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Semester 3 > Infection Session 4 > Flashcards

Infection Session 4 Flashcards

1
Q

What broad types of infection account for the majority of healthcare acquired infections?

A

UTI
URT
GI infections

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2
Q

Give some examples of healthcare infection viruses.

A 
Hep B&C
HIV
Norovirus
Influenza
Chickenpox
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3
Q

Give some examples of healthcare infection bacteria.

A 
Staph aureus inc. MRSA
C.diff
E.coli
Klebsiella pneumoniae
Mycobacterium tuberculosis
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4
Q

Give some examples of healthcare infection fungi.

A

Candida albicans

Aspergillus sp.

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5
Q

What are the 4 P’s of infection prevention and control?

A

Patient
Pathogen
Practice
Place

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6
Q

What general patient interventions can be used in infection prevention and control?

A

Optimise pt condition
Antimicrobial prophylaxis
Skin preparation
Hand hygiene

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7
Q

What specific patient interventions can be used in infection prevention and control?

A

MRSA screens
Mupirocin nasal ointment
Disinfectant body wash

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8
Q

How can pt–>pt spread of healthcare acquired infection be prevented?

A

Isolate infected pts
Protect susceptible pts
Use +ve and -ve pressures

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9
Q

What practice factors can be used in infection prevention and control?

A

Healthy healthcare workers
Effective policies and implementation e.g. Hand washing, surgical technique, Abx prescribing
Effective organisational structure and engagement
Leadership at all levels

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10
Q

What pathogen factors should be considered in infection prevention and control?

A

Virulence factors

Ecological interactions w/other bacteria, Abx and disinfectants

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11
Q

What interventions can be implemented when considering place in infection prevention and control?

A

Built environment: single rooms, toilets, hand basins
Variable features: furnishings
Cleaning w/disinfectants, steam and H2O2 vapour
Single-use medical devices where possible
Hygienic food provision

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12
Q

Will an immune response be mounted if you have any number of T cells and tumour cells/pathogens?

A

No, need an APC present

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13
Q

Where are APCs located?

A

Strategically where B and T cells are present in lymphoid tissue (ALT), lymphoid organs and blood

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14
Q

What can carry out phagocytosis for whole microbes and macropinocytosis for soluble particles such as toxins?

A

APCs

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15
Q

Where are dendritic cells located?

A

Lymph nodes
Mucosa
Blood

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16
Q

What is included in the term ‘healthcare infections’?

A

Infection not incubating or present on admission to hospital (onset at least 48hrs after admission)
Infections in hospital visitors
Infections in healthcare workers

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17
Q

What allows APCs to detect both extracellular and intracellular pathogens?

A

Diversity in pathogen recognition receptors

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18
Q

Where are Langerhans cells found?

A

Skin

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19
Q

Where are B cells found?

A

Lymphoid tissues

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20
Q

What do B cells signal?

A

Switch from IgM to IgG production

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21
Q

How are MHC genes expressed?

A

Co-dominant, 3 paternal and 3 maternal

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22
Q

Do MHC genes show variance across the population?

A

Yes, they are polymorphic

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23
Q

Describe the peptide binding cleft of an MHC.

A

Variable region with polymorphic residues

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24
Q

What characteristic of MHCs means many peptides are presented by the same MHC molecule?

A

Broad specificity

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25
Q

What does having co-dominant expression, polymorphic genes, variable peptide binding cleft and broad specificity confer in MHCs?

A

Increase in diversity to more likely to present protein

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26
Q

Where are class I MHCs found?

A

All nucleated cells

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27
Q

What peptides do class I MHCs present?

A

Intracellular peptides

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28
Q

What is the responsive T cell to class I MHCs?

A

CD8+

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29
Q

Where are class II MHCs found?

A

Dendritic cells
Macrophages
B cells

30
Q

What peptides do class II MHCs present?

A

Extracellular microbe

31
Q

What are the responsive T cells to class II MHCs?

A

CD4+

32
Q

What is unique about the MHCs found on dendritic cells?

A

Nucleated cells so have both class I and class II

33
Q

Are self and non-self peptides presented by APCs?

A

Yes

34
Q

Why are all peptides from the same microbe presented using different MHC molecules?

A

Increase chances of T cell activation

35
Q

What type of microbial protein is the endogenous pathway used for?

A

Intracellular

36
Q

Which MHC class does the endogenous pathway of antigen presentation use?

A

Class I

37
Q

What type of microbial protein does the exogenous antigen processing pathway present?

A

Extracellular

38
Q

Which MHC class does the exogenous antigen processing pathway use?

A

Class II

39
Q

What is the importance of MHC molecules in Elite Controllers and Long Term Non-Progressors?

A

Allow them to keep viral load low

40
Q

How is an effective T cell response brought about in an HIV infected individual?

A

MHC molecules possessed by individual present key viral peptides that the virus cannot mutate due to their essential nature

41
Q

Why do Rapid Progressors who are infected with HIV not mount a T cell response?

A

Their MHC molecules present less critical peptides which the virus can mutate so they are not recognised

42
Q

Which viral proteins are essential for viral entry in HIV infection?

A

Docking and transmembrane glycoproteins

43
Q

What can cause organ transplant rejection?

A

HLA molecule mismatch b/w donor and recipient

Graft vs host reaction

44
Q

Which two autoimmune diseases are associated with specific HLA molecules?

A

Ankylosing spondylitis

Insulin-dependent DM

45
Q

What causes Guillan Barré syndrome?

A

Campylobacter jejuni has a microbial protein similar to myelin associated gangliosides so the microbial protein is assumed to be self

46
Q

In what conditions is cross-reactivity between microbial and host antigens seen?

A

Rheumatic heart disease
Guillan-Barré syndrome
T1DM

47
Q

What extracellular microbes may have their proteins presented by the exogenous pathway?

A

Bacteria
Parasites
Worms
Fungi

48
Q

What microbes may have their proteins presented by the endogenous pathway?

A

Viruses
Bacteria
Protozoa

49
Q

Which type of immunity do CD4+ cells stimulate?

A

Humoral

50
Q

What type of immunity do CD8+ T cells stimulate?

A

Cell-dependent

51
Q

How do the components of humoral and cell dependent immunity compare?

A

Both have antibodies and complement

Cell dependent also has macrophages and cytotoxic T cells

52
Q

What are the two main types of T cells?

A

T-helper and cytotoxic T cells

53
Q

Why can T cells produce a range of cytokines?

A

They have a range of cellular responses

54
Q

What is required for full activation of a naïve CD4+ T cells?

A

Cross-stimulation

55
Q

Which two T cells are produced from an exposed naïve CD4+ T cell to deal with extracellular microbes?

A

TH2

TH17

56
Q

Which T cell is produced following exposure of a naïve CD4+ T cell in order to clear intracellular microbes?

A

TH1

57
Q

Why is TH1 produced for intracellular microbes when a naïve CD4+ T cell is activated?

A

Best type for differentiation into cytotoxic T cells

58
Q

What are the T cell responses against intracellular microbes?

A

Cytotoxic T lymphocytes –> perforin granzymes
B cells –> isotype switching of antibodies to IgG
Cytokine release –> macrophages –> kill opsonised microbes

59
Q

Which cell type do long-term HIV survivors maintain high levels of to prevent progression to AIDS?

A

Cytotoxic T lymphocytes

60
Q

What are the T cell responses against extracellular microbes?

A

TH2 –> eosinophils for parasites, B cells for antibody and mast cells for local inflammation
TH17 –> neutrophils for phagocytosis

61
Q

How does the primary and secondary response to antigen exposure by antibodies compare?

A

Secondary is faster, stronger, longer duration and higher affinity due to isotype switch from IgM –> IgG

62
Q

Which antibody response has greater levels of total antibody and IgG but lower levels of IgM?

A

Secondary

63
Q

How does the activation capacity of IgG and IgM differ?

A

IgG v. good in activating opsonisation

IgM v. good at activating complement

64
Q

What are the immune functions of IgG?

A

Fc-dependent phagocytosis
Complement activation
Neonatal immunity
Toxin/virus neutralisation

65
Q

What is the immune function of IgA?

A

Prevent microbes binding to mucosa

66
Q

What are the immune functions of IgE?

A

Immunity against helminths

Mast cell degranulation

67
Q

What is the immune function of IgM?

A

Complement activation

68
Q

Why is IgM better than IgG at complement activation?

A

It is pantomeric

69
Q

How are immune deficiencies treated?

A

Take pool of antibodies from ~1000 pts to build a profile for a pt who cannot make antibodies (immunoglobulin therapy)

70
Q

What can antibody-based diagnostic tests be used for?

A

Infectious diseases
Autoimmune diseases
Blood type
HLA type

71
Q

When might an antibody transfer be used?

A

To confer passive immunisation for immediate protection if a pregnant lady is found to be not immune to varicella zoster

Semester 3 (50 decks)

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