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ESA 3 > Infection Session 4- Healthcare Infections And Adaptive Immunity > Flashcards

Infection Session 4- Healthcare Infections And Adaptive Immunity Flashcards

1
Q

What are healthcare infections?

A

Infections arising as a consequence of providing healthcare, so for hospital patients the infection was neither present nor incubating at time of admission

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2
Q

Why are healthcare infections important?

A

Frequent
Impact on health
Impact on healthcare organisations
Preventable

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3
Q

Give some examples of healthcare infection pathogens

A 
Hep C
HIV
Norovirus
MRSA
E coli
Malaria
Candida Albicans
C diff
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4
Q

What can make a patient more at risk of a healthcare infection?

A 
Extremes of age
Obesity/malnourished
Diabetes
Cancer
Immunosuppression
Smoker
Surgical patient
Emergency admission
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5
Q

What general patient interventions can prevent healthcare infections?

A

Optimise patient’s condition- smoking, nutrition, diabetes
Antimicrobial prophylaxis
Skin preparation
Hand hygiene

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6
Q

What specific patent interventions can prevent healthcare infections?

A

MRSA screens
Mupirocin nasal ointment
Disinfectant body wash

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7
Q

What can be done to prevent patient to patient transmission of healthcare infections?

A 
Vaccination
Good clinical techniques
Hand hygiene
PPE
Antimicrobial prescribing
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8
Q

What environmental interventions can be done to prevent healthcare infections?

A

Wash hand basins
Cleaning- disinfectants, steam cleaning and H2O2 vapour
Medical devices- single use equipment, sterilisation and decontamination
Appropriate kitchen and ward food facilities
Good food hygiene practice
Positive/negative pressure rooms

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9
Q

What are the five I’s when it comes to healthcare infections?

A 
Identify
Isolate
Investigate
Inform
Initiate treatment
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10
Q

Describe the main features of antigen presenting cells

A

Strategic location (B+T cell interaction)
Pathogen capture
Diversity in pathogen sensors (PRRs)

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11
Q

Where can antigen presenting cells be found?

A

Skin
Mucous membranes
Lymphoid organs
Blood circulation

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12
Q

What methods of pathogen capture can antigen presenting cells do?

A

Phagocytosis

Macropinocytosis

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13
Q

Name the different types of antigen presenting cells

A

Dendritic cells
Langerhans’ cells
Macrophages
B cells

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14
Q

Where are dendritic cells found and what do they present to?

A

Lymph nodes, mucous membranes, blood

Present to T+B cells

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15
Q

Where are Langerhans’ cells found and what do they present to?

A

Skin

Present to T cells

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16
Q

Where are macrophages found and what do they present to?

A

Various tissues

Present to T cells

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17
Q

Where are B cells found and what do they present to?

A

Lymphoid tissue

Present to T cells

18
Q

What substances are involved in humoral immunity?

A

Antibodies

Complement

19
Q

What substances are involved in cell-dependant immunity?

A

Cytotoxic T cells (CD8+ T cells)
Macrophages
Antibodies

20
Q

Where are class I + II major histocompatability complexes found?

A

Class I- found on all uncleared cells

Class II- found on dendritic cells, macrophages and B cells

21
Q

What are the key features of MHC class I and II?

A

Co-dominant expression- both parental genes are expressed to increase number of different MHC molecules
Polymorphic genes- different alleles among different individuals to increase presentation of different antigens/microbes

22
Q

What is the main difference between class I + class II MHC?

A

Class I present peptides from intracellular microbes

Class II present peptides form extracellular microbes

23
Q

What is the significance of the structure of the peptide binding cleft?

A

Variable region with highly polymorphic residues so have a broad specificity- many peptides presented by the same MHC molecule.

24
Q

Which T cells are activated by MHC class I?

A

CD8+

25
Q

Which T cells are activated by MHC class II?

A

CD4+

26
Q

Describe the antigen presenting features

A

Both self and non self peptides are presented
All peptides from the same microbe are presented by different MHC molecules
Susceptibility to infections depends on the types on MHC molecules

27
Q

What clinical problems are associated with MHC molecules?

A

Major causes for organ transplant rejection- HLA molecules mismatch between donor and recipient
HLA association and autoimmune disease

28
Q

Which microbes are extracellular or intracellular?

A

Extracellular- bacteria, parasites, worms and fungi

Intracellular- viruses, bacteria, protozoa

29
Q

What do CD4+ and CD8+ differentiate into?

A

CD8+ becomes cytotoxic T cells

CD4+ become TH1,2 and 17 cells

30
Q

Which T helper cells are activated by extracellular microbes?

A

TH2 and TH17

31
Q

Which T helper cells are present in response to intracellular microbes?

A

TH1

32
Q

What do TH1 do?

A

Activate B cells and macrophages

Assist antigen presenting cells to activate CD8+

33
Q

What do TH2 do?

A

Activate eosinophils, B cells and mast cells

34
Q

What do TH17 do?

A

Activate neutrophils

35
Q

What are the different antibodies and what are their functions?

A

IgG- Fc dependant phagocytosis, complement activation, neonatal immunity, toxin/virus neutralisation
IgE- immunity against helminths, mast cell degranulation
IgA- mucosal immunity
IgM- complement activation

36
Q

Describe the characteristics of C. Diff

A 
Watery diarrhoea
Severe abdominal pain
Loss of appetite
Fever
Blood in stools
Weight loss
37
Q

How is C. Diff caused?

A

C. Diff is a minor component in normal flora of large intestine so when other flora are cleared the c diff is no longer competing for resources so can grow and cause infection.

38
Q

Which antibiotics can cause C. Diff?

A

Amoxicillin
Ampicillin
Cephalosporins
Clindamycin

39
Q

Describe the characteristics of MRSA

A

Causes bacteraemia and infective endocarditis

40
Q

Describe the characteristics of norovirus

A 
Acute gastroenteritis
Nausea
Vomiting
Diarrhoea
Abdominal cramps
Abdominal pain
Mucus in stool
Headache and fever

ESA 3 (18 decks)

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