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micro 1 Flashcards

1
Q

what immune system is the mucocillary elevator?

A

innate immune system

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2
Q

3 parts of URT

A

nasal cavity
pharynx
larynx

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3
Q

3 parts of LRT

A

trachea
bronchi
lungs

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4
Q

3 types of immunity in the lung

A

mechanical
chemical
immune cells

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5
Q

% of particles removed from bronchioles to trachea?

A

90%

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6
Q

components of mucocillary elevator?

A

ciliated epithelial cells
secretory cells (mucus)
periciliary liquid (PCL)
mucus layer

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7
Q

Main component of mucocillary elevator?

A

mucins

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8
Q

What allows cilia to beat?

A

mucus floating on the PCL

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9
Q

What do secretory cells prosuce?

A

mucus

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10
Q

How is depth maintained in mucociliary elevator?

A

by pumping Cl ions into PCL which attracts water

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11
Q

Which respiratory tract infection is mostly acute?

A

Upper RTI

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12
Q

Are URTIs MOSTLY viral or bacterial?

A

viral

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13
Q

bronchitis

A

inflammation of the bronchi

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14
Q

bronchiolitis

A

inflammation of the bronchioles

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15
Q

pneumonia

A

inflammation of the alveoli

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16
Q

Does influenza affect URT or LRT?

A

both

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17
Q

How are respiratory infections transmitted?

A

droplets

contact

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18
Q

How many virus particles per sneeze/cough in influenza?

A

> 0.5 million

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19
Q

How long does influenza survive for?

A

24 hrs

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20
Q

How long does TB survive for?

A

6 months

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21
Q

Common species that cause COPD exacerbation?

A

H influenzae
S pneumoniae
M catarrhalis

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22
Q

Most common species that causes COPD exacerbation in ADVANCED idease?

A

P aeruginosa

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23
Q

What happens to lungs in pneumonia?

A

inflammation of the lung

alveoli fill with fluid

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24
Q

3 types of pneumonia?

A

community
hospital
ventilator

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25
What is hospital pneumonia?
acquired > 48hrs after hospital admission
26
typical microorganisms that cause community pneumonia?
S. pneumonia Group A Streptococcus H. influenza M. catarrhalis
27
microorganisms that cause hospital/ventilator pneumonia?
G neg bailli - E coli, P. aeruginosa | G pos cocci - MRSA
28
another name for group A streptococcus?
Streptococcus pyogenes
29
Describe group A streptococcus?
Gram positive grows in chains beta haemolytic has a group specific polysaccharide - Lancefield antigen
30
What can group A streptococcus cause?
strep throat | tonsilitis
31
How many serotypes are there of group A streptococcus?
> 100
32
How are group A streptococcus serotypes categorised?
by M-protein antigen
33
Where is the M-protein antigen on group A streptococcus serotypes?
on cell surface and fimbriae
34
How is group A streptococcus identified now (M protein has gone over time)?
PCR/sequencing of the EMM gene
35
How many genotypes are there of the EMM gene?
> 200
36
What is attachment/invasion mediated by in group A streptococcus?
M proteins pili F proteins hyaluronic acid capsule
37
How does the body react when group A streptococcus is detected?
pro inflammatory response cytokines released - IL6, TNF recruits macrophages and neutrophils
38
How does group A streptococcus evade the immune system?
- hyaluronic acid capsule - M protein (both protect from phagocytosis) - secretes enzymes
39
What enzymes does GAS secrete?
- streptolysin O and S - proteinase - streptokinase - C5a peptidase
40
What does secreted proteinase from GAS do?
cleaves IL-8 | interferes with neutrophil recruitment
41
What does streptokinase in GAS do?
dissolves fibrin clots
42
What does C5a peptidase in GAS do?
cleaves C5a | stops complement from working
43
What is the cause of TB?
mycobacterium tuberculosis
44
What other species can also cause TB?
M bovis M africanum M canetti M microti
45
When is TB transmitted?
obligate pathogen: | disease transmitted during active infections
46
What % of TB involves the lungs?
90%
47
What type of bacteria is TB?
aerobic bacillus rod G+ or G-
48
What is in the cell wall of TB?
lipids | mycolic acid
49
How long does TB take to divide?
15 - 20 hours
50
How long to culture TB in lab?
3 - 4 weeks
51
obligate pathogen?
has to cause disease to be transmitted
52
TB cycle in the body?
1) TB inhaled 2) bacteria ingested by macrophages, survives, 3) cemokines surround the infected cell, chemokines recruit lymphocytes 4) lymphocytes kill the infected macrophages, necrotic zone in the middle of granuloma - latent TB (no symptoms, years) 5) active TB - granuloma disintegrates, spreads to other parts of the body, coughing spreads it
53
old TB diagnosis test?
Heaf test
54
What is the Heaf test?
6 needles injected tuberculin PPD into wrist left for 2-7 days scale of negative to 4
55
What replaced the TB Heaf test in 2005?
Mantoux test
56
What does the Mantoux test do?
single needle injection of PPD tuberculin looks for red bump - immune reaction to tuberculin diagnoses latent TB graded on bump size (pos = > 5mm)
57
False positives for Mantoux TB test?
allergy to tuberculin previous infection with non-tuberculous mycobacterium BCG vaccination
58
False negatives for Mantoux TB test?
recent TB infection (<10 weeks ago) | immuno compromised
59
2 other diagnostics for TB?
sputum microscopy and culturing
60
What 3 sputum samples?
deep cough induced sputum bronchoscopy and lavage preferably one from early morning
61
What stain is used for microscopy of sputum samples?
Ziehl Neelson stain
62
problem with sputum microscopy?
- need a lot of bacteria (5000 bacteria/ml) - can't tell the difference between mycobacteria - difficult for some patients - contains different microbes - doesn't account for viruses
63
Problem with culturing for TB diagnosis?
long turn around time (> 16 days) | longer if waiting for drug sensitivity
64
2 other diagnostics for TB? (2nd)
1. radiography | 2. interferon gamma release assay
65
2 types of radiography used?
chest x-ray | thorax CT
66
problems with radiography
hard to distinguish between active and cured TB because of scarring
67
How does interferon gamma release assay work?
uses blood samples looks for T lymphocyte release of IFN - gamma not affected by BCG status (different antigens) diagnoses latent TB
68
1 line TB treatment
isoniazid and rifampicin for 6 months | pyrazinamide and ethambutol for 1st 2 months
69
2 resistant forms of TB
MDR -TB (multi drug resistant, to isoniazid and rifampicin) | XDR -TB (extremely drug resistant, ison, rif, 1/3 injectable 2nd line drugs)
70
What is the TB vaccine?
BCG: | Bacillus Calmette Guerin vaccine
71
What is BCG vaccine made from?
live attenuated vaccine made from M. bovis
72
% effectiveness of BCG for severe forms (TB meningitis)?
70 - 80%
73
What groups are offered BCG vaccine? (4)
- children <5 in high TB area - people with parents/grandparents born in countries with high TB - living in country > 3 months with high TB rate - close contact for long time with someone who has pulmonary TB
74
What are streptolysin O and S (secreted from GAS)?
hemeloytic exotoxins

microbiology (4 decks)

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