microbiology and pathology Flashcards
give an example of ectopia
normal tissue forming in the wrong place, merkels diverticulum - epithelium at small intestine
give an example of atrophy
break down of tissue, if not being used or in disease, osteoporosis - decreased bone density
what is hypertrophy and describe a disease in which this is a factor
increase size of cells - muscle cells have reduced mitotic ability so increase in size instead of dividing. heart failure, increased load on heart so muscle bulk increases - ventricular hypertrophy
what is hyperplasia and what can cause it
increase number of cells, tissue becomes much thicker , can be caused by medications - gingival hyperplasia by epilepsy medication.
what is metaplasia and give an example of this
change of one differentiated tissue to another, change in epithelial type - barrett’s oesophagus, in response to GORD, change from stratified squamous to simple columnar
what is the difference between metaplasia and dysplasi
metaplasia is controlled change, dysplasia is uncontrolled, cells dividing all through the tissue, not just at bottom - could become malignant
describe 3 differences between benign and malignant tumours
benign tumours are encapsulated, keeping their growth localised. malignant tumours have no capsule, can invade other tissues (metastases). benign tumours have fewer mitotic bodies so have a slower growth rate, malignant tumours have several mitotic bodies so grow much faster. benign tumour cells all look relatively normal and are all similar from same tissue of origin. malignant tumour cells are difficult to see where they come from, all very different and pleumorphic
name the 3 types of carcinogens
chemical - tobacco, alcohol
physical - ionising radiation, UV light
viral - HPV
how can carcinogens result in tumour formation
initiation - mutating gene of cell giving it neoplasmic potential, another factor then required to cause division and formation of tumour (promotion), then progression, as division continues, malignancy is developed
what is the role of proto-oncogenes
produce proteins involved in cell division, growth factors, growth factor receptors, signal transducer
how can proto-oncogenes play a role in cancer
one genetic mutation in this gene causes the production of oncogenes which produce oncoproteins - this stimulate cell proliferation, which if uncontrolled can result in tumour formation
what are tumour suppressor genes
genes which control cell division, prevents uncontrolled growth
how can tumour suppressor genes play a role in cancer
two mutations to this gene results in cells dividing and proliferating in an uncontrolled manner
what is P53 and how is this involved in tumour formation?
as cells undergo mitosis, they have check points to check for defective DNA, if this is detected, the P53 can send the cell for DNA repair. If this is not possible, P53 sends the cell into apoptosis, this prevents any mutation being passed down cell lineage. In cancer, this protein is not produced, so mutated genes are passed to all cells, forming more tumour cells
what are the 6 main hallmarks of cancer
self-sufficient growth signals, insensitive to anti-growth signals, limitless replicative potential, production and maintenance of angiogenesis, evade apoptosis and metasises and invade other tissues
what is the difference in spread between epithelial cancers and connective tissue cancers
epithelial spread via lymph nodes and then blood vessels, connective tissue (sarcomas) spread via blood vessels first
what is tumour grading?
looking at a tumour down a microscope, at the histological appearance of the tumour cells - high grade cells are very different to cells of origin (pleomorphic) and many mitotic bodies
what is tumour staging?
determining the extent of spread of the tumour, if it is localised or metastised
what staging mechanism is used for oral cancers?
TNM - tumour size, lymph node involvement and metastasis
what are the 3 E’s in cancer immunology and what do they mean?
Elimination - immune system is removing cancer cells
Equilibrium - immune system and cancer cells are balanced but immune system coping and controlling
Escape - due to immunosuppression or another disease, the cancer cells can escape the immune system and spread to other areas
describe the process of the gram stain
stain cells with crystal violet, then iodine. then treat cells with alcohol - if gram negative, this will wash away the iodine stain, if gram positive the stain will remain. then counter stain with safrinin, this will stain colourless gram negative cells pink.
why do certain bacteria retain the gram stain
gram positive cells have a lipid bilayer and an outer cell wall of peptidoglycan, between these layers is the periplasmic space. it is in here that the gram stain is retained, as alcohol cannot penetrate through the cell wall to get to here so it is not washed away
describe the structure of gram negative bacteria
has a lipid bilayer, peptidoglycan wall and periplasmic space between. but it also has an outer most lipopolysaccharide layer. there is then another periplasmic space between the LPS and peptidoglycan, this is where the iodine is trapped. however, as cells are treated with alcohol, this can penetrate through the LPS and wash away the stain, making it gram negative
what medication can be given for gram positive infections
penicilin - breaks down cross-link bonds in peptidoglycan wall
what is the difference between an endotoxin and exotoxin
exotoxin - peptides produced within the bacteria, normally gram positive, much more potent and lethal. endotoxin - embedded in LPS in gram negative bacteria, large amount required to be lethal
give an example of a gram positive cocci bacteria
in bunches like grapes - stauphlococcus aureus, in chains - streptococcus mutans
give an example of a gram positive bacilli bacteria
closstridium difficile
give an example of a gram negative cocci
n. meningitis
give an example of a gram negative bacilli
prevotallus intermedium
what people are more at risk for fungal infections
immunocompromised
what are the 3 types of fungi
candida, asperilligus, cryptococcus
how do candida get into the blood stream
have hypha that extend from spore, these hypha can get between cells, releasing enzymes to break down the attachments
how are fungal infections treated
main aim of treatment is to attack the cell membrane - ergostril, nystatin breaks this down so the cytoplasm leaks out, fluconazol prevents the production of the membrane
describe the structure of a fungi membrane and cell wall
wall - beta glucans and chitin, membrane - ergostril
describe structure of a virus
nuclei acids, protein coat, some have a lipid envelope, have HA and NA on outside - HA for entrance to a cell, NA for leaving a cell
what effects can a virus have on a cell
death, transformation (HPV changes epithelial cell to tumour cell) or latent infection - stays in cell, embeds its DNA into cellular DNA so it is always being replicated, when a person is stressed or immunocompromised, this breaks out of cell
name the steps in the chain of infection
infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host
what is a differential diagnosis
the diagnosis after a medical history and examination, determining what diseases could be linked to the symptoms and signs, but special tests required to determine which one
what are the 2 cell lineages for defence cells
myeloid and lymphoid
what defence cells contain granulocytes and what are these
granulocytes - vesicles of destructive enzymes and anti-microbial peptides. neutrophils, basophil, eosophil, mast cells
what is the role of the dendritic cell in immunity
dendritic cell is in the blood, has long processes which can extend into tissues when detect an infection. their main role is antigen presenting - runs from the site of infection to lymphoid tissue to present antigens to B and T cells
describe antigen presentation
dendritic cells internalise and degrade antigen into linear peptides. these are then attached to MHC proteins - either I or II. T cells then bind to these proteins - CD4 to MHC II, CD8 to MHC I
what is the role of natural killer cells
respond to cells infected with virus or tumour, tries to kill these whilst waiting for adaptive immunity to kick in
what is koch’s postulates
the theory that one bacteria or organism causes one disease. can be proved by taking a sample of those with the disease and growing in culture, showing the organism is present, then putting this organism in an animal model, showing the disease will form, then removing this again and culturing to show its present
how can bacteria attach to surfaces
pilli - projections of the outer wall, allow for adhesion, or are capsulated - capsule is thick and sticky
give an example of an infection in which pilli are required
UTI - need to stick on to mucosal membrane so they are not washed away by urine
how are capsulated bacteria more dangerous
the capsule allows them to hide from the immune system, they are not phagocytosed or attacked therefore they replicate in large numbers and can then be fatal
what are non-professional immune cells
epithelial cells and fibroblasts
what are the 3 divisions of innate immunity
physical barrier, cellular mechanisms, plasma factors
how do antimicrobial peptides work
they are cationic, so are attracted to negatively charged membranes - bacteria. this brings them close to bacteria, then they have a water loving and lipid loving part. the lipid loving part tries to get through bacterial membrane as the water loving part stays outside, creates a pore through which the cell cytoplasm of bacteria leaks through and the cell is lysed
what proteins in saliva have antimicrobial peptides
cystatin, lactoferrin, lysosome
how can secretory IgA provide immune defence
it is found on mucosal membranes, binds to flagella of bacteria, prevents it moving, stops bacteria from adhering to surfaces and binds to antigens
give an example of a pattern recognition receptor
toll-like receptor
what binds to pattern recognition receptors
microbial associated molecular patterns - cell wall or membrane or nucelic acids specific
what is the result of activation of pattern recognition receptors
activates phagocytosis, alters gene transcription to produce chemokines and cytokines
what is the role of chemokines in innate immunity
sets up a chemokine concentration gradient to recruit immune cells to the site of infection
how can leukocytes be recruited in from the bloodstream
cytokines activate the endothelial cells to produce selectins - these can bind to carbohydrates in the leukocytes. slows the movement of leukocytes so they are not travelling as fast - neutrophil rolling. integrins are then activated which stop the neutrophils from moving so they can then be pulled through the gap junctions in endothelial cells by CD31
how do neutrophils attack foreign cells
has neutrophil extracellular traps, these hold the bacteria close to the neutrophil, it then degranulates releasing antimicrobial peptides to kill the infection
explain phagocytosis
the phagocyte engulfs the bacteria so it is in a vesicle in the cell - phagosome, this then fuses with a lysosome to form a phagolysosome, this then breaks the infection down to residual bodies and waste
how does phagocytosis differ to antigen presentation
antigen presentation also engulfs the cell and then fused with a lysosome - phagolysosome but instead of waste being produced, it is broken down to smaller peptides these are then paired with MHC proteins
what co-receptor is required for activation of CD4 or CD8
CD3, anchors TCR and antigen
describe the basic structure of the TCR
two chains, one alpha, one beta, each with a constant region and a variable region
how many gene segments make up the variable region in the alpha chain of the TCR
2, joining segment and variable segment
how many gene segments make up the variable region in the beta chain of the TCR
3, joining, diversity and variable segment
how is diversity of the TCR generated
due to gene re-arrangment, many possible combinations of genes which results in different proteins structures
how is it decided if a t cell will be a helper cell or cytotoxic in thymic education
the epithelial cells of the cortex of the thymus express either MHC I OR II, if the T cell binds to I it will become CD8, if it binds to II, it will become CD4