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NBDE PART 1 MICRO/PATH > Infections, Heart Disorders, Immunology > Flashcards

Infections, Heart Disorders, Immunology Flashcards

1
Q

most common VIRAL cause of pericarditis

A

coxsackie B virus and echovirus

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2
Q

Primary pericarditis (pericardial sac contains 50mL of pericardial fluid, lubricates the heart, barrier to spread of infection, prevents deformation and dislocation of heart) is almost of viral/bacterial origin

A

VIRAL

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3
Q

name the infectious viruses that can cause pericarditis

A

HIV, herpes, echovirus, coxsackievirus, mumps

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4
Q

name the pyogenic bacteria that can cause pericarditis

A

staph, strep, pneumococcus, meningococcus, haemophilus, influenza, mycoplasmosis, borreliosis, chlamydia, tuberculosis

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5
Q

fungi that can cause pericarditis

A

histoplasmosis, coccidiodomycosis

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6
Q

cardiac tamponade

A

type of pericardial effusion in which fluid accumulates in the pericardium.

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7
Q

the most serious complication of pericarditis is

A

cardiac tamponade

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8
Q

Beck’s triad (decreased BP, muffled heart sounds, bulging or distension of the veins in the neck) are signs of

A

cardiac tamponade

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9
Q

___ pericarditis = serious, pericardium becomes thickened and so scarred it loses elasticity, compresses the heart so it cant pulp well, reduces amount of blood pumped to body.

A

Constrictive

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10
Q

symptoms of ___ = chest pain, difficulty breathing, swelling of feet and ankles, fatigue and weakness

A

constrictive pericarditis

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11
Q

aortic dissection aka dissecting aneurysm = results in aortic rupture, most often into __ causing ___

A

pericardial sac = fatal cardiac tamponade

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12
Q

most common cause of right sided heart failure

A

left sided heart failure

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13
Q

in heart failure, which side and part usually fails first?

A

left ventricle

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14
Q

earliest and most common signs of heart failure

A

exertional dyspnea

and paroxysmal nocturnal dyspnea (patient wakes up gasping for air)

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15
Q

other signs of CHF:

A

peripheral edema (swollen ankles), cyanosis, orthopnea (sitting or standing in order to breathe), high venous pressure

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16
Q

Patients with heart failure should be in ___ position during dental treatment to decrease collection of fluid in the lungs.

A

upright

When fully reclined they may experience difficulty breathing

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17
Q

unstable/stable angina - prolonged or recurrent chest pain at rest

A

unstable

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18
Q

___ occurs when the heart’s need for oxygen increases beyond what is delivered

A

angina

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19
Q

angina is the classic symptom of __ disease

A

coronary heart disease

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20
Q

___ angina - repeating pattern of chest pain which has not changed in character frequency intensity or duration for several weeks. level of activity or stress that provoke angina is predicatable and the pattern changes slowly.

A

stable

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21
Q

which kind of angina is the most common form

A

stable

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22
Q

stable angina is precipitated by exertion but can be relieved by

A

rest, vasodilators (ex. nitroglycerin)

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23
Q

_angina is variable, increasing in freq or intensity and with irregular timing or duration. it is PROLONGED OR RECURRENT PAIN AT REST.

A

unstable

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24
Q

unstable angina is often indicative of

A

myocardial infarction

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25
Q

Prinzmetal’s angina - aka variant angina is caused by ___

A

vasospasm - spasms that narrow the coronary artery and lessen the blood flow to the heart. it is intermittent chest pain at rest

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26
Q
  1. intermittent chest pain at rest
  2. prolonged/recurrent chest pain at rest
  3. chest pain from exertion
A
  1. prinzmetal’s angina (variant angina)
  2. unstable
  3. stable
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27
Q

coronary artery disease is aka

A

ischemic heart disease

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28
Q

___ = atheromas (atherosclerotic plaque) accumulate in coronary artery and obstruct blood flow

A

coronary artery disease (ischemic heart disease)

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29
Q

major complications of coronary artery disease (ischemic heart disease)

A

heart attack and angina

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30
Q

the primary effect of CAD coronary artery disease is

A

loss of oxygen and nutrients to myocardial tissues bc diminished coronary blood flow

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31
Q

what is the first cardiac marker to increase after a myocardial infarction

A

myoglobin

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32
Q
  1. ___ = rises in 1-2 hours after MI, peaks in 4-6 hours, duration 1-2 days.
  2. ___= rises 3-6 hours, peaks 20 hours, duration 14 days
A
  1. myogolobin

2, troponin (longest in system along with LDH)

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33
Q
  1. Subunits of troponin: Troponin T and Troponin I- (troponin ___ > 1.0 suggests acute mi)
A

I

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34
Q
  1. Creatine phosphokinase (CPK) rises 4-6 hours peaks 12-24 hours duration 4-5 days
  2. Glutamic oxaloacetic transaminase (AST, SGOT) peaks 24-36 hours, duration 5 days
  3. Lactic dehydrogenase: peaks 24-48 hours, duration 14 days
    give order of markers= which appear first etc
A

myoglobin > troponin > creatine phosphokinase (CPK) > glutamic oxaloacetic transaminase and lactic dehdrogenase

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35
Q

MI are most commonly caused by

A

coronary atherosclerosis

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36
Q

CK-MB is only present if CPK increases.

if CK-MB is >5% it means ___

A

myocardial injury

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37
Q

signs of __ are crushing pain in chest over the heart, sweating, and GI upset

A

MI

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38
Q

the prognosis of MI is good if they reach the hospital. most deaths from MI occur outside the hospital due to

A

arrhythmias causing ventricular fibrillaiton

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39
Q
  1. Underlying structural valve disease is usually present in patients before developing ___ endocarditis
  2. It is usually caused by a form of ___
A
  1. subacute
  2. streptococci viridans bacteria that normally live in the mouth and throat (Streptococcus mutans, mitis, sanguis or milleri). Other strains of streptococci (bovis and equines) can also cause subacute endocarditis, usually in patients who have a form of gastrointestinal cancer
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40
Q

__endocarditis is a fulminant (process that occurs suddenly and quickly, and is intense and severe to the point of lethality = explosive) illness over days to weeks, and is more likely due to Staphylococcus aureus which has much greater virulence, or disease-producing capacity and frequently causes metastatic infection

A

Acute bacterial endocarditis (ABE)

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41
Q

Infectious endocarditis is an inflammation of the

A

heart valves

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42
Q
  1. infection of heart muscle
  2. infection of heart lining
  3. infection of heart valve
A
  1. myocarditis
  2. pericarditis
  3. endocarditids
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43
Q

many bacteria can cause endocarditis in patients with underlying valve problems:

  1. most common are (50%)
  2. other common organisms
  3. less common organisms
A
  1. step viridans
  2. staph aureus, enterococcus
  3. candida, pseudomonas, serratia
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44
Q

___ can infect NORMAL heart valves and is the most common cause of infectious endocarditis in ___

A

Staph Aureus

IV drug users

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45
Q

infectious endocarditis:

large, soft, friable, easily detached ___ consisting of fibrin intermeshed with inflammatory cells and bacteria.

A

vegetations

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46
Q

complications with infectious endocarditis:

A

ulceration and perforation of the valve cusps or rupture of one of the chordae tendineae

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47
Q

__- endocarditis caused by staph aureus (50% of time). this type is usually secondary to infection occurring somewhere else in the body.

A

acute

think Acute Aureus

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48
Q

subacute (bacterial) endocarditis caused by a less virulent organism such as Strep. Viridans
tends to occur in patients with ___ .

A

congenital heart disease or pre-existing valvular heart disease

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49
Q

What is the hallmark of acute and subacute endocardities

A

fever

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50
Q

which valve is most frequently involved in endocarditis

A

mitral

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51
Q

the mitral valve along with __ valve involved in 40% of endocarditis cases

A

aortic

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52
Q

the __ valve is involved in more than 50% of cases of endocarditis of IV drug users

A

tricuspid

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53
Q

____ result from changes in blood flow across valves when vegetations collect on valves

A

murmurs

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54
Q

Most common neck space infection: __

A

ludwig’s angina

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55
Q

Ludwig’s angina is usually an extension of infection form the ___ since their roots lie below the attachment of which muscle

A

mandibular MOLAR TEETH into the floor of the mouth since their roots lie below the attachment of the mylohyoid muscle

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56
Q

Ludwig’s angina

  1. Brawny induraton = does it pit under pressure?
  2. Does it have fluctuance?
  3. how many facial spaces are involved?
  4. is it unilateral or bilateral
  5. patient has a __ appearance
  6. onset is slow/fast
A
  1. No it does not pit under pressure: brawny means strong and muscular
  2. NO. Fluctuance is an indication of the presence of pus in a bacterial infection
  3. three facial spaces
  4. bilateral
  5. open mouthed.
  6. rapid onset
    dysphagia (difficulty swallowing), dyspnea (difficulty swallowing), and fever present
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57
Q

when can Ludwig’s angina become an emergency situation

A

if the swelling blocks the airway.

intubation (breathing tube placed) or tracheostomy (direct opening to lungs thru surgical tube placed in neck).

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58
Q

Ludwig’s Angina:

  1. goal is to get rid of infection by giving
  2. Most cases it is a ___ infection, however ___are almost always present
A
  1. Antibiotics (penicillin or penicillin like drugs given to treat infection) via IV
  2. mixed infection, streptococci
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59
Q

____chronic infection Slow growing deep, lumpy abscesses that extrude a thin, purulent exudate through multiple sinuses. Develops chiefly in jaw and neck, less freq in the lungs and alimentary tract . treated with long term penicillin therapy.

A

actinomycosis aka lumpy jaw

infection with Actinomyces usually A. israelii.

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60
Q
  1. Actinomyces naeslundii

2. vs Actinomycosis A. israeli

A
  1. gram + branching, filamentous bacteria normal inhabitant of gingival crevice and tonsillar crypts
  2. causes actinomycosis = lump jaw
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61
Q

actinomycotic lesions have characteristic __ granules

A

sulfur

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62
Q

Tetanospasmin is a neurotoxin that inactivates proteins that regulate the release of which neurotransmitters

A

glycine and GABA

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63
Q

tetanus is aka _jaw

A

lock

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64
Q
  1. tetanus is caused by an acute EXOTOXIN mediated infection caused by anaerobic spore forming gram __
  2. occurs thru a
A

positive bacillus Clostridium tetani

2. puncture wound that is contaminated by soil or dust

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65
Q

tetanus toxin (tetanospasmin) = neurotoxin that inactivates proteins that regulate the release of inhibitory neurotransmitters ___

A

glycine and GABA = leads to unregulated excitatory synaptic activity of motor neurons = spastic paralysis

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66
Q

is tetanus toxin binding reversible

A

no. recovery depends on whether new axonal terminals form

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67
Q

which kind of tetanus is the most common form?

A

generalized tetanus

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68
Q

in generalized tetanus what muscle is involved

A

masseter

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69
Q

Risus sardonicus seen in?

A

tetanus and poisoning with strychnine

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70
Q

opisthotonos seen in?

A

persistent back pains associated with tetanus. a state of severe hyperextension and spasticity in which an individual’s head, neck and spinal column enter into a complete “bridging” or “arching” position. caused by spasm of the axial muscles along the spinal column. It is seen in some cases of severe cerebral palsy and traumatic brain injury or as a result of the severe muscular spasms associated with tetanus

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71
Q
  1. diphtheria toxin inhibits
A

protein synthesis

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72
Q

____ toxin is made up of 3 proteins: one is a PROTECTIVE ANTIGEN and two are called EDEMA FACTOR and LETHAL FACTOR

A

anthrax toxin

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73
Q

clostridium is always anaerobic and gram +. causes what two things

A

tetanus and botulism

clostridium tetani and botulinum

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74
Q

botulism can occur form

A

ingesting contaminated food, colonization of the infant GI tract, or wound infection

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75
Q

the most potent toxin known to man is

A

clostridium botulinum

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76
Q

also known as trismus

A

tetanus

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77
Q

The ___ toxin initially binds to peripheral nerve terminals. It is transported within the axon and across synaptic junctions until it reaches the central nervous system. There it becomes rapidly fixed to gangliosides at the presynaptic inhibitory motor nerve endings, and is taken up into the axon by endocytosis. The effect of the toxin is to block the release of inhibitory neurotransmitters glycine and gamma-Aminobutyric acid (GABA) across the synaptic cleft, which is required to check the nervous impulse. If nervous impulses cannot be checked by normal inhibitory mechanisms, the generalized muscular spasms characteristic of tetanus are produced

A

tetanus

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78
Q
  1. Clostridium botulism prevents the release of ____
A

acetylcholine = blocks neurotransmission at peripheral cholinergic synapses leading to flaccid paralysis

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79
Q
  1. flaccid paralysis caused by

2. spastic paralysis caused by

A
  1. clostridium botulinum (inhibits AcH release)

2. clostridium tetanii (inhibits release of inhibitory NT’s glycine and GABA)

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80
Q

the inability to transmit impulses thru motor neurons can cause ___ failure

A

respiratory (botulism)

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81
Q

as with tetanus, recovery of function after botulism requires

A

regeneration of the nerve endings

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82
Q

What are highly resistant to heat: the spores or the toxins

A

spores

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83
Q

this toxin is produced WITHIN canned food and ingested PREFORMED

A

c. botulinum

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84
Q

proper canning and heating of food prevents

A

botulism

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85
Q

nausea, vomiting, abdominal cramps precede neurological symptoms: dry mouth, diplopia (double vision) loss of pupillary reflexes, followed by descending paralysis and respiratory failure =

A

botulism

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86
Q

Eosinophilia is often associated with:

a. acute infections
b. viral infections
c. tuberculosis
d. parasitic infections

A

d. parasitic infections

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87
Q

___ = WBC greater than 11,000 per mm3. normal range is 5000-10,000 per mm(cubed)

A

Leukocytosis

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88
Q

an elevated WBC count =

A

bone marrow’s normal response to infectious or inflammatory process

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89
Q

Leukocytosis Nuetrophils/eosinophils/lymphocytes/monocytes high in:

Allergy, asthma, parasitic infections

A

Eosinophils

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90
Q 
Nuetrophils/eosinophils/lymphocytes/monocytes high in: 
acute infections (bacterial) and stress
A

neutrophils

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91
Q

Nuetrophils/eosinophils/lymphocytes/monocytes high in: TB and Viral infections

A

lymphocytes

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92
Q

Nuetrophils/eosinophils/lymphocytes/monocytes high in:

TB malaria rickettsia

A

monocytes

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93
Q

in an allergy Nuetrophils/eosinophils/lymphocytes/monocytes high in:

A

eosinophil

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94
Q

in rickettsia

Nuetrophils/eosinophils/lymphocytes/monocytes high in:

A

monocytes

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95
Q

in malaria

Nuetrophils/eosinophils/lymphocytes/monocytes high in:

A

monocytes

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96
Q

in tb

Nuetrophils/eosinophils/lymphocytes/monocytes high in:

A

monocytes and lymphocytes

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97
Q

in stress

Nuetrophils/eosinophils/lymphocytes/monocytes high in:

A

nuetrophils

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98
Q

in asthma

Nuetrophils/eosinophils/lymphocytes/monocytes high in:

A

eosinophils

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99
Q

Not all bacterial infections show leukocytosis in neutrophils. name the 2 that result in depression of neutrophils

A

typhoid fever and brucellosis

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100
Q

many ___ infections result in a lowered number of leukocytes (leukopenia), particularly neutrophils.

A

viral infections

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101
Q

a general indication of whether a disease is of bacterial or viral origin can be obtained by performing a

A

leukocyte count (esp neutrophils)

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102
Q

on occasion the circulating blood level of leukocytes can reach very high level up to 100,000 per cu mm of blood. such an even is called

A

leukemoid rxn and hard to differentiate from leukemia

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103
Q

marigination of leukocytes refers to

A

lining up of Wbc along wall of a vessel

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104
Q

while the cause and cure are unknown, there is a link bw Reye’s Syndrome and use of

A

aspirin

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105
Q
  1. Reye’s Syndrome - rare and fatal syndrome of __dysfunction.
  2. occurs predominantly in
  3. accumulation of __
A
  1. mitochondrial
  2. children
  3. fat droplets within hepatocytes (microvesicular steatosis)
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106
Q

aspirin should be avoided in kids with ___illness

A

febrile (fever). basic rule is don’t give aspirin to a child unless specifically recommended by the child’s dr. when taking aspirin must minimize the risk of acquiring a viral illness (such as influenza and varicella vaccinations)

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107
Q

___ has been associated with aspirin consumption by children with viral illness

A

reye’s syndrome

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108
Q

___ - viral infection that causes a fever, runny nose, cough, headache, malaise, and muscle ache.

A

influenza (flu)

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109
Q

what distinguishes influenza (flu) from the common cold?

A

the fever and symptoms distinguish it.

influenza (flu) causes a fever

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110
Q

Influenza A, B, and C are the only member of what virus family

A

orthomyxovirus

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111
Q

which Influenza A, B, and C is the most common

A

A

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112
Q

influenza virus has what 2 envelope glycoprotein spikes

A

hemagglutinin and neuraminidase = exhibit the majority of antigen changes and increases ability for it to bind to human cells and establish infection

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113
Q

Amantadine (Symmetrel) inhibits the replication of

A

influenza A virus by interfering with viral attachment and uncoatin

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114
Q

Rimantadine
Zanamivir
Oseltamivir are medications

A

antiviral for Influenza A

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115
Q

main mode of prevention of influenza

A 
vaccine = killed influenza A and B viruses 
remember mnemonic: RIP Always:
killed viruses: 
Rabies
Influenza
Polio (Stalk given orally)
HAV (hepatitis A)
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116
Q

___ symptoms = bad cough that last 3 weeks or longer, pain in the chest, coughing up blood or sputum, weakness or fatigue, weight loss, no appetite, chills, fever, and sweating at night

A

TB

hallmark: fever and night sweats but may not be present in elderly who may exhibit change in activity or weight

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117
Q

_____ is the INITIAL INFECTION characterized by development of GOHN FOCUS (parenchymal lung lesion) which then becomes the GHON COMPLEX (parenchymal lung lesion and nodal involvement). often asymptomatic and does not progress to clinically evident disease

A

primary tuberculosis

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118
Q

___ usually results from ACTIVATION OF GOHN COMPLEX which spreads to new pulmonary or extrapulmonary sites. Localized lesions favor the UPPER LOBES of the lung and involve HILAR LYMPH NODES.

A

secondary tuberculosis

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119
Q

tubercle formation: caseous granulomas frequently rupture and the contents are expelled and result in cavitary lesions. CAVITATIONS are characteristic of __ TB

A

secondary

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120
Q

secondary TB may be complicated by complicated lymphatic spread resulting in

A

miliary TB or disseminated TB
form of tuberculosis that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1–5 mm). Its name comes from a distinctive pattern seen on a chest radiograph of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds—thus the term “miliary” tuberculosis. Miliary TB may infect any number of organs, including the lungs, liver, and spleen

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121
Q

granulomatous inflammation is characteristic of __ TB

A

both primary and secondary

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122
Q

the granuloma of TB is called a

A

tubercle

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123
Q

rebound tenderness in lower RIGHT quadrant of the abdomen is characteristic of

A

acute appendicitis

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124
Q

what is rebound tenderness

A

It refers to pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.)

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125
Q

the most common emergency surgical procedure performed are

A

appendectomies

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126
Q

rebound tenderness suggests that the inflammation has

A

spread to peritoneum = the serous membrane that forms the lining of the abdominal cavity

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127
Q

if appendix ruptures, the pain may disappear for short time until peritonitis sets in and pain returns. t/f

A

true

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128
Q

does the appendix have a physiological function

A

no. it is a vestigial structure representing a degeneration of part of the cecum.

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129
Q

Non necrotizing granulomatous chronic inflammation of intestinal wall, with ulcers, structures, and fistulas

A

Crohn’s disease

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130
Q

__= most common neoplasm of appendix

A

Carcinoid tumor

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131
Q

___ chronic disease in which LARGE INTESTINE becomes inflamed and ulcerated leading to episodes of bloody diarrhea abdominal cramps and fever

A

ulcerative colitis

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132
Q

the most common sexually transmitted infection

A

chlamydial cervicitis

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133
Q

chlamydial cervicitis caused by what bacteria

A

c. trachomatis

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134
Q

this bacteria can grow in warm moist areas of reproductive tract, including cervix, uterus, fallopian tubes in women, and in urethra in women and men. also can grow in the mouth throat eyes and anus

A

Neisseria gonorhoeae

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135
Q

second most common sexually transmitted infection

A

Neisseria gonorhoeae

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136
Q

Neisseria gonorhoeae treated with

A

single injection of ceftriaxone plus doxycycline

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137
Q

in women gonorrhea is a common cause of

A

pelvic inflammatory disease

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138
Q

in men ____causes epididymitis = painful condition of ducts attached to testicles – can lead to infertility
and acute purulent urethritis and burning when urinating

A

Neisseria gonorhoeae

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139
Q

symptoms in women who have ____ = bleeding with intercourse, painful/burning urination, vaginal discharge is yellow or bloody

A

Neisseria gonorhoeae

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140
Q

Gonorrhea often occurs together with what other 2 diseases

A

chlamydia and syphilis

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141
Q

Chlamydial cervicitis is the most common sexually transmitted disease caused by C. trachomatis and is most often symptomatic/asymptomatic

A

asymptomatic

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142
Q

young women who contract ____ may also acquire SALPINGITIS

A

CHLAMYDIAL CERVICITIS = SALPINGITIS = INFLAMMATION OF FALLOPIAN TBES

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143
Q
  1. PID is the infection, salpingitis is the __-
A

inflammation of the fallopian tubes

144
Q

the characteristic lesion of secondary syphilis is known as

A

condyloma lata

145
Q

Spirochetes: Treponema pallidum causes

A

syphilis

146
Q

Syphilis is contagious, systemic, venereal (sexually transmitted) or congenital disease. where does it begin and where does it travel to

A

begins in mucous membranes and quickly spreads to nearby lymph nodes and bloodstream.

147
Q

transmission of syphilis occurs primarily thru ___ during what stage of the infection

A

sexual contact, secondary stage

148
Q

There are 3 stages in syphilis: primary/secondary/tertiary

  1. Primary stage: firm, painless ulcer called ____ appears 3-6 weeks later AT THE SITE OF LOCAL CONTACT.
  2. the most common site for these in oral syphilis are?
A
  1. chancre

2. lips

149
Q

There are 3 stages in syphilis: primary/secondary/tertiary

which stage is the most (highly) infectious stage

A

2nd

150
Q

There are 3 stages in syphilis: primary/secondary/tertiary
1. Secondary stage = highly infectious, occurs 6 weeks after non treatment of primary syphilis. A ___ and ___ appear on the skin and mucosal surfaces

A

maculopapular rash and condyloma lata (gray, flattened wart-like lesion)

151
Q

There are 3 stages in syphilis: primary/secondary/tertiary

  1. the tertiary stage occurs in 30% of infected pp MANY YEARS AFTER NON TREATMENT OF SECONDARY SYPHILIS. the ___ typifies this stage.
  2. most commonly occurs on the ___
  3. is it contagious?
  4. are there neurological signs
A
  1. GUMMA
  2. palate and the tongue
  3. not contagious
  4. yes
152
Q
  1. condyloma lata
  2. chancre
  3. maculopapular rash
  4. gumma
A
  1. secondary stage of syphilis (gray flat wart like lesion)
  2. primary stage = painless ulcer often on lip
  3. secondary stage
  4. tertiary stage = nodular mass
153
Q

prognosis of syphilis is good if treated early. tertiary syphilis causes irreversible

A

heart failure, dementia (long term loss of the ability to think and reason clearly), and disability

154
Q

condyloma acuminatum is

A

benign squamous cell papilloma caused by human papilloma virus (HPV) sexually transmitted disease common in anogenital region. treated by surgical excision

155
Q

encephalitis: is most often caused by Viral/bacterial infection

A

viral

156
Q

viral encephalitis of the brain is almost always associated with ___

A

meningeal inflammation (meningoencephalitis) and sometime involves spinal cord (encephalomyelitis)

157
Q

Latency is important in several __ infections of the CNS

A

viral

158
Q

In urban areas encephalitis is most frequently caused by

A

enteroviruses: coxsackievirus, polio virus, and echovirus.

159
Q

Arboviruses are an important cause of epidemic encephalitis especially in

A

tropical regions around the world

160
Q

in meningitis, the _ and _ become inflamed

A

brain and spinal cord (CNS)

161
Q

the most common organisms causing meningitis in adults is

A

Neisseria meningitidis and Strep pneumonia

162
Q

the most common organisms causing meningitis in children under the age of 2

A

Hemophilus influenzae

163
Q

the organisms that cause meningitis are thought to enter body thru

A

nose and throat

164
Q

Waterhouse-Friderichsen syndrome caused by

A

Neisseria meningitidis = rapidly progressing infection produces severe diarrhea vomiting seizures internal bleeding (bilateral adrenal hemorrhage), low blood pressure, shock and often death.

165
Q
  1. ____= it has worldwide distribution
  2. ____– occurs more frequently than normal in a population
  3. ____ = occurs at minimal levels within a population
  4. ___ = highly communicable
A
  1. pandemic
  2. epidemic
  3. endemic (think it is about to end)
  4. contagiuos
166
Q

acute/chronic = short term active infection with symptoms

A

acute

167
Q

acute/chronic = long term active infection with symptoms

A

chronic

168
Q

many infections are unapparent or ____ and can only be detected by demonstrating a rise in antibody titer or isolating the organism

A

subclinical

169
Q

____ - organism continues to grow with or without producing symptoms in the host

A

chronic carrier

170
Q

___ is the phase in certain viruses’ life cycles in which, after initial infection, proliferation of virus particles ceases. However, the viral genome is not fully eradicated. The result of this is that the virus can reactivate and begin producing large amounts of viral progeny without the host being infected by new outside virus

A

Latency

171
Q

is latency part of the lysogenic or lytic part of the viral life cycle

A

lysogenic

172
Q

which leukemia is most responsive to treatment

A

acute leukemia

173
Q

the leading cause of cancer death in children under the age of 15

A

leukemia

174
Q

acute leukemias symptoms are from suppression of normal bone marrow function. they are

A

anemia, fatigue, fever (usually bc of infection), bleeding, thrombocytopenia.

175
Q

chronic leukemias can occur with non specific symptoms like

A

fatigue weight loss anemia

176
Q

acute leukemias are fatal within

A

weeks if untreated

177
Q

persons with __ leukemia live longer

A

chronic

178
Q

acute vs chronic leukemia distinguished histologically by ?

A

acute leukemia have IMMATURE BLAST CELLS

chronic leukemia have MATURE AND WELL DIFFERENTIATED CELLS

179
Q

some chronic leukemias can transform into an acute phase called

A

blast crisis

180
Q

leukemias can be classified into what 4 types

A

acute lymphoblastic leukemia (ALL)
chronic lymphoid leukemia (CLL)
acute myeloblastic leukemia (AML)
chronic myeloid leukemia (CML)

181
Q

lymphoblastic leukemia means precursors are

A

b and t lymphocytes

182
Q

myelogenous leukemia means precursors

A

are RBC, monocytes, megakaryoctyes

183
Q

which form of luekemia is most responsive to therapy

A

acute lymphoblastic leukemia (ALL)

184
Q
  1. which form of leukemia is the most malignant type

2. which form of leukemia is the LEAST malignant type

A
  1. acute myeloblastic leukemia (AML)
  2. chronic lymphoid leukemia (CLL)
    = rarely affects pp under 40 and has very slow progression
185
Q

which leukemia is associated with Philadelphia chromosome

A

chronic myeloid leukemia (CML)

186
Q

mnemonic to remember leukemias

A 
AM = most malignant M = most
CL = least malignant think L = least
CM = Ph 
AL = most responsive
187
Q

the principal organ involve in acute leukemia is

A

bone marrow

188
Q

in ___ leukemia the abnormal myeloblast cells grow rapidly and do not mature

A

acute myeloblastic leukemia (AML) = most malignant form

189
Q

in acute lymphoblastic leukemias, the growth of the lymphoblasts are not as rapid as that of the myelpoblastic cells. the cells tend to

A

accumulate.

190
Q

common to both types of leukemia is the

A

inability of carry out the functions of healthy white blood cells.

191
Q

blast cells are

A

immature precursor of either lymphocytes (lymphoblasts) or granulocytes (myeloblasts)

192
Q

blast cells are predominant in acute/chronic leukemia

A

acute

193
Q

petechiae and ecchymosis

feature of?

A

small (1 - 2 mm) red or purple spot on the skin, caused by a minor hemorrhage
acute leukemia

194
Q
  1. Laboratory findings in ____ leukemias: leukocytosis: 30,000 - 100,000 per cu.mm
  2. leukocytosis above 100,000 per cu.mm with ___ forms predominating
A 
1. acute = with immature forms of myeloblasts and lymphoblasts predominating
2 chronic,
mature forms (granulocytes and lymphocytes)
195
Q

in 75% of the cases of acute lyphocytic leukemia, the lymphocytes are neither T or B cells and are called

A

null cells

196
Q

Acute leukemia occur most often in children/adults and exhibit a second peak incidence after __ years of age

A

children

60

197
Q

Luekemia can or cannot modify the inflammatory reaction

A

can modify

198
Q

Philadelphia chromosome and low levels of leukocyte alkaline phosphatase are common characteristics of which type of leukemia

A

chronic myeloid leukemia

remember mneumonic
AM = most malignant M = most
CL = least malignant think L = least
CM = Ph 
AL = most responsive = highest survival
199
Q

Ph Chromosome describes a ___

A

TRANSLOCATION b/w chromosome 9 and 22. the resulting abnormal gene codes for enzyme tryrosine kinase that drives the growth of CML cells. (chronic myeloid leukemia)

200
Q

although no definitive cause of leukemia, possible risk factors:

  1. genetic predisposition: __ has higher incidence of acute leukemias
  2. environmental exposure to chemicals like____
  3. radiation usually involves ___ type leukemias
  4. viruses like ___
A
  1. down syndrome
  2. benzene and some anti cancer drugs
  3. myelogenous
  4. HTLV-1 = ADULT T CELL LEUKEMIA AKA Human T-lymphotropic virus 1. leukemic patients may have antibody titer to EBV
201
Q

Human T-cell lymphotropic virus or human T-lymphotropic virus type 1 (HTLV-I), also called the adult T-cell lymphoma virus type 1, is a ___ that has been implicated in several kinds of diseases including very aggressive adult T-cell lymphoma

A

retrovirus

202
Q

immunoglobulins are glycoproteins found in blood serum synthesized by plasma cells in the

A

spleen and lymph nodes

203
Q

Arthus reaction is a type of __reaction

A

local type III hypersensitivity

204
Q

___ have two roles:

they can act as antigen receptors bound to the plasma membrane of B cells or as antibodies free in fluid

A

immunoglobulins

205
Q

immunoglobulins are composed of 4 polypeptide chains: 2 light chains made of ___ and two heavy chains =

A 
light = kappa/lamda (think L = lamda and k right before it)
heavy = alpha, delta, episolon, or mu
206
Q

the type of heavy/light chain determines the immunoglobulin isotype?

A

heavy chain

207
Q

heavy chains = alpha, delta, episolon, or mu make?

A 
Alpha = IgA
delta = IgD
epsilon = IgE
mu = IgM
208
Q

the only immunoglobulin in mucosal secretions

A

IgA

209
Q

the only immunoglobulin that can cross the placenta

A

IgG

210
Q

this immunoglobulin principal biological effect is anaphylaxis

A

IgE

211
Q

this immunoglobulin principal biological effect is B cell activation

A

IgD

212
Q

this immunoglobulin principal biological effect is resistance, precipitin, and is the primary responder (1st responder on the scene)

A

IgM

213
Q

precipitin is

A

is an antibody which can precipitate out of a solution upon antigen binding. (IgM)

214
Q

which immunoglobulin principal biological effect is opsonin, secondary response, resistance

A

IgG

215
Q

which Ig principal site of action is the serum

A

IgM

216
Q

which Ig principal site of action is the serum and tissue

A

IgG

217
Q

which Ig principal site of action is the mast cells

A

IgE

218
Q

which Ig principal site of action is the secretions

A

IgA

219
Q

which Ig principal site of action is as the receptor for B cells

A

IgD

220
Q

which Ig principal biological effect is B cell activation

A

IgD

221
Q

most abundant to least abundant Ig

A

IgG&raquo_space;> IgA > IgM > IgD > IgE

85% 15% 10% < 1%

222
Q

which Ig is a dimer

A

IgA

223
Q

which Ig has the largest molecular mass

A

IgM > IgE > IgD > IgA > idG

224
Q

which Ig has the longest serum half life

A

IgG (23 days) > IgA (6days) > IgM (5 days) > IgE/IgD (2-3 days)

225
Q

Ig __ is the most abundant and second responder

A

IgG

226
Q

Ig __ is the first responder

A

IgM (think momma comes first then comes Grandma)

227
Q

a patient with a true allergy to a medication is unknowingly injected with a medication. this will lead to:

  1. systemic anaphylaxis
  2. localized anaphylaxix
  3. hyperglobulinemia
A
  1. systemic anaphylaxis
228
Q

death by anaphylaxis usually caused by

A

constriction of airways and swelling of epiglottis

229
Q

Immediate treatment of anaphylactic shock:

  1. injection of epinephrine IM or subcutaneously into a ___patient
  2. Injection of epinephrine IV
  3. must always maintain ___
A
  1. conscious patient
  2. unconscious
  3. airway
230
Q
  1. CPR is administered when someone’s ___(or both) stops.

2. It is a procedure that is as simple as ABC: which stands for?

A
  1. breathing or pulse

2. Airway, Breathing and Circulation

231
Q

epinephrine stimulates reformation of

A

tight junctions bw endothelial cells. this reduces their permeability and prevents fluid loss from the blood. it also relaxes bronchial smooth muscle and stimulates the heart

232
Q

what may be given to further reduce symptoms of anaphyhlaxis (after life saving measures and epinephrine administered)

A

antihistamines such as diphenhydramine (Benadryl) and corticosteroids such as prednisone.

233
Q

the most common cause of systemic anaphylaxis is an allergy to ___

A

penicillin and related antibiotics

234
Q

cellular immunity is immunity mediated by

A

t lymphocytes

235
Q

cellular immunity common in type _ hypersensitivity

A

3 delayed

236
Q

cellular immunity is immunity produced by activation of

A

B lymphocytes

237
Q
  1. during complement activation, _ and _ are cleaved into two fragments
A
  1. C3 and C5
238
Q

C3b and C5b continue in the complement pathway while C3a and C5a which are also active will

A

increase inflammation at the site of complement activation via binding to receptors on several cell types

239
Q

in some cases C3a and C5a induce _ and are therefore called ___

A

anaphylaxic shock = acute inflammatory response that occurs simultaneously in tissues throughout body
C3A AND C5A = CALLED ANAPHYLATOXINS

240
Q

Of the anaphylatoxins, which one is more stable and more potent?

A

C5a is more stable and more potent than C3a

241
Q

Phagocytes, endothelial cells, and mast cells have receptors for

A

the anaphylatoxins (C3a and C5a)

242
Q

anaphylatoxins induce

  1. __ of smooth muscle
  2. ___ of mast cells and basophils
A

1 contract smooth muscle
2. degranulation of mast cells and basophils = increase capillary permeability, increase blood flow and vascular permeability.

243
Q

C5a also acts directly on neutrophils and monocytes to

A

increase their adherence to blood vessel wall and acts as a chemoattractant to direct their migration toward the site.

244
Q

which one is more common: anaphylaxis caused by complement components or anaphylaxis caused by Type 1 (IgE mediated) hypersensitivity

A

anaphylaxis caused by Type 1 (IgE mediated) hypersensitivity

245
Q

complement fixationis the binding of complement as a result of its interaction with immune complexes = ___ or particular surfaces = ____-

A

immune complexes = classical pathway

particular surfaces = alternative pathway

246
Q

Wassermann test is for?

A

Syphilis = an antibody test for syphilis

247
Q

only which antibodies can fix complement?

A

IgM and IgG

248
Q

atopy =

A

exaggerated IgE response to allergen due to hereditary allergy

249
Q

exaggerated IgE response to allergen, a condition known as atopy, manifests itself into

A

dermatitis, rhinitis, asthma

TYPE 1 Hypersensitivity rxns, IgE

250
Q

a child w/ one parent who has suffered allergies runs 30% risk of also being allergic. if both parents =

A

60% risk

however allergies can JUMP a generation (skip)

251
Q

allergic rhinitis is aka

A

hay fever = occurs when allergen interacts with sensitized cells of upper respiratory tract. coughing sneezing congestion teary eyes respiratory difficulties.
primary mediator is histamine

252
Q

allergic asthma = rxn of __ respiratory tract. common in?

A

lower. common in children

253
Q

Atopic dermatitis aka eczema = chronic skin disorder = scaly itchy rashes. it is most common in?

A

infants

254
Q

most frequently used diagnostic lab technique for detection of antigens in tissue secretions or cell suspensions?

A

immunofluorescence = fluorescent dye such as fluorescein and rhodamine covalently attached to antibody = visible in uv light. this is a labeled antibody used to identify antigens on the surface of bacteria

255
Q

___ method used for QUANTIFICATION of antigens or haptens (a small molecule that can elicit an immune response only when attached to a large carrier such as a protein) that can be radioactively labeled

A

radioimmunoassay (RIA)

256
Q

Enzyme linked immunosorbent assay (ELISA)

A

quantification of antigen or antibodies in patient specimens

257
Q

precipitation (Precipitin)

A

antigen is the solution, antibody is cross linked = aggregates and precipitates out

258
Q

in this test the antigen is a particulate (bacteria/rbc). antibody (agglutinins).

A

agglutination

259
Q

__ is the basis for blood typing and distinguishes presence of type A or type B antigen on RBC

A

hemagglutination

260
Q

which MAJOR complement activation pathway is triggered by infection but does not involve antibody

A

alternative pathway

261
Q

Complement activation is a feature of type __ hypersensitivity rxn

A

3 (delayed)

262
Q

3 major pathways of complement activation are?

A

classical, alternative, and lectin

263
Q

the __ pathway is activated by antibody bound to antigen ad involves C1, C4, and C2 in the generation of C3 and C5 convertase

A

classical

264
Q

the __ pathway is activated by binding of mannose-binding lectin present in blood plasma to mannose-containing peptidoglycans on bacterial surfaces

A

lectin

265
Q

the alternative and lectin pathways are activated in an antibody __ fashion

A

independent

266
Q

all pathways of complement lead to

A

C3 activation, deposition of C3b on the pathogens surface

267
Q

C3 is unique and potent because of its

A

high energy thioester bond with glycoprotein

268
Q

cytolysis

A

lysis of bacteria or cells such as tumor or RBC’s by insertion of MAC (membrane attack complex) derived from complement activation

269
Q

C1 is part of ___ pathway and composed of what 3 proteins? what is required for its activation?

A

classical
C1q, C1r, C1s = 3 proteins
Calcium required for activation of C1

270
Q

Acquired immunity occurs both naturally and artificially and can be active or passive. in naturally acquired immunity, if the person is exposed to the antigen and produces his own antibodies, it is called

A

natural acquired active immunity

271
Q

Acquired immunity occurs both naturally and artificially and can be active or passive. in naturally acquired immunity, if mom passes IgG to fetus during pregnancy and IgA passed from mom to newborn during breast feeding, this is called

A

natural acquired passive immunity

272
Q

does passive naturally acquired immunity last as long as active?

A

no! if mom passes IgG to fetus during pregnancy and IgA passed from mom to newborn during breast feeding, these antibodies will disappear between 6-12 months of age! so active lasts longer

273
Q

Artificially acquired immunity, just like naturally acquired immunity can be active and passive. a vaccination with killed, inactivated or attenuated bacteria or toxoid is which one?

A

artificially acquired active immunity

274
Q

Artificially acquired immunity, just like naturally acquired immunity can be active and passive. Injection of immune serum or gamma globulin is which one

A

artificially passive active immunity

275
Q
  1. person is exposed to the antigen and produces his own antibodies,
  2. a vaccination with killed, inactivated or attenuated bacteria or toxoid
  3. Injection of immune serum or gamma globulin
  4. mom passes IgG to fetus during pregnancy and IgA passed from mom to newborn during breast feeding,
A
  1. naturally acquired active immunity
  2. artificially acquired active immunity
  3. artificially acquired passive immunity
  4. naturally acquired passive immunity
276
Q

in __ immunity the host actively produces immune response.

A

active

277
Q
  1. the main advantage of active immunity is

2. the main disadvantage is

A

the resistance is long term (years)

2. slow onset

278
Q

in __ immunity, antibodies are PREFORMED in another host. it is not as permanent and does not last as long as active immunity

A

passive

279
Q

tetanus and snake venom are examples of __ immunity

A

passive

280
Q

the main advantage of passive immunity is

the main disadvantage is

A 
immediate availability of antibodies
short duration (months)
281
Q

a small molecule that is not antigenic by itself that can react with antibodies is called

a. epitope
b. hapten
c. plasmid
d. immunogen

A

hapten (incomplete immunogens) have antigenic determinants but are TOO SMALL to elicit the formation of antibodies by themselves they become immunogenic (provoke immune response) by attaching to a CARRIER MOLECULE such as a protein.

282
Q

haptens are NOT immunogenic because they cannot

A

activate helper T cells

283
Q

antibody production involves activation of __ lymphocytes by hapten and helper T lymphocytes by the __

A
  1. B = hapten

2. T = carrier

284
Q

___ is any substance that can specifically bind antibodies or the T cell antigen receptor

A

an antigen

285
Q

antigens that can stimulate an immune response are called

A

immunogens

286
Q

T/F all immunogens are antigens

A

true

287
Q

T/F all antigens are immunogens

A

false

288
Q

a large variety of molecules can bind antibodies like

A

proteins carbs lipids nucleic acids

289
Q

only __ are recognized by T cells

A

peptides

290
Q

in order to immunogenic, antigens must be foreign with a high/low MW

A

high

291
Q

Plasmids are extrachromosomal genetic structures that can replicate independently in bacterial cell. they determine traits that are/are not essential for the viability of the organism

A

are not essential.

they change the ability to adapt

292
Q

R (resistance) factor (Rf) is an example of a

A

plasmid

293
Q

most antibiotic resistance in bacteria is caused by genes that are carried on DNA/plasmids

A

plasmids

294
Q

___ is the specific portion of an antigen to which the antibody binds

A

epitope

295
Q

type of immunity that is conferred by transferring lymphoid cells from an actively immunized donor to a naïve or immunocompromised host

A

adoptive immunity

296
Q

__immunity occurs naturally as a result of a person’s genetic constitution or physiology and DOES NOT ARISE from a previous infection or vaccination

A

natural/innate immunity

297
Q

in contrast to acquired immunity, natural immunity is

  1. specific/nonspecific
  2. does/does not improve after exposure to organism
  3. memory?
A
  1. non specific (acquired is specific)
  2. does not (acquired does)
  3. no memory (acquired has LONG TERM MEMORY)
298
Q

__ immunity is conferred by antiserum or antibodies. it grants immediate protection but is only temporary

A

passive

299
Q

_ immunity is acquired by introducing an antigen which in turn provokes an adaptive immune response

A

active

300
Q

__ immunity is conferred by transferring LYMPHOID CELLS from an actively immunized donor to a NAIVE OR IMMUNOCOMPROMISED HOST

A

ADOPTIVE IMMUNITY

301
Q

T/F the complement system is a group of plasma proteins that attack pathogens

A

true

302
Q

complement proteins are made in the

A

liver.

some are made in macrophages

303
Q

C1 in complement is made in

A

GI epithelium

304
Q

Complement system is a system of 30 SOLUBLE and cell-surface proteins that act in innate and adaptive immunity. soluble means

A

not contained in cells. ie antibodies, cytokine. soluble substances act as messengers to attract and activate other cells.

305
Q

the classical pathway is initiated in the INNATE immune response by the binding of __ to bacterial surfaces and
in the adaptive immune response by the binding of __ to pathogen surfaces

A

C-reactive protein

antibodies

306
Q

the alternate pathway is triggered by changes in the local environment that are caused by bacterial surfaces. this pathway acts at the ___ times during infection

A

earlies

307
Q

the lectin pathway is initiated by the

A

mannose binding lectin (MBL) in plasma which bind to carbs found on bacterial cells and other pathogens. this pathways is induced by infection and contributes to innate immunity

308
Q

Complement protein C5 is similar to C3 in structure but lacks the

A

thioester bond and has a different function

309
Q

__ initiates the formation of the MAC

A

C5

310
Q

After MAC makes holes in the membrane of bacterial pathogens and euk cells, C6 and C7 bin to ___

A

C5b = expose a hydrophilic site in C7 which inserts into the lipid bilayer

311
Q

When C8 binds to C5b, a hydrophobic site in C8 is exposed and on insertion into the membrane, this part of C8 initiates

A

polymerization of C9 = the component that forms the transmembrane pores

312
Q

Slow-reacting substance of anaphylaxis or SRS-A

which is stronger histamine or SRS-A?

A

a mixture of the leukotrienes LTC4, LTD4 and LTE4. Mast cells secrete it during the anaphylactic reaction, inducing inflammation. It can be found in basophils.

It induces prolonged, slow contraction of smooth muscle and has a major bronchoconstrictor role in asthma. Compared to histamine, it is approximately 5000 times more potent and has a slower onset but longer duration of action.

313
Q
  1. mast cell is a resident granulocyte of several types of tissues that contains many granules rich in ___ and __
  2. are mast cells the same as basophils
A
  1. histamine and heparin.
  2. no. The mast cell is very similar in both appearance and function to the basophil, a type of white blood cell. However, they are not the same, as they arise from different cell lines. Both are granulated cells that contain histamine and heparin, an anticoagulant. Both cells also release histamine upon binding to immunoglobulin E. Basophils leave the bone marrow already mature, whereas the mast cell circulates in an immature form, only maturing once in a tissue site.
314
Q
  1. ___ is responsible for the principal symptoms of anaphylaxis
  2. ___ are the principal mediators of asthma
A
  1. histamine

2. SRS-As (slow reacting substance of anaphylaxis-A)

315
Q

the __ reaction involves the degranulation of mast cells and the release of histamine, heparin, platelet activating factors, SRS-As, and serotonin into the bloodstream

A

anaphylaxis

316
Q
  1. serotonin is derived from what amino acid?

2. epinephrine and norepinephrine are derived from what amino acid?

A
  1. serotonin = tryptophan

2. epi and norE = tyrosine and phenylalanine

317
Q

3 places you find serotonin

A

GI tract, platelets, and CNS

318
Q
  1. Approximately 90% of the human body’s total serotonin is located in the ____, where it is used to regulate intestinal movements
  2. The remainder is synthesized in serotonergic neurons of the CNS, where it has various functions. These include the regulation of ___
A
  1. enterochromaffin cells in the alimentary canal (gut

2. mood, appetite, and sleep

319
Q
  1. Serotonin secreted from the enterochromaffin cells eventually finds its way out of tissues into the blood. There, it is actively taken up by ____, which store it. 2. When the platelets bind to a clot, they release serotonin, where it serves as a vaso____ and helps to regulate hemostasis and blood clotting. Serotonin also is a growth factor for some types of cells, which may give it a role in wound healing.
A

blood platelets

vasoconstrictor

320
Q
  1. Leukotrienes are ___ synthesized from
  2. Prostoglandins are ___ synthesized from
  3. leukotrienes and prostaglandins are known as
  4. ___ cells synthesize and secrete these inflammatory mediators upon activation
A
  1. lipids, fatty acids
  2. lipids, fatty acids
  3. eicosinoids
  4. mast cells
321
Q

Leukotrienes are a family of eicosanoid inflammatory mediators produced in _____ by the oxidation of arachidonic acid by the enzyme arachidonate 5-lipoxygenase

A

leukocytes

leuko-triene = comes from the words leukocyte and triene (indicating the compound’s three conjugated double bonds).

322
Q

One of their roles (specifically, leukotriene D4) is to trigger ___ in the smooth muscles lining the bronchioles; their overproduction is a major cause of inflammation in asthma and allergic rhinitis.[

A

contractions

323
Q

arachidonic acid is generated by inflammatory and injured tissues: it is metabolized thru 2 pathways:

  1. cyclooxygenation = produces __ and ___
  2. lipooxygenation producese __ and _ and _
A
  1. prostaglandins and thromboxanes

2. leukotrienes and HETEs and diHETEs

324
Q

leukotrienes activities are similar to those of histamine, which are more potent leukotrienes or histamine

A

lueukotrienes are 100x more potent

325
Q

histamine provides a more __ response while leukotrienes are still being made. in the later stages of allergic reactins, leukotrienes are principally responsible for inflammation, smooth muscle contraction, constriction of airways and the secretion of mucus from mucosal epithelium

A

rapid

326
Q

Luekotrienes C4, D4, and E4 are collectively known as __ and are responsible for much of the clinical symptoms of allergic rxns

A

slow reacting substances of anaphylaxis (SRS-As)

327
Q

what are the main antibodies present in blood, lymph, and the intracellular fluid in CT

A

IgG, monomeric IgA, IgM

328
Q

which antibody is dimeric

A

secretory IgA

329
Q

__ antibody lines mucosal epithelium in GI, eyes, nose, throat, respiratory, urinary, genital, and mammary glands

A

dimeric secretory IgA

330
Q

IgA has two subclasses (IgA1 and IgA2) and can exist in a dimeric form called secretory IgA (sIgA).The secretory component of sIgA protects the immunoglobulin from being degraded by proteolytic enzymes, thus sIgA can survive in the harsh gastrointestinal tract environment and provide protection against microbes that multiply in body secretions. Its heavy chains are of the type

A

α

331
Q
  1. IgA exists in two isotypes, IgA1 and IgA2. While ___predominates in serum (~80%),
  2. ___ percentages are higher in secretions than in serum (35%)
A
  1. IgA1

2. IgA2

332
Q
  1. ___ is the predominant IgA subclass found in serum. Most lymphoid tissues have a predominance of IgA-producing cells
A

IgA1

333
Q

In secretory IgA, the form found in secretions, polymers of IgA monomers are linked by two additional chains; as such, the molecular weight of slgA is 385,000D. One of these is the ___, which is a polypeptide of molecular mass 15kD, rich with cysteine and structurally completely different from other immunoglobulin chains. This chain is formed in the IgA-secreting cells.

A

J chain (joining chain)

334
Q
  1. ____IgA circulates in the blood and is produced in the bone marrow by plasma cells derived from B cells activated in lymph nodes or the spleen.
  2. __ IgA is secreted in mucosal tissues by plasma cells that derive from B cells activated in the mucosal immune system.
A
  1. monomeric

2. secretory

335
Q

which IgA has little capacity or opportunity to activate complement or act as an opsin and cannot induce infalammation

A

secretory IgA

336
Q

IgA is one of the most prevalent humoral antibodies produced by the body. it is only second to

A

IgG

337
Q

___ is always the first antibody to be secreted in the immune response

A

IgM (remember momma always comes first, then Grandma)

338
Q

during the secondary humoral immune response (a second exposure to the same antigen, for example when a person receives a third immunization with tetanus toxoid, a more rapid and greater response ensues which is predominantly composed of __ antibody

A

IgG (not IgM)

339
Q

as the severity of the infection increases (ex. periodontal disease), there is an increase in plasma cells that produce __ antibody

A

IgG

340
Q

the most important function of __ antibodies is to facilitate the engulfment and destruction of extracellular microorganisms and toxins by phagocytes

A

IgG

341
Q

no function is known for __ antibodies other than as a membrane receptor

A

IgD

342
Q

_ is the immunoglobulin responsible for allergic or anaphylactic reactions

A

IgE

343
Q

universal donor blood type

A

O. bc O has no antigens

344
Q

AB has what antigens (agglutinogens) and what antibodies (agglutinins)

A

AB has A and B agglutinogens

and no agglutinins (antibodies) = universal recipients

345
Q

if blood was incorrectly cross matched and transfused, it would cause agglutination of the donor/recipients erythrocytes

A

donor

346
Q

contact dermatitis is what type of hypersensitivity rxn

A

type IV

347
Q

IgE is involved in what type of hypersensitivity rxn

A

Type 1

348
Q

IgG is involved in what type of hypersensitivity rxn

A

Type II and Type III

349
Q
  1. humoral and cell mediated immunity are part of innate/adaptive immunity
  2. __ immunity provides immunity against EXTRACELLULAR pathogens
  3. __ immunity is mediated by antibodies produced by B cells
  4. __ immunity antibodies neutralize and eliminate pathogens and toxins from the blood, mucosal surfaces and lumen of organs
A
  1. adaptive
  2. humoral = extracellular
  3. humoral
  4. humoral
350
Q

___ immunity is designed to provide immunity against INTRACELLULAR pathogens
2. it is mediated by T cells which activate macrophages to kill phagocytosed microbes (T-Helper cells) and kill infected cells = eliminating infection (Cytotoxic T cells)

A
  1. cell mediated immunity
351
Q

MHC molecules are membrane glycoproteins that are/are not secreted by cells

A

are not secreted by any cells

352
Q

MHC genes are highly polymorphic group of genes. The MHC genes are located on short arm of chromosome 6. they are divided into 3 subgroups: MHC1, MHC1, and MHC class3. Classes __ code for glycoproteins and class_ codes for proteins of the complement system (C2, C4 and factor B_

A 
class 1 and 2 = glycoproteins
class 3 = complement proteins
353
Q

MHC class __ are expressed on all nucleated cells

A

MHC Class 1

354
Q
  1. MHC Class 1 is recognized by CD__ T cells

2. MHC Class 2 is recognized by CD__T cells

A
  1. Class 1 = CD8+ Tcells

2. Class 2 = CD4+ Tcells

355
Q

in humans the MHC molecules are referred to as __

A

Human Leukocyte Antigens (HLA). HLA tissue typing is used to match donated tissue/organs/one marrow with transplant recipients. A mismatch results in acute rejection of the transplanted tissue

NBDE PART 1 MICRO/PATH (20 decks)

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