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Infectious Disease & Immunology Flashcards

1
Q

Where are microbes found?

A

Human body surfaces and at sites of interface between human and the environment.

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2
Q

What is true about colonization by the normal microbiota?

A

Colonization by normal microbiota and even potential pathogens is not associated with infection.

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3
Q

What can triggers a disease?

A

Disruptions in microbiota composition and or translocation of commensals to unintended host tissues trigger a disease.

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4
Q

How does immune defenses works?

A

Limit the severity and duration of infection with pathogen elimination commonly occurring after an acute phase.
- Pathogens routinely evolve a variety of properties that enable them to evade destruction by the immune system.

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5
Q

What body mechanisms does immune system comprises that protect from microbial invaders and cancerous cells?

A

Physical barriers; skin and mucous membranes
Rapidly activated, nonselective, innate immune system
Slowly developing but highly specific adaptive immune system

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6
Q

What characteristics contribute to the severity and clinical course of many infections?

A

Pathogen virulence features and host susceptibility
- Often human immune response to microbe invasion that produces the clinically detectable signs and symptoms of infection

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7
Q

What is viruses?

A

Acellular. Nonliving particles that are unable to replicate without host cell machinery.

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8
Q

What kind of pathogen are viruses?

A

Intracellular pathogens that often kill host cells as part of their life cycle and proliferation efforts.

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9
Q

What is the immune system protection against viruses?

A

Occurs after an initial exposure, frequently through immunization.

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10
Q

What are the life cycle of viruses?

A
  1. Binding to cell surface receptors
  2. Entry
  3. Uncoating (RNA viruses-> viral RNA)
  4. Replication (DNA)
  5. Transcription (mRNA)
  6. Translation
  7. Virion assembly
  8. Release
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11
Q

What is a Innate immune response?

A

Recognizes general molecular patterns of pathogens.
Rapidly recruits many phagocytic cells to engulf and destroy the pathogens

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12
Q

What is a adaptive immune response?

A

Recognizes specific patterns of pathogens called antigens and stimulates limited numbers of B and T lymphocytes responsive to those antigens to proliferate and generate immune defenses.

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13
Q

What is the primary lymphoid organs?

A

Bone Marrow, site of lymphocyte production and B cell development

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14
Q

What is the Thymus gland?

A

Site where T cells develop

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15
Q

What is the secondary lymphoid organs?

A

Lymph nodes, site of communication between antigen-presenting cells (APC), T cells, and B cells during the developing immune response to antigen

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16
Q

What are major sites of antigen presentation and interactions of T cells and B cells?

A

Lymph nodes, spleen, and gut-associated lymphoid tissues

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17
Q

What is a B lymphocytes?

A

Express B cell receptors with antigen-recognizing characteristics identical to the antibodies they will eventually secrete

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18
Q

What is a gene rearrangement?

A

Method by which a small number of B cell receptor genes can code for a huge number of potential antibodies

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19
Q

What is the process for B cells?

A

B cells recognize circulating antigens through their B cell receptors, migrate to lymph nodes and tissues, and are stimulated to maturation and activation by T-helper cells selective for the same antigen

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20
Q

What cell help to stimulate B cells maturation and activation?

A

T-helper cells selective

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21
Q

Once B cells is mature, what is the process of antibodies secretion?

A

Once mature, B cells proliferate and secrete antibodies, beginning with immunoglobulin M (IgM) and maturing to immunoglobulin G (IgG) secretion.

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22
Q

What is the continued presence of the antigen stimulates in B cells?

A

Stimulates affinity maturation of B cells to produce antibodies with increasing affinity for antigen

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23
Q

What does B cells ultimately differentiate into?

A

Plasma cells and B memory cells

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24
Q

What is a plasma cells that B cells differentiate into?

A

Large cells with greatly enhanced capacity for antibody secretion

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25
What is a b memory cells that B cells differentiate into?
Long-lived cells that can rapidly activate in response to a later encounter with their antigen. Memory b cells can provide protection for many years to decades.
26
What is a T lymphocytes?
Express T-cell receptors from genes that have undergone gene rearrangement, creating a great diversity of antigen recognition possibilities among the T-cell population
27
How does T cell recognize antigen?
Each T cell can only recognize one antigen, and the antigen must be presented on membrane proteins termed major histocompatibility class (MHC) or human leukocyte antigen (HLA) proteins
28
Can T cells be subdivided?
Subdivided based on their membrane proteins. Marker CD4 is associated with T-helper cells whereas the marker CD8 is associated with cytotoxic T cells
29
What are the functions of antibodies?
Bind to and neutralize toxins Opsonize bacteria to promote phagocytosis Bind to bacteria to activate complement-mediated killing 2nd time encountered for pathogen = rapid production of antibodies clears pathogen before illness is experienced
30
What is the most abundant antibody?
IgG is the most abundant IgA predominates at mucosal surfaces IgE is present at very low levels but elevated in individuals with allergies
31
What is the 1st sequence of events of acute inflammation following a tissue injury?
Innate immune system is initiated when tissue injury and invasion stimulate sentinel cells such as macrophages and mast cells
32
What is the 2nd sequence of events of acute inflammation following a tissue injury?
Acute inflammation ensues, with release of chemotactic factors that rapidly recruit additional neutrophils and monocytes into the region of injury.
33
What is the 3rd sequence of events of acute inflammation following a tissue injury?
Leukocyte chemotaxis is added by release of histamine and prostaglandins that produce vasodilation and increased capillary permeability.
34
What is the 4th sequence of events of acute inflammation following a tissue injury?
Neutrophils and macrophages phagocytose invading organisms and release cytokines that stimulate further chemotaxis, as well as promote bone marrow leukocyte proliferation.
35
What is a complement proteins?
Synthesized by the liver and circulate as pro-proteins that need cleavage for activation (similar to the clotting cascade)
36
What is the complement proteins activated by?
Bacterial exposure Antibody binding Mannose-binding lectin - cascade generates proteins that directly opsonize and kill bacteria and promote chemotaxis
37
What is a chronic inflammation?
Pathological state in which a localized immune responses does not proceed to normal wound healing. Instead, long-lived macrophages, T cells, and B cells perpetuate a response to one or more tissue antigens, creating pain, swelling, and impaired function
38
What are the characteristics of acute inflammations?
Primary cells- neutrophils and macrophages Mediators- Histamine, prostaglandins, cytokines (IL-1, TNF-a) Time- Rapid onset (minutes to hours), short durations (days) Purpose- Eliminate initial cause of cell injury, clear out necrotic cells and tissues Outcome- Resolution, abscess formation, or progression to chronic inflammation
39
What are the characteristics of chronic inflammation?
Primary cells- macrophages, lymphocytes, plasma cells Mediators- Cytokines (IL-1, TNF-a, IFN-y), growth factors Time- Slow onset (weeks-months), long durations (months-years) Purpose- Persistent inflammation, tissue destruction and repair Outcome- tissue destruction, fibrosis, and scarring
40
What is a CD4 T cells?
Recognize antigen presented by specialized APCs on the APC cell MHC II molecules. Once activated, many CD4 cells stimulate B cell responses and other responses of adaptive immunity Subdivided into Th1, Th2, Th17, Tfh, and Tregs each with a unique spectrum of activity
41
What is a CD8 cells?
CD8 cells release perforin and granzyme enzymes to lyse infected/abnormal cells and can also trigger apoptosis via the Fas pathway
42
What does all nucleated cells have in common?
Express MHC 1 proteins on their membranes - Intracellular protein turnover is linked to presentation of protein fragments on MHC 1.
43
When does CD8 cells bind via their T-cell receptors?
when a virus-infected or cancerous cell begins to display abnormal protein antigens on MHC 1
44
What is true about memory T cells of both the CD4 and CD8 types lifespan?
Memory T cells of both the CD4 and CD8 types are produced throughout the lifespan. They may reside in the tissue where their antigen was first encountered, or circulate through the blood, tissues, and lymph tissues.
45
What are the characteristics of Humoral Immunity?
Cells- B cells, plasma cells Function- produces antibodies to neutralize pathogens Targets- extracellular pathogens (bacteria, viruses) Mechanism- Antibodies bind to antigens, marking them for destruction by other immune cells Memory cells- Memory B cells Activation- Activated by free antigens in body fluids
46
What are the characteristics of Cell-mediated immunity?
Cells- T cells (Helper T cells, Cytotoxic T cells) Function- Directly attacks infected or abnormal cells Targets- Intracellular pathogens (viruses, some bacteria), cancer cells Mechanism- T cells recognize and destroy infected cells directly Memory cells- Memory T cells Activation- Activated by antigen-presenting cells (APCs)
47
What is a hypersensitivity reactions?
Excessive immune responses to normally innocuous stimuli.
48
What is the most common form of hypersensitivity?
Type 1 hypersensitivity, aka atopy or allergy In allergy, individuals respond to allergen exposure with Th2-promoted class-switching of B cells to produce IgE instead of IgG. - Mast cells become sensitized through IgE binding to mast cell membrane receptors for the IgE constant region - Subsequent exposures lead to mast cell degranulation and generation of an allergic inflammatory response in the exposed tissue.
49
What is a hypersensitivity type 2?
Overlap with autoimmunity when antibodies are produced to self-proteins
50
What is a autoimmunity?
pathological immune response to one’s own cells and tissues. The genetics of autoimmunity involves, in part, certain classes of human leukocyte antigen (HLA) genes that code for the MHC/HLA proteins. Vulnerable individuals often have more than one autoimmune disorder.
51
What is immunodeficiency disorders?
Immunodeficiency disorders are less common than hypersensitivity and autoimmunity. The most common immunodeficiency is secondary, occurring in patients with HIV infection who have loss of CD4 cells to viral attack.
52
What is a cytokine storm?
Cytokine storm is a complication of certain infectious diseases and other immune system insults. The rapid and exaggerated release of inflammatory cytokines can result in shock and multiorgan dysfunction syndrome and has a high mortality rate.
53
What is the fetal development changes at birth?
At birth, neonates have circulating IgG that crossed the placenta from the mother’s blood. In the early postnatal period, vulnerability to infections is high, as this passive protection wanes.
54
What is the fetal changes development?
Fetal development includes the development of the main features of the immune system, but the cells and tissues are in a latent stage until birth.
55
When does the colonization with commensal bacteria begins?
At birth and the spectrum of bacteria varies with method of delivery (vag vs. c-section).
56
What is the beneficial of breastfeeding?
Beneficial in the development of the infant’s gut microbiota and by providing maternal IgA that continues to protect the infant. In the first several months of life, the infant is exposed to many environmental microorganisms and often has many immunizations. Thus, within the first year of life, the immune system has gained experience and strength in responding to pathogens.
57
What is true about treatment with antibodies in the early life?
Early in life, treatment with antibiotics or failure to experience certain exposures may lead to later life immune vulnerabilities, particularly allergies.
58
What is true about neonates acquiring maternal infections?
Neonates can acquire maternal infections during pregnancy and delivery. After birth, infants are exposed to many bacteria, rapidly developing their own normal flora. Early exposure to viruses leads to the development of many childhood illnesses, such as infectious diarrheas and fungal infections of the skin and scalp. Classic childhood viral diseases such as measles, mumps, and rubella are less common now due to widespread immunization, although sporadic outbreaks occur in areas of high vaccine refusal.
59
What is the immunity changes in older adults?
The thymus gland involutes, with decreased immune function and accumulation of fatty, nonfunctional tissue. Few naive T cells are produced, and the diversity of the T-cell repertoire decreases. Infections induce greater morbidity and mortality, and vaccines are less effective.
60
What is true about cells of innate immunity in older adults?
less active in older adults, but other cells can develop an inflammatory phenotype. Cytokine levels tend to be higher in older adults and contribute to age-related decline in function, in the phenomenon of inflammaging.
61
Why is older adults at a greater risk of infections?
waning immunity (immunosenescence) and, in some cases, greater exposure in assisted living and long-term care facilities. - Infection-related signs and symptoms such as fever and discomfort may be blunted, absence, or under-reported, allowing greater progression before an infection is suspected. In many cases, infections in older adults result in greater morbidity and mortality than in younger age groups.
62
Who should get pneumococcal vaccine?
Pneumococcal vaccine should be given to those over 65 years of age. Older adults are more vulnerable to community-acquired pneumonia than those who are younger, and may have a more serious course.
63
What can cause shingles?
Reactivation of dormant varicella-zoster virus can cause shingles, and vaccine treatment is recommended.
64
What does the progression to wound healing cannot occur without?
influx of white blood cells and generation of inflammatory mediators, followed by production of mediators that stimulate regenerative growth of normal tissues and blood vessels.
65
What are the rapidly acting cells of the myeloid lineage?
monocytes, neutrophils, basophils, eosinophils, mast cells
66
What are the more slowly acting cells of the lymphoid lineage?
T lymphocytes, B lymphocytes, NK cells and other innate lymphoid cells
67
What can cause cells to proliferate rapidly increasing their circulating levels to mount their protective responses?
Acute infections, tissue injuries, and certain chronic immune disorders
68
Some of these cells undergo further differentiation within the bone marrow or after release from the bone marrow:
- Monocytes enter tissues and become macrophages or dendritic cells. - B lymphocytes further differentiate in the bone marrow and in lymph nodes, under the influence of follicular helper T cells (Tfh). The final differentiation state of a B cell is a large “antibody-factory” type cell called plasma cell. - T cells migrate to the thymus and differentiate into CD4+ T-helper cells or CD8+ cytotoxic “killer” T cells. T-helper cells can further differentiate into Th1, Th2, Th17, and Tfh types, as well as regulatory (Treg) cells.
69
Where are the specialized macrophages-like cells located for immune surveillance?
Langerhans cells in the skin Kupffer cells in the liver Microglial cells in the brain Gut is protected by phagocytic mucosal “M” cells and Peyer’s patches—localized clusters of immune cells (risk of oral pathogen ingestion)
70
Example of disorders in common regardless of specific tissue or organ manifesting
rheumatoid arthritis (joints) has a great deal in common with psoriasis (skin), inflammatory bowel disease (gut), and systemic lupus erythematosus (connective tissue in many sites).
71
The atopic disorders all have similar pathophysiological pathways of immune signaling:
allergic rhinitis (nasal mucosa), asthma (lower respiratory system), food allergies (gut), and atopic dermatitis (skin).
72
What fundamental property of T and B lymphocytes gives a body the capacity to recognize millions of different antigens? The property of:
Somatic gene rearrangement
73
Which of the following locations in the body plays the most important role in the activation of an adaptive immune response?
Lymph nodes
74
Why does eradication of Mycobacterium tuberculosis (MTB) require prolonged antimicrobial treatment?
MTB can exist in latent form inside granulomas.
75
Which of the following is the earliest step in the acute inflammatory response?
Mast cells release histamine.
76
When macrophages, T cells, and B cells respond to one or more tissue antigens, what is the result?
Chronic inflammation

Patho (8 decks)

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