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Microbiology Flashcards

1
Q

Pro karyote

A

70s
no nucleus
plasmid chormosome
no organelles

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2
Q

Eukaryote

A

80s
nucleus
organelles and cytoskeleton

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3
Q

size order of microbes

A 
virus
bacteria
fungi
protozoa
helminths
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4
Q

gram positive

A

thick peptidoglycan retains the stain

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5
Q

gram staining

A 
fixation
crystal violet
iodine treatment
decolonisation- acetone
counterstain
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6
Q

catalase

A

+=staph
-=strep

enzyme decomposes hydrogen peroxide into water and oxygen

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7
Q

coagulase

A

+=staph aureaus (MRSA and MSSA)

-= CoNS (epidermis and saphrophyticus)

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8
Q

different strep

A

alpha- partial clearing, green
beta- complete clearing
gamma- non haemolytic

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9
Q

optochin

A

susceptible- strep pneumonia

resistant- viridans strep (oral)

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10
Q

viridans strep

A

mitis
oralis
salivarius
mutans

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11
Q

lactose fermentor

A

pH agar change

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12
Q

beta lactams examples

A 
penicillin
cephalosporin
carapenams
monobactams
beta=lactamase inhibitors
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13
Q

beta lactams all contain…

A

common ring
binds to dalamine on bacteria
inhibits cell wall synthesis

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14
Q

penicillins

A

natural V or G
penicillinase resistant fluclox
broad spectrum
b/lactam+blactamase inhibitor= coamoxiclav

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15
Q

cephalosporins

A

1st gen: +cocci and -UTI ORAL

2nd: +cocci and -UTI ORAL +CAP/COPD IV
3rd: -rods
4th: pseudomonas and some +cocci

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16
Q

clavam

A

clavulanic acid

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17
Q

cephalosporins types

A

1st cefalexin

  1. cefuroxime
  2. cefotaxime and ceftriaxone (T’s)
  3. cefepime (strange name)
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18
Q

mono bactam

A

aztreonam

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19
Q

penicillin ADME

A

IV/oral
1-2hours
body water
urinary excretion

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20
Q

side effects of penicillins

A 
allergy
c.diff
liver
platelet
cns
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21
Q

Pen V

A

beta strep
pneumococci
meningococci
gonococci

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22
Q

fluclox

A

s. aureus

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23
Q

co-amoxiclav

A 
otitis media
COPD
CAP
UTI
skin and soft tissue
gonococcus
salmonella
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24
Q

tazobactam+piperacillin=tazocin

A

hospital IV therapy

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25
carbapenem
meropenem IM only 2/3 line works like other beta lactams
26
cephalosporins dont' work for
``` MRSA enterococci listeria legionella c.diff camplylobacter ```
27
hospital acquired sepsis unknown site
ceftazidime +2nd agent
28
CAP you give
ceftriaxone
29
intra abdominal infection you give
metronidazole
30
pseudomonas you give
ceftazidime
31
fluoroquinolones
ciprofloxacin
32
use fluoroquinolones for
gram -ves | lower urinary tract
33
fluroquinolones
inhibit gyrase
34
fluroquinolones ADME
PO/IV | metabolism and renal clearance
35
SE of fluroquinolones
rashes/photosensitivity tendenitis and rupture c.diff QTC PROLONGATION with moxi- suddent death and hepatotoxicity
36
ciprofloxacin good for
gram -ves | atypical chest pathogens
37
moxifloxacin good for
like cipro but also staph and strep
38
aminoglycasides
gent | inhibit protein making at ribosome
39
aminoglycasides ADME
IV/IM concentrates in kidneys and ears (toxic) renal excretion
40
use aminoglycasides for..
gram -ves e coli pseudomonas
41
always use gent...
with something!
42
SE of aminoglycasides
kidney, ear toxicity kidney reversible. required therapeutic monitoring and dose adjustment.
43
glycopeptides
IV only cell wall vancomycin
44
glycopeptides for...
MRSA gram +ves nearly all! no action against negs
45
glycopeptides ADME
IV renal excretion nephro/oto toxicity
46
side effects of glycopeptides
red man syndrome | thrombocytopaenia with teicoplanin
47
oral vancomycin for
c.diff
48
macrolides examples
erythromycin, clarithrymycin
49
macrolides
IV/PO lower respiratory tract good for penicillin allergic inhibits protein at ribosome
50
macrolides ADME
renal and biliary excretion
51
macrolides SE
nausea, GI upset.
52
macrolides good for....
gram +ves (staph, strep) legionella mycoplasma, clamydia only neg good for it campylobacter
53
tetracyclines
minocycline, doxycyline
54
tetracyclines good for
acne | oral against MRSA
55
tetracyclines ADME
inhibits ribosome resistance quite common NOT for kids- binds to calcium, funny teeth.
56
metronidazole
anaerobes resistance rare disrupts DNA
57
side effects of metronidazole
disulphiram like reaction with alcohol | peripheral neuropathy with long term use.
58
trimeth works by
inhibiting folate synthesis
59
linezolid
PO/IV | gram +ves including MRSA
60
side effects of linezolid
thrombocytopenia (FBC EVERY WEEK) | neuropathy
61
when do we use linezolid?
second ling against serious gram +ve infection
62
daptomycin
IV only | good for MRSA
63
side effects of daptomycin
muscle toxicity | not suitable for lung infections.
64
HSV drugs
aciclovir, valaciclovir, famiclovir
65
CMV drugs
ganciclovir | foscarnet
66
Hep B drugs
lamivudine, adefovir | interferon and peg.
67
Hep C drugs
ribavirin | interferon
68
Influenza A drug
``` Amantadine rimantidine non-nucleosides block function of matrix protein hardly ever used because of parkinsonianism post exposure NOT treatment ```
69
Infuenza drugs
Zamanavir | Oseltamirvir
70
Broad spectrum antivirals
ribavirin- anti RNA | cidofovir- anti DNA
71
nucleosides
mimic ACTG but need to be phosphorylated
72
aciclovir
guanosine inhibits viral DNA polymerase needs phosphate from viral thymidine kinase incorporated into viral DNA
73
how to give aciclovir
5x a day! for a week need to start within 72 h IV is much better! 8 hourly. topical sucks.
74
aciclovir and renal failure
dose reductino
75
valaciclovir
prodrug for aciclovir take 3x a day good for immunocompromised when aciclovir causes GI problems..
76
famiciclovir
prodrug take it just once! Old people with zoster
77
ganciclovir
``` PO/IV nucleoside inhibits polymerase needs viral kinase becomes resistant after 3 months ```
78
ganciclovir side effects
induces neutropaenia
79
Foscarnet
IV only doesn't need phosphorylation if resistant to ganciclovir
80
foscarnet side effects
renal toxicity.
81
NRTI (nucleoside)
Zidovudine require host cell phosphate resistance after 2-5 years
82
pNRTI (nucleotide)
Tenofovir already phosphated chain terminator
83
NNRTI (non-nucleoside)
Nevirapine blocks reverse transcriptase resistance after 3 years ALWAYS WITH NRTI/pNRTI
84
PI
nelfinavir makes HIV immature very, very potent but high resistance metabolised by p450 (use with ritonavir to inhibit P450) ALWAYS WITH NRTI/pNRTI
85
FI
T20
86
start HAART when
uner 350/ml of blood
87
HAART treatment failure
not VL<400
88
viral rebound
more than one drug changed at a time
89
side effects of NRTIs
anaemia neutropenia lactic acidosis
90
triple therapy
zidovudine, lamivudine, nelfinavir
91
side effects of NNRTIs
rash, fever, myalgia, hepatitis, diarrhoe
92
side effects of PIs
GI.
93
good types of hep C (genotype
2/3 | treat for 24 weeks
94
bad types of hep C
1/4/5 | treat for 48 weeks
95
Interferon alpha side effects
lethargy insomnia diarrhoea depression
96
no interferon for
heart and liver disease renal filaure epilepsy pregnant
97
pegylated IFalpha for
HCV 1 | normal for others
98
meningococcus live in
the nose
99
h.influenza lives in
the nose
100
strep pneumonia lives in
the nose
101
moraxella catarrhalis lives in
the nose
102
cefotaxime
third gen ceph gram -ves! neisseria, hinfluenza SOME +ves IV 8 hourly good CSF penetrance
103
amoxicillin
``` broad gram -ve and +ve resistance frequent can be oral can be with betalactamase inhibitor (Co-amoxiclav) ```
104
penicillin sensitivity
pneumococcus- almost always menigococcus- usually H.influenza b- nearly never m catarrhalis- frequently not
105
how many amoxicillin in one day?
8 | bananas
106
how many penV in a day?
6 | petrol
107
2 methods of spread of bone infection
``` deep penetration (adults) haematogenous (children- have capillaries that cross joint) ```
108
3 types of osteomyelitis
haematogenous- bacteraemia contiguous- trauma or surgery, external fixation etc. diabetic- reduced blood flow, skin changes, reduced immunity
109
osteomyelitis and antibiotics
don't start antibiotics until samples taken...
110
most common cause of osteomyelitis
s.aureus collagen binding adhesin (cartilage) fibronectin binding adhesins (foreign)
111
septic arthritis
usually hip or knee | usually just one
112
how does septic arthritis happen
membrane very vascualr local cellular response releases proteolytic enxymes and bacterial toxins destroys cartilate joint effusin decreased blood supply (becomes so swollen it cuts it off)
113
most common cause of septic arthritis
s.aureus or strep
114
septic arthritis in under 3?
h. influenzae
115
gram negative septic arthritis?
IVDU pseudomonas
116
reactive arthritis is NOT
an infection
117
reactive arthritis may occur (EXAM)
after infectious diarrhoea Chlamydia Gonorrhoea Hep B NO BACTERIA TO CULTURE
118
prosthetic joint infection
``` within 3 months (early) or else late direct inoculation- skin type flora usually haematogenous if late biofilm multiple organisms not uncommon ``` COAGULASE NEGATIVE STAPH
119
biofilm
glood on a bone under a duvet glycocalx because not dividing- antibiotics won't work.
120
tests for prosthetic joint infection
histology more important than culture.
121
treatment for prosthetic joint infection
surgical drainage +6 weeks Abx | replacement (1 stage or 2 stage) 2 stage better
122
Abx for bone infection
2-3 weeks septic arthritis 4 weeks kids 6-8 weeks adult osteomyelitis.
123
ultra clean ventilation
air changed 30 times an hour | fine filter to catch viruses
124
mycosis
infection caused by fungi
125
mycotoxicosis
condition resulting from ingestion of fungus
126
fungi are..
eukaryotes
127
yeast
single oval cell
128
moulds
tubes (hyphae) and multicelled structures
129
superficial funcal infections
dermatophytes candidosis pityrisasis versicolor
130
Anthropophilic
man
131
zoophilic
animals
132
geophilic
soil
133
rubra
athletes foot
134
microsporum
hair and skin
135
epidermophyton
skin and nails
136
candidiasis
cutaneous nail mucosal chronic mucocutaneous (usually immunosuppressed) subcutaneous infection- spread through lymphatic system.
137
opportunistic deep funal infections
usually environmental organisms inhaled life threatening disseminating infection
138
4 opportunistic deep fungal infections
mucoromycosis cryptococcosis (neoformans) candidosis aspergillosis
139
mucoromycosis
grow in 3 weeks spreads so fast you have to ACT man without a face
140
saksenaea vasiformis
burns, deep cuts, wounds
141
cryptococcosis
usually meningitis AIDS patients most common fungal meningitis
142
invasive candidosis
oesophagus endocarditis disseminated osteomyelitis
143
aspergillosis
soil, plants, air, dust, food waxy spores ``` onychomycosis cutaneous otitis externa keratitis aspergilloma in lungs invasive- brain ```
144
diagnosing fungal infections
direct microscopy culture and immunofluorescence serology
145
antifungals
``` echinocandins -fungin polyenes- amphoterecin B and nystatin Azoles Allylamine- Terbinafine flucytosine- fluoropyrimidine ```
146
scalp and nail fungal infections need...
oral therapy
147
sporotrichosis
``` rose thorns spores nodules ulcers along lymphatic channel ```
148
cryptococcus treatment
ampho B and flucytosine
149
aspergillosis treament
voriconazole
150
zygomyocosis
mucor rhizo rhinocerebral and cutaneous in wounds. uncontrolled diabetes or neutropenia
151
most common bacterial gi bug
campylobacter or salmonella
152
bacillus cereus
rice
153
gastro viruses
rota calici, adeno, astro etc...
154
gastro parasites
giardia cryptosporidium entamoeba
155
natural defences against gi bugs
``` gastric acid- breaks down coating bile salt- disrupts cell wall normal flora- competition mucosa- immunity and IgA motility- clear it out! ```
156
adult gut hands.....ml a day
6500
157
fluid in stool per day
250ml
158
ORS
coupled transport of sodium and glucose into enterocytes to water follows.
159
3 types of enteric infection
1. non-inflammatory: watery 2. inflammatory 3. penetrating
160
non-inflammatory infection gi
clostridium, b. cereus, s aureus, crypto, rota, noro, ETEC, EPEC
161
inflammatory gi infection
dysentery, shigella, c. diff, VTEC, entamoeba
162
penetrating infection
typhi, yersinia
163
investigating gi infection
stool blood culture microscopy for ova, cysts specific typing
164
ETEC
eneterotoxigenic- cholera like, hypersecretion commonest bacteria diarrhoea in children in africa uncommon england
165
VTEC
verotoxigenic- kills cells, causes HUS 0157 normal cow flora
166
EIEC
Enteroinvasive
167
EPEC
Enteropathogenic
168
haemorrhagic colitis
0157 diarrhoea--> bloodly abdo pain low fever
169
HUS
high urea, creatining, haemolytic anaemia, thrombocytopenia fitting need dialysis
170
0157
doesn't fermet SORBITOL
171
E COLI treatment
ciprofloxacin not for HUS.
172
salmonella
``` 1-3 days poulty dairy products summer gut epithelium watery diarrhoea ```
173
complications of salmonella
can lead to colitis bacteraemia (bones, joints) reactive arthritis
174
salmonella treatment
cipro
175
commonest cause of shigellosis
s.sonnei invade gut, destroy submucosa infect cells spread cell to cell shiga toxin produced
176
commonest cause of food poisoning
campylobacter | birds
177
campylobacter
24h prodrome watery diarrhoea can be bloody systemic rare GUILLAIN BARRE SYNDROME
178
gull wing morphology
campylobacter
179
c diff
c diff toxin testing stop or change antibiotics fluids treat with metronidazole or vanc
180
viral GI tests
stool microscopy stool immunoassay (rota) stool PCR
181
rotavirus
``` dsRNA no envelope group A is human one abrupt D and V (more diarrhoea) mild fever recover in 2 days ```
182
calici viruses
noro and sapo
183
norovirus
10-50 hours explosive diarrhoea lasts 1-2 days
184
enteric adenovirus
hot places watery 10 days incub
185
Hep A-
``` pico virus no envelope 10-50 days incub 10 days prodrome icteric phase- yellow, fever, ill (pale stool, dark urine) convalescense ```
186
Hep A may progress to
fulminant hep cholestasis relapsing hepatitis
187
Hep A diagnosis and treatment
serology IgM no treatment notifiable disease NHIG post exposure give to IVDUs
188
Hep E
``` water refugee camps virus in stool during illness undercooked pork, shellfish old bloke bad if preggers no chronic progression in immunocompetent 40 days inc ```
189
diagnose hep E
exposure IgG/IgM no treatment no prophylaxis
190
hep b
acute, resolved infection OR chronic infection ``` sex, mum, IVDU Hepadna virus DNA 60-90 days in children- fine in adults- disease! ```
191
treatment for hep B
antivirals not usually given check liver function transplant if need be
192
chronic hep B
more than 6 months
193
treat hep B
1st line: tenofovir or pegylated IFN. | lamivudine
194
hep D
IVDU sexual contact fairly uncommon friends with B. prevent: pre or post exposure to HBV
195
Hep C
``` IVDUs cirrhosis and hepatocellular carcinoma liver transplant! flavivirus hepacivirus usually become chronic usually don't notice the acute ```
196
managment of hep C
``` high dose inteferon otherwise supportive NOTIFIABLE immunise against hep A and B RIBAVIRIN sustained virological response ```
197
single cell parasites
``` protozoa (malaria, giardia) sporozoa- intracellular flagellates amoeba- blobs cilliates- beating cilia. ```
198
multicellular parasites
metazoa (helminths)
199
ectoparasites
lice!
200
Malaria 4 types
falciparum- KILLER (most common) vivax- can take up to a year! ovale malariae
201
malaria
7-30 days
202
hypnozoites
reactivated years later
203
symptoms of malaria
``` Flu respiratory- cough, pulmonary oedema Gi- nausea, vomiting CNS- headache, coma Shock, acidosis, renal impairment, DIC, hypoglycaemia, speen rupture. ```
204
malaria tests
``` malaria film malaria antigen test FBC (reduced platelets) clotting U+E culture serology pH ```
205
viral haemorrhagic fever
Lassa Marburg Ebola
206
malaria treatment
antimalarials (quinine, doxy, fansida, prima) supportive therapy consider exchange transfusion
207
leishmaniasis
sandflies diagnose- biopsy treat- antimonials, pentamidine, amphotercin
208
trypanosomiasis
sleeping sickness tsetse fly CHAGAS
209
CHAGAS
big oesophagus big colon big heart
210
helminths
eat it inocculated by it bit by it (and burrows)
211
schistosomiasis
swimmer's itch- trematode haematobium mansonii japonicum OVA IN URINE, STOOL OR BIOPSY.
212
soil transmitted helminths
ascaris lumbricoides strongyloides hook work cutaneous larva migrans
213
hyatid disease
ecchinococcus
214
filariasis
arthropod borne helminth
215
acute bronchitis
influenza RSV rhino
216
anthonisen criteria
COPD if 2/3 give antibiotics SOB sputum volume sputum purulence
217
treatment for COPD
amoxicillin
218
CAP
<48h s.pneumoniae narrow spectrum
219
HAP
multi-resistant flora | broad spectrum
220
aspiration causes... of CAP
10% usually posterior upper right lobe.
221
CURB 65
``` Confusion Urea >7 RR >30 BP 3: SEVERE- admit 2: non-severe, consider 1: non-severe, home ```
222
sputum only good for
legionella | TB
223
typical pneumonia
strep. pneumonia lobar amoxicillin sensitive can use macrolides too
224
atypical pneumonia
``` multilobar mycoplasma chlamydia coxiella legionella need a macrolide ```
225
HiB vaccine ineffective against
non-capsular strains
226
Hinfluenza needs
haem (X) and V to grow | sensitive to amoxicillin, cefuroxime, co-amoxiclav.
227
mycoplasma resistant to beta lactams
because of no wall. | need to use macrolides, tetracyclines and quinolones.
228
Legionella
survive and multiply in macrophages. pontiac fever severe pneumonia+organ damage=legionnaires disease) macrolides, quinolones
229
coxiella
Q fever airborne, milk, faeces, animal urine. SEROLOGY chronic disease and endocarditis treat with tetracycliens.
230
CAP increasing treatment
amoxicillin oral amox+erythro oral ampicillin+erythro IV
231
HAP treatment
co-amoxiclav/cefuroxime but if recent drugs then third gen cephalosporin
232
PJP
``` Ch4<200 co-trimoxazole pneumocystis diagnose on induced sputum or lavage. cannot be cultured. ```
233
parapneumonic effusion
reactive, pH>7.2
234
empyema
infected, pH<7.2 DRAIN
235
haematogenous abscess usually due to
s.aureus
236
rare lung abscesses
klebsiella pseudomonas fungi.
237
mycobacterium
acid and alcohol fast. | air droplets.
238
MTB complex
tuberculosis bovis leprae
239
1 Tb to make infection
10 infected by 1 | 20 hours to replicate on a plate.
240
tuberculin skin test (HEAF) (Mantoux)
cross reactivity of PPD with BCG. <5mm- good response a person who has been exposed to the bacteria is expected to mount an immune response in the skin containing the bacterial proteins.
241
ELISPOT
detects IFN-gamma each spot is a footprint of reaction to an antigen VERY sensitive rapid
242
MDR TB
resistant to at least 2 main first line TB drugs
243
XDR-TB
three or more of the 6 second line drugs.
244
MOTT
mycobacterium other than TBx
245
TB cavity contains 10^7 to 10^9 bacilli
spontaneous MDR is 1 in 10^14
246
infective endocarditis
bacterial or fungal infection of a heart valve | or area of endocardium.
247
mortality with IE
20%
248
rheumatic fever used to be prime risk factor
but now rare | s.aureus and strep responsible for >80% now
249
4 categories of IE
native valve infective prostetic valve infective IVDU associated nosocomial
250
Native valve IE
``` congenital heart disease rheumatic heart disease mitral valve prolapse degenerative valve lesions STREP VIRIDANS ```
251
Prosthetic valve IE
early or late | CoNS
252
IVDU IE
``` 30 years Males right side more common usually tricuspid valve STAPH AUREUS ```
253
nosocomial IE
usually underlying cardiac disease IV lines, surgery right sided.
254
pathogenesis of IE
``` heart defect pressure gradient across valve fibrin-platelet deposition colonized further depostion of thrombus vegetation ```
255
HACEK
``` haemophilis aphrophilus actinobacillus cardiobacterium Eikenella Kingella ```
256
culture negative causes of IE
Q fever Chlamydia Brucella
257
strep and staph with IE
strep>staph
258
symptoms of IE
malaise, pyrexia, murmur, Osler node, Janeway lesion, splinter haemorrhages Roth spots Splenomegaly Cerebral emboli
259
Definitive infective endocarditis
1. positive blood culture (2 sites)- persistently positive. 2. evidence of endocardial involvement (vegetation, abscess, regurg etc). ``` minor: Fever Immunological phenomena microbiological evidence (but not enough for major) Echo- consistnet underlying heart condition vascular phenomena ```
260
IE bloods
normal anaemia, raised WCC, raised CRP, raised ESR
261
complications of IE
``` cardiac failure embolisation acute renal failure mycotic aneurysms death ```
262
in most cases of IE....
4 weeks of therapy required (parenteral)
263
neutropenic sepsis
<0.5 x 10^9 AND temperature or other signs
264
85% of infections are due to
endogenous flora
265
door to needle
1 hour | fever in neutropenia
266
which drug for suspected sepsis?!
anti-pseudomonal taz or meropenem or ceftazidime start empiric therapy then consider need to broader OR add gent at 2-3 days
267
ciprofloxacin for duration of neutropenia
--
268
protective isolation
HEPA
269
meningitis in HIV
cryptococcus neoformans
270
primary prophylaxis in HIV
give Abx when CD4<200
271
protein deficiency and hypo/asplenism
cause b cell loss
272
Erysipelas
Group A strep
273
Erysipeloid
Erysipelothrix
274
Erythrasma
Corynebacterium
275
Cellulitis
Strep usually.
276
scarlet fever
group A strep | desquamation 2-5 days later
277
Scalded skin
group A strep
278
Toxic shock syndrom
group A strep
279
necrotising fasciitis types
1=poly (pre existing conditions) | 2=group A strep (IVDU)
280
clostridial cellulitis
gas gangrene
281
regiment for necrotising fasciitis
meropenem + vanc | imepenem + vanc
282
gas gangrene
usually the result of trauma clostridia spores on wound can happen after bowel surgery gas bubble under diaphragm
283
gas gangrene treamtent
benpen + gent +metronidazole! surgery vital! only 2 hyperbaric chambers in england (not used
284
sepsis
evidence of infection and evidence of systemic response
285
severe sepsis
infection + SIRS= sepsis
286
septic shock
sepsis + hypoperfusion/organ dysfunction/hypotension
287
SIRS
temp above 38 below 36 hr below 90 RR >20 WCC >12 or <4 systemic inflammatory response syndrome
288
septic shock
severe sepsis refractory to fluid
289
cell pathogen interaction
classical pathway or MB lectin pathway and complement pathway
290
pro inflammatory cytokines
TNFalpha IL1 IL6
291
complement cascade
recruitment of inflammatory cells lysis of pathogen opsonisation of pathogen
292
Platelet activation factor
causes inccreased platelet aggregation TNF causes increased permeability No causes loss of contractility of vascular smooth muscle
293
TNFalpha and IL1 activate the
coagulation cascade
294
heart in sepsis
initial bounding pulse | then cold, clammy, poor pulse
295
NO on the tissues
causes damage | toxins release by pathogens also damage the tissue.
296
early sepsis
respiratory alkalosis oliguria consider vasopressor agents
297
late sepsis
increase lactate! metabolic acidosis decreased capillary refill consider inotropic agents.
298
SOFA
score for organ failure. | sequential organ failure assessment
299
HIV envelope
GP 120 and 41 specific binding to CD4 cells coreceptors on host cells are required for viral entry.
300
types of virus
lymphotrophic and macrophage trophic (lymphotrophic predominant later in course of infection
301
innate immunity
no memory
302
adaptive immunity
specific and memory
303
b cells
from bone marrow respons to antigen need T cell help
304
T cell
thymus recognizes antigents CD4- helper (type 2 MHC) CD8- killer (type 1 MHC)
305
big 5 foodborne illnesses
``` salmonella campylobacter e.coli listeria clostridium ```
306
mandatory surveillance
MRSA c.diff e.coli surgical site infections
307
contact tracing for
Meningococcal H. influenza TB Strep A
308
conjugation vaccine
attachment of a carrier protein to a polysaccharide antigen
309
PCV
children under 2 | 13 types
310
PPV
over 65 | 23 types

ACS (4 decks)

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