Microbiology/Pathology Flashcards
B cells complete maturation in ___ and migrate to ____.
bone marrow; lymphoid organs
T cells complete maturation in the ___ and become ___.
thymus; thymocytes
Life span of B cells
short life span
Life span of T cells
Long life span
T cells are important in ____ immunity, Type ___ hypersensitivity
cell-mediated immunity; Type IV (contact dermatitis)
T cells lack __ receptors but have ___, which recognize a unique Ag only in conjunction with MHC proteins
IgG; CD3
CD8+ lymphocytes release ___ and induce ___.
perforins; apoptosis
____ potentiates the growth of NK cells.
IL-2
Helper T cells (TH cells) aka
CD4+ lymphocytes
Cytotoxic T-cells (Tc cells)
CD8+ lymphocytes
Plasma cells Ig what are expressed on surface as antigen receptors?
IgM and IgD
Ig receptors found in B cells
IgM and IgG
RAAS=
Renin-angiotensin-aldosterone system
Renin (proteolytic enzyme, released by kidneys) stimulates formation of ____ in blood –>stimulates release of ___ from adrenal coretex
angiotensin; aldosterone
Renin release stimulated by
- sympathetic stimulation
hypotension
decreased sodium delivery
Nonsense mutation
results in stop codon that translates into premature chain termination.
Missense mutation
Results in a difference in the aa added to a going pp chain (e.g. valine replaces glutamate causing sick cell anemia)
Silent mutation
no detectable change (e.g. serine stays serine though 3rd base changed.
Metaplasia
change in cell type
“reversible” change where one adult cell type is replaced by another adult cell type.
Hyperplasia
increase in cell number
hypertrophy
increase in cell size
atrophy
decrease in cell size
etiology of localized aggressive periodontitis and periodontitis in juvenile diabetes
Actinobacillus actinomycetemcomitans (Aa)
S. mutans produces dextransucrase, which catalyzes the formation of ____, which contribultes to the formation of___.
glucans; dental plaque
Dental plaque holds ___ which is procued by S. mutans.
lactic acid.
Streptococci found in dental plaque
S. sanguis (produce H2O2)
S. mutans (is aciduric and produces lactic acid)
S. salivarius (found in saliva and oral soft tissue)
S. mitis (produces H2O2)
Etiology of necrotizing ulcerative gingivitis (NUG)
prevotella intermedia
Ringworm aka
tinea corporis- trunk, extremities, and face
Fungi description
eukaryotic, complex cell wall, Gram +, grow in Sabouraud medium, DNA and RNA
infections
Dermatophytes-members of keratinophiilic (keratin digesting) soil fungi include
Microsproum and Trichophyton-human and animal
epidermophyton-human
Dimorphism (fungi that form diff. structures at diff. temperatures) ex.
blastomyces, histoplasma, coccidioides, sporothrix schenckii
examples of sexual spores include
zygospores, ascospores, basidiospores
Fungal spores completely killed when
heated at 80C for 30 minutes
Fungus producing sexual spores termed
teleomorph
2 types of asexual spores (anamorph)
sprangiospores and conidia
Coccidioidomycosis aka
Valley fever or San Joaquin fever
Disease caused by inhaling spores of a fungus called coccidioides immitis.
Blastomycosis aka
Gilchrist disease or North America blastomycosis
Disease caused by a fungus, blastomyces deratitidis, inhaltation of airborn conidia (spores) after distrubance of contamined soil.
Histoplasmosis
Disease caused by Histoplasma capsulatum.
Asymptomatic, can cause granulomatous, TB-like infection.
Yeast cells found in macrophages
Mucormycosis
In immunocompromised pts, and poorly controlled diabetes mellitus.
Sym: rhino -orbital-cerebral and pulmonary infections
Aspergillosis infection
caused by type of mold.
Affect respiratory system
Leading cause of death in people with leukemia.
Pneumocystis pneumonia (PCP) or pneumocystosis
form of pneumonia, caused by yeast-like fungus
In lungs of healthy people as opportunistic infection for people with HIV etc
Amebiasis
intestinal illness caused by entamoeba histolytica (parasite).
sym: amebic dysentery (bloody, mucus containing diarrhea)
Cryptosporidiosis
Caused by intestional protozoan, Cryptosporidium parvum.
Sym: watery diarrhea (this Parvaneh Khanoom)
Worse in immunocompromised pts.
Nematodes (roundworms)-3 types
Tissue-dwelling
Human intestinal
Zoonotic
Trematodes (flukes)-flat leaf-shaped worms includes what 3
Blood flukes
Lung flukes
Intestinal/hepatic flukes
Swish and swallow treatment
nystatin and clotrimazole
Penicillin Drugs
Penicillin VK
Amoxicillin
Ampicillin
Penicillin action
inhibits cell wall synthesis
Macrolide action
Antibiotics that are primarily bacteriostatic, by binding to 50S subunit of ribosome, they inhibit bacterial protein synthesis
Macrolide
ACE
Azithromycin (Z-pak)
Clarithromycin (Biaxin)
Erythromycin
Penicillin-like in action against bacteria are
cephalosporins
Tetracycline used to treat
acne, honorrhea, syphilis, chronic bronchitis, Mycoplasma, Chlamydia, Rickettsia infections.
“gold standard” to treat life -threatening systemic fungal infections
amphotericin B
Adjuvant approved in humans and animals
Humans-alum (aluminum hydroxide and MF59)
animals–freund complete adjuvant
Toxoid
bacterial toxin whose toxicity has been weakened or destroyed by either chemical or heat treatment.
Naturally active
exposed to Ag and body produces Ab.
e.g. recovery of inf. with mumps virus gives lifelong immunity
Most infectious known blood-borne pathogen
Hep B
Quaternary ammonium compounds
cationic detergent.
Used as disinfectants and antiseptics
bacterial spore has high concentration of
calcium bound to dipicolinic acid
melanoma describe growth phases
radial (initial phase)-horizonal-lack the capacity to metastasize
Vertical (later phase)-tumor invade downward. metastatic potential
Superficial spreading melanoma
most common
large flat irregularly pigmented legion. Radial growth phase predominates
Nodular melanoma
Most aggressive type.
Rapidly growing nodule that bleeds and ulcerates
Vertical growth phase predominates.
Poorest prognosis.
Lentigo maligna
On sun exposed skin.
Radial growth predominates.
Usu. develops from pre-existing lentigo maligna (Hutchinson freckle)
Acral-lentiginous
least common
palms, sole or under the nail.
Pheochromocytoma
composed of chromaffin cells–>synthesize and release catecholamines (epi and norepi)
Surgically correctable hypertension
Rule of 10s
Neuroblastoma
Highly malignant catecholamine-producing tumor of early childhood usu. originals in adrenal medulla.
Most common malignant tumor of childhood and infancy.
Abdominal mass, hypertension
Ganglioneuroma (worse differentiated form)
Epidermoid (squamous cell) carcinoma
Arise in or near the hilus
Most common in men and smokers
Adenocarcinoma
In periphery of lung and is small.
Most common in women and nonsmokers
Small cell (oat cell) carcinoma
Most arise in or near the hilus.
Most aggressive form and highly malignant.
Mostly in men and smokers
Metastasize widely, virtually incurable
Large cell (anaplastic) carcinoma
composed of large, undifferentiated malignant cells, variable location.
Bronchogenic carcinoma
malignant neoplasm of the lung from epithelium of the bronchus.
bronchial mucosa–>bronchial lumen–>lymph nodes–>organs (liver, brain, bone)
Usu. hilus, some by periphery of lung. like adenocarcinomas
non-Hodgkin Lymphomas (NHL)
malignant tumors
70% B cell origin
Unknown cause
Ass. with EBV virus of DNA, HIV, H. pylori, Herpes, etc
Burkitt lymphoma
high-grade, non-Hodgkin lymphoma 2 types: 1. African or endemic form-males, jaws 2. NOn-African form: no sex predilection, abdominal mass Viral etiology
Malignant lymphoma is similar to Hodgkin’s disease, but ___ is not present
Reed-Sternberg cells
Malignant lymphomas histology
“starry-sky” in non-neoplastic macrophages
e.g. burkitt lymphoma
keratin pearls
squamous cell carcinoma
Squamous cell carcinoma
keratinocytes, ass. with chemical carcinogens, histology resembles cervical cancer
90% of all diagnosed malignant neoplasms in oral cavity (usu. lower lip b/c of sun exposure)
Most common cancer in humans
Basal cell carcinoma
Basal cell carcinoma
rarely metastasizes
local invasion destroys underlying and adjacent tissue.
Usu. on exposed surfaces like face, scalp (in bald)
Due to sun and x-ray
most common site: nose
Skin carcinoma with locally destructive growth and distant metastasis
SCC
Well-defined nodule with central ulceration, prominent surface telangiectasias (spider veins), rolled borders, pearly opalescence when compressed . Can form ulcerations and bleed.
BCC
benign tumor of smooth muscle
leiomyoma
striated (skeletal) benign tumor
Rhabdomyoma
Prostate cancer
Increase Prostate-specific antigen (PSA)
Increase acid phosphatase levels
Uterine fibroid aka
uterine leiomyomas (also called fibroid)-most common pelvic tumor. They are benign.
1 and #2 killer in cancer
- Lung cancer (bronchogenic carcinoma
2. Breast cancer (most common affecting women)-(adenocarcinoma)
mesotheliomas
lung cancer arising from pleura (thin layer surr.lungs)
anaplastic
less well-differentiated
Staging of lung cancer is TMN system elaborate
T:=tumor size
M=metastasis
N=Nodal movement
Multiple myeloma
malignancy of plasma cells, specifically terminally differentiated B lymphocytes. in bone marrow.
“Punched out” bone lesions due to
multiple myeloma
Bence Jones protein in urine due to (Bence Jones proteinuria)
multiple myeloma
Ewing sarcoma
cancer in bone or soft tissue, and can metastasize to other organs.
Second most common malignant bone tumor in children and adolescents.(osteosarcomas are most common). Usu. children age 10-20
C rearrangement btw. c #11 and #22.
Most common malignant bone tumor
osteosarcomas
histologic features of malignancy
anaplasia
hyperchromatism
pleomorphism
abnormal mitosis
Osteogenic sarcoma
arises from osteoclasts and osteoblasts
Usu. in femor, tibia or humerus
usu. males age 10-30
Parosteal osteogenic sarcoma
Develops on the surface of bone instead of the inferior, progresses slowly.
usually in distal femor
usu. females 20-40
Chondrosarcoma
develops from cartilage (malignant)
no pain, grows slowly
Most commly in pelvis, proximal femor, ribs, shoulder girdle
Usu. males 30-50
Malignant giant cell turmor
Most commonly in long bones, esp. knee joint
Usu. females 18-50
osseous vs. nonosseous tumors
osseous bone tumors arise from bony structure itself.
e.g. chondrosarcoma, malignant giant cell tumor, osteogenic sarcoma, parosteal osteogenic sarcoma
nonosseous tumors arise from hematopoietic, vascular, or neural tissues.
e.g. chordoma, ewing sarcoma, fibrosarcoma.
Firbrosarcoma
rare, in fibrous tissue of bone,; invades long or flate bones
usu. males 30-40
chordoma
Derived from embryonic remnants of notochord; progresses slowly,
Occurs at end of vertebral column
males age 50-60
dermatofibromas
benign neoplasm that appear as small , red to brown numps that results from accumulation of fibroblasts
acrochordon aka
skin tag.
acanthosis nigricans
cutaneous disorder makered by hyperkeratosis and pigmentation of axilla, neck, etc. Usu. have cancer
Seborrheic keratosis (seborrheic warts)
very common benign neoplasm of older people.
Warts are flesh-colored, brown, black growth that can appear anywhere on skin.
Keratoacanthoma (KA)
common skin tumor
thought to be benign but now we know–>SCC
originates in pilosebaceous glands and looks like SCC
Char. by very rapid enlargement
Clinical warning signs of melanomas-“The ABCDEs of Melanoma”
A=asymmetric lesion B=borders are irregular C= color becomes variegated or pigmented D= diameter is 6mm or greater E= evolution of the lesion, meaning change has occured
Leading cause of death in children under 15
leukemias
lymphoblastic vs. myelogenous leukemia
lymphoblastic-orginating from a precursor B or T lymphocyte
myelogenous-originating from precursor granulocytes, monocytes, erythrocytes, or megakaryocytes
Acute myeloid leukemia (AML)
most malignant. 90% of acute leukkeumias in adults.
Incidence increases with age and smoking
Acute lymphoblastic leukomia (ALL)
most responsive to therapy and most common in children. Due to chemicals and radiation.
Highest survival rate
Chronic lymphocytic leukemia (CLL)
least malignant.
Occurs in older age 55 and never in children.
slow progression
Chronic myelogenous leukemia (CML)
ass. with Philadelphia (Ph) chromosome.
low levels of leukocyte alkaline phosphatase
massive splenomegaly
Acute leukemias char. by presence of
immature, blast cells.
Occur mostly in children
Chronic leukemia char. by presence of
mature and well differentiated cells.
Nonspecific symptoms
Leukemic patients have a high Ab titer to the
Epstein-Barr virus (EB
aortic dissection
tear in aorta
sym: sudden sever chest or upper back pain. Feeling of tearing
cardiac markers elevated after myocardial infarction
myoglobin-first cardiac marker to increase troponin creatine phosphokinase glutamic oxaloacetic transaminase lactic dehydrogenase
Subacute bacterial endocarditis (SBE) caused by:
Streptococcus viridans
Acute endocarditis
caused by S. aureus. Usu. secondary to infection
centriacinar (centrilobular) emphysema
most common. ass. with chronic bronchitis and smoking. Upper lobes of lungs mostly affected.
panacinar (panlobular) emphysema
destroys alveoli and alveolar ducts.
Lower lobes of lungs affected
ass. with aging and alpha-antitrypsin deficiency (natural substance in lungs helps with it unless deficient)
paraseptal (distal acinar) emphysema
causes spontaneous pneumothorax in young adults
irregular emphysema
acinus is irregularly involved.
Ass. with scaring.
Asthma pathologic change
smooth muscle hyperplasia, excess muscus, inflammation
Chronic bronchitis
mucous gland hyperplasia, hypersecretion
bronchiectasis
airway dilation and scarring
small-airway disease
inalmmatory scarring/ obliteration
cor pulmonale
enlargement of the right ventricle of heart
pulmonary edema
excess fluid in the lungs.
Due to increased hydrostatic pressure
atelectasis
incomplete expansion of lungs (neonatal atelectasis–common in premature infants due to lack of surfactant)
von Hippel-Lindau disease
hemangiomas of the regina and cerebrum. ass. with cysts in organs
Familial hypercholesterolemia
anomalies of receptors for low density lipprotein (LDL receptors). Can result in atherosclerosis.
Cystic fibrosis
most common fatal genetic disease in white children.
Cystic fibrosis affects the cells that produce mucus, sweat, and digestive juices. It causes these fluids to become thick and sticky. They then plug up tubes, ducts, and passageways.
Impaired exocrine pancreas function results in deficiency of fat-soluble vitamins.
Lobar pneumonia
caused by S. pneumoniae
Char. by intra-alveolar exudate
Bronchopneumonia
Caused by S. aureus, S. pyogenes.
Char. by patchy distribution.
Interstitial pneumonia
caused by Mycoplasma pneumoniae or virsues (adenovirus)
hydrothorax
fluid in pleural cavity.
Healing by 1st intention
healing in surgical wounds closed with sterile suture.
Clean wounds that don’t involve infection.
Healing by 2nd intention
Healing without surgical suture.
Wound is allowed to “GRANULATE IN”
More prone to infection, and take long time.
Healing by 3rd intention
slow filling of a wound cavity or ulcer by granulations, subsequent cicatrization (process of SCAR tissue)
Addison’s Disease
Kennedy
Sym: hypotension, increased pigmentation of skin, hypoglycemia, increased serum potassium.
Low ACTH
Increased melanin (endogenous) pigmentation
Txt: administer cortisol (hydrocortisone)
Deficiency of Hemogentisic acid oxidase
alkaptonuria=black urine
Body can’t process the amino acids phenylalanine and tyrosine.
hemochromatosis
extreme accumulation of Iron.
Ass. with liver, heart, pancreatic damage, resulting in liver fibrosis, heart failure, and diabetes mellitus.
hematemesis
vomiting of blood
Common in esophageal varices or peptic ulcers
esophageal varices
Abnormal veins in the lower part of the tube running from the throat to the stomach.
Usu. alcoholics get this.
Hemoptysis
coughing up of blood from resp. tract.
dis: blood streaked sputum=minor upper resp. inf or bronchitis
TB, pneumonia cause hemoptysis
Zollinger-Ellison Syndrome
marked gastric hypersecretion of HCl
recurrent peptic ulcer disease
hypergastrinemia
diabetes insipidus
deficiency in ADH (isn’t Diabetes mellitus)
Whipple disease
distinctive periodic acid-Schiff (PAS)-positive macrophages
Gardener’s Disease
Dominant
numerous adenomatous polyps
Peutz-Jegher’s
Dominant
Hamartomatous polyps-in small intestine, less common in colon
Melanin pigmentation in mouth, lips, hands, genitalia
Chvostek sign
tape facial nerve above mandibular angle, near earlobe. If there is a twich, tetany is confirmed.
Classical Pathway
Ab
Characteristic of C1
Alternative Pathway
Acts at the earliest times during infection
Does not involve Ab
Lectin Pathway
mannose-binding lectin
Bacteria involved in hyaluronidase
streptococci
staphylococci
clostridia
