
  3. Other: TB, typhoid, toxoplasmosis
  4. Malignant lymphoproliferative disorders: lymphomas, lymphocytic leukaemias, myeloma
85
Q

What are the 3 functions of lymphocytes?

A
  1. Helper cells: help B cells make antibodies
  2. Regulatory: regulate immune response
  3. Cytotoxic: kill virally infected cells
86
Q

What is the role of natural killer cells?

A

Recognise and destroy cells infected w/ virus

Act against malignant cells

87
Q

What are the 5 epithelial barriers in innate immunity?

A
  1. Mucus, peristalsis
  2. Enzymes
  3. Microbial
  4. Cells that recognise pathogen patterns, produce chemicals that disrupts viral replication
  5. Antibacterial peptides
88
Q

What are the 5 molecules of the innate immune system?

A
  1. Lysozyme
  2. Pepsin-digestive enzyme
  3. Complement: plasma cells mark pathogens for phagocytosis
  4. Cytokines and Chemokines: cell-cell communication
  5. Antimicrobial substances: cryptidins, defensins
89
Q

What are the 8 functions of antibodies?

A
  1. Neutralise toxins
  2. Neutralise viral activity
  3. Activating complement
  4. Agglutination
  5. Immobilisation of microorganisms
  6. Binding soluble antigen
  7. Antibody dependent cellular cytotoxicity: killing infected cells
  8. Opsonisation: marking bacteria
90
Q

Describe the basic structure of antibodies

A

2 light chains and 2 heavy chains both w/ variable and constant region
Held together by S=S bond
Hinge region allows flexibility of antibody

91
Q

What determines the isotype of antibody?

A

Position of S=S

92
Q

Compare the constant and variable regions

A

Constant region is effector functions region where antibody can bind to receptor proteins

Variable region is the antigen binding portion and has 2 antigen binding sites. It is the upper part, V shape of Y.

93
Q

How are polymers of antibodies held together?

A

J chains

Joining chains

94
Q

Describe IgM, G, A

A

M: pentameric; 1st AB produced in immune response; best at activating complement
G: monomeric: AB associated w/ immune response in serum; best at opsonisation
A:
monomeric: in serum
dimeric: prevalent in secretions; signature Ig of all secretions

95
Q

What are paraproteins?

A

Abnormal Igs synthesised by atypical cells in the reticuloendothelial system
If only light chains lead to Bence-Jones paraproteinaemia where proteins found in urine and blood

Most present themselves as m-component (monoclonal gammopathy) in electrophoresis

96
Q

In what diseases is Bence-Jones paraprtoeinaemia found?

A

Myeloma

Malignant B cells only produce Ig light chains

97
Q

What lymphoproliferative diseases are associated w/ paraproteins?

A

Myeloma, lymphoma, chronic lymphatic leukaemia

98
Q

What Ig is the foetal Ig?

A

IgG

Only Ig that can cross placenta

99
Q

What Ig is the maternal Ig?

A

IgA

Predominates in all secretions including breastmilk

100
Q

What is hypogammaglobulinaemia?

A

Disorder caused by a red. in B cells thus there are less Ig resulting in immunodeficiency

101
Q

What is X-linked Agammaglobulinaemia?

A

Total loss of Ig production

102
Q

What can hypogammaglobulinaemia result in?

A

Recurrent infections

103
Q

What is hypergammaglobulinaemia?

A

Overproduction of Ig resulting in inc. Ig levels in serum

Observed in chronic infections

104
Q

What is Hyper IgM syndrome?

A

Inability to activate B cells fully prevents formation of germinal centres and switching of IgM to other isotypes

105
Q

Why is AB class switching important?

A

As different isotypes have different functions

106
Q

Describe the primary and secondary response

A

Primary: 1st contact w/ antigen, small Ig response, wanes after 3 weeks

Secondary: repeated contact, massive inc. in response, IgG production massively inc., IgM doesn’t inc.

BDS 1 (11 decks)

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