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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
What does having co-dominant expression, polymorphic genes, variable peptide binding cleft and broad specificity confer in MHCs?
Increase in diversity to more likely to present protein
26
Where are class I MHCs found?
All nucleated cells
27
What peptides do class I MHCs present?
Intracellular peptides
28
What is the responsive T cell to class I MHCs?
CD8+
29
Where are class II MHCs found?
Dendritic cells Macrophages B cells
30
What peptides do class II MHCs present?
Extracellular microbe
31
What are the responsive T cells to class II MHCs?
CD4+
32
What is unique about the MHCs found on dendritic cells?
Nucleated cells so have both class I and class II
33
Are self and non-self peptides presented by APCs?
Yes
34
Why are all peptides from the same microbe presented using different MHC molecules?
Increase chances of T cell activation
35
What type of microbial protein is the endogenous pathway used for?
Intracellular
36
Which MHC class does the endogenous pathway of antigen presentation use?
Class I
37
What type of microbial protein does the exogenous antigen processing pathway present?
Extracellular
38
Which MHC class does the exogenous antigen processing pathway use?
Class II
39
What is the importance of MHC molecules in Elite Controllers and Long Term Non-Progressors?
Allow them to keep viral load low
40
How is an effective T cell response brought about in an HIV infected individual?
MHC molecules possessed by individual present key viral peptides that the virus cannot mutate due to their essential nature
41
Why do Rapid Progressors who are infected with HIV not mount a T cell response?
Their MHC molecules present less critical peptides which the virus can mutate so they are not recognised
42
Which viral proteins are essential for viral entry in HIV infection?
Docking and transmembrane glycoproteins
43
What can cause organ transplant rejection?
HLA molecule mismatch b/w donor and recipient | Graft vs host reaction
44
Which two autoimmune diseases are associated with specific HLA molecules?
Ankylosing spondylitis | Insulin-dependent DM
45
What causes Guillan Barré syndrome?
Campylobacter jejuni has a microbial protein similar to myelin associated gangliosides so the microbial protein is assumed to be self
46
In what conditions is cross-reactivity between microbial and host antigens seen?
Rheumatic heart disease Guillan-Barré syndrome T1DM
47
What extracellular microbes may have their proteins presented by the exogenous pathway?
Bacteria Parasites Worms Fungi
48
What microbes may have their proteins presented by the endogenous pathway?
Viruses Bacteria Protozoa
49
Which type of immunity do CD4+ cells stimulate?
Humoral
50
What type of immunity do CD8+ T cells stimulate?
Cell-dependent
51
How do the components of humoral and cell dependent immunity compare?
Both have antibodies and complement | Cell dependent also has macrophages and cytotoxic T cells
52
What are the two main types of T cells?
T-helper and cytotoxic T cells
53
Why can T cells produce a range of cytokines?
They have a range of cellular responses
54
What is required for full activation of a naïve CD4+ T cells?
Cross-stimulation
55
Which two T cells are produced from an exposed naïve CD4+ T cell to deal with extracellular microbes?
TH2 | TH17
56
Which T cell is produced following exposure of a naïve CD4+ T cell in order to clear intracellular microbes?
TH1
57
Why is TH1 produced for intracellular microbes when a naïve CD4+ T cell is activated?
Best type for differentiation into cytotoxic T cells
58
What are the T cell responses against intracellular microbes?
Cytotoxic T lymphocytes --> perforin granzymes B cells --> isotype switching of antibodies to IgG Cytokine release --> macrophages --> kill opsonised microbes
59
Which cell type do long-term HIV survivors maintain high levels of to prevent progression to AIDS?
Cytotoxic T lymphocytes
60
What are the T cell responses against extracellular microbes?
TH2 --> eosinophils for parasites, B cells for antibody and mast cells for local inflammation TH17 --> neutrophils for phagocytosis
61
How does the primary and secondary response to antigen exposure by antibodies compare?
Secondary is faster, stronger, longer duration and higher affinity due to isotype switch from IgM --> IgG
62
Which antibody response has greater levels of total antibody and IgG but lower levels of IgM?
Secondary
63
How does the activation capacity of IgG and IgM differ?
IgG v. good in activating opsonisation | IgM v. good at activating complement
64
What are the immune functions of IgG?
Fc-dependent phagocytosis Complement activation Neonatal immunity Toxin/virus neutralisation
65
What is the immune function of IgA?
Prevent microbes binding to mucosa
66
What are the immune functions of IgE?
Immunity against helminths | Mast cell degranulation
67
What is the immune function of IgM?
Complement activation
68
Why is IgM better than IgG at complement activation?
It is pantomeric
69
How are immune deficiencies treated?
Take pool of antibodies from ~1000 pts to build a profile for a pt who cannot make antibodies (immunoglobulin therapy)
70
What can antibody-based diagnostic tests be used for?
Infectious diseases Autoimmune diseases Blood type HLA type
71
When might an antibody transfer be used?
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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