Mosby's Micro/Path: Immune System and Antibiotics Flashcards
(166 cards)
1
Q
Name the cells involved in the acute inflammation stage of the innate immune response
A
neutrophils (polymorphnuclear leukoctyes) basophils mast cells natural killer cells (T cells) that kill tumor/viruses
2
Q
Explain the inflammation types in the innate immune response
A
Acute inflammation
Chronic inflammation
Granulomatous inflammation (a form of chronic inflammation characterized by the presence of granulomas)
3
Q
The result of acute inflammation is
A
a. complete resolution
b. scarring
c. abscess formation
4
Q
if abscess enters soft tissue it is called
A
cellulitis
5
Q
2 dentally significant formations of cellulitis include
A
Ludwig’s angina and cavernous sinus thrombosis
6
Q
granulomas are areas the immune system walls off if phagocytes fail to destroy particles or microbes present in them.
- Tubercles are associated with granulomas involved in what infection ___
- Gumma are granulomas associated with what infection?
A
- TB Mycobacteria
2. Syphilis (treponema pallidum)
7
Q
- Granulocytes are a category of white blood cells characterized by the presence of granules in their cytoplasm. They are also called _____ because of the varying shapes of the nucleus, which is usually lobed into ___segments. This distinguishes them from the mononuclear agranulocytes. In common parlance, the term polymorphonuclear leukocyte often refers specifically to neutrophil granulocytes,the most abundant of the granulocytes; the other types (eosinophils, basophils, and mast cells) have lower numbers. Granulocytes are produced via granulopoeisis in the bone marrow.
A
polymorphonuclear leukocytes (PMN, PML, or PMNL) three
8
Q
monocytes are granular/agranular? how many lobes?
A
agranular and one lobe.
9
Q
name the monocytes
A
All WBCs: macrophages, lymphocytes: T, B, natural killer cells,
10
Q
the 2 types of acquired (specific) immunity are
A
cell mediated - t lymphocytes
humoral immunity- mediated by antibodies made by B cells
11
Q
CD4+ T cells are __ cells
A
helper cells
12
Q
CD8 T cells are __ cells
A
cytotoxic cells
13
Q
- natural killer cells are found in __ immune system
2. cytotoxic T cells are found in __ immune system
A
1 innate
2. acquired
14
Q
(CD4) helper t cells release which interleukins after it interacts with MHC class II
A
IL-4 and IL-5. This stimulates B cells and growth = to make antibodies.
15
Q
CD8 cytotoxic and suppressor T cells recognize which MHC class
A
class I MHC molecules on antigen presenting cells
16
Q
CD __ T cells are mainly for the recognition of bacterial antigens
A
CD4
17
Q
CD __ T cells are mainly for the recognition of viral antigens
A
CD8
18
Q
T cells are made in __ and mature in __
A
made by haematopoietic stem cells in the bone marrow
most mature in thymus, some in tonsils
19
Q
mononuclear cells: called __ in the blood and __ in the tissues
A
monocytes in blood and macrophage in tissue. when monocytes enter into tissue they mature into macrophages
20
Q
mononuclear cells are produced in the
A
bone marrow
21
Q
the presence of macrophages indicates __ inflammation
A
chronic
22
Q
the body has an extensive network of ___ known as the reticuloendothelial system.
A
macrophages (REL system)
23
Q
reticuloendothelial system: macrophage in the ___ are called dust cells/heart-failure cells
A
lungs
24
Q
reticuloendothelial system: macrophage in the ___ are called Kupffer cells
A
liver
25
reticuloendothelial system: macrophage in the ___ are called microglia
CNS
26
reticuloendothelial system: macrophage in the ___ are called mesangial
kidneys
27
reticuloendothelial system: macrophage in the ___ are called macrophages
lymph nodes
28
reticuloendothelial system: macrophage in the ___ are called monocytes
blood
29
reticuloendothelial system: macrophage in the ___ are called histocytes
CT
30
reticuloendothelial system: macrophage in the ___ are called spleenocytes
spleen
31
Mast cells have surface antigen receptors including __ antibody receptor
IgE
32
IgE plays important role in type _ hypersensitivity rxn
1
33
Histamine released by mast cells causes __ (vaso__)
| and broncho ___
vasodilation and bronchoconstriction
34
There are two kinds of Histamine receptors:
1. H1 receptors cause
2. H2 receptors play role in
1. bronchoconstriction and vasodilation
| 2. gastric acid and pepsin secretion
35
Prostoglandins and leukotrienes are mediators of inflammatory response. The are metabolites of __
arachidonic acid
36
Prostoglandins and leukotrienes are produced by __ pathways
cyclooxygenase (prostaglandins) and lipoxygenase (leukotrienes) pathways
37
Prostoglandins and leukotrienes cause broncho___
bronchoconstriction and vasodilation
38
Macrophages release this cytokine: IL-#
IL-1 stimulate activity/production of cells including lymphocytes, macrophages, endothelial cells. also cause fever
39
Helper T cells release cytokine: IL -# that activates other helper T cells and cytotoxic T cells
IL2
40
Activated T cells release IL# that stimulates production of RBC in bone marrow
IL3
41
Helper T cells secrete IL # stimulates B cell growth and production of IgE and IgG
IL-4
42
Helper T cells IL # stimulate B cell differentiation into plasma cells and activity of eosinophils and production of IgA
IL-5
43
Name the two types of cytokines
interleukins (ILs) and interferons (INFs)
44
1. ___ are cytokines (mediators) that affect lymphocytes
| 3. __ are cytokines that are important for antiviral immunity
1. inteleukins
| 2. interferons
45
opsonin is
any molecule that enhances phagocytosis by marking an antigen for an immune response
46
the most abundant immunoglobulin we have
IgG (75%)
47
The first responder immunoglobulin
IgM
48
The second responder immunoglobulin
IgG
49
the only immunoglobulin that can cross the placenta and is present in newborns
IgG
50
which antibody activates complement and therefore plays a key role in pathogenesis of adult periodontitis
IgG
51
list the antibodies in order or abundance
IgG (75%) > IgA (15%) > IgM (9%) > IgD (0.2%) > IgE (0.004%) GAMDE
52
which antibody is associated w immunity of mucous membranes, found in mucous secretions in respiratory tract, intestinal tract, genitourinary, tears, saliva, and colostrum (mammary glands)
IgA
53
Which antibody is associated w body's primary immune response?
IgM
54
which immunoglobulin acts as an antigen receptor for B cells that induces B cell activation
IgM
55
which antibody acts as a receptor for granulocytes including basophils and mast cells and stimulates their degeneration
IgE
56
IgE plays an impt role in type _ hypersensitivity reaction
1
57
treatment of anaphylaxic shock
epinephrine (vasoconstrictor and bronchodilator) or antihistamine
58
what antibody is involved with type I hypersensitivity reactions
IgE - histamine release...anaphylaxis...asthma hayfever
59
what antibody involved with type II hypersensitivity rxn
IgM and IgG = complement system, MAC
| ex erythroblastosis fetalis, blood transfusions
60
what antibody involved with type III hypersensitivity rxn
IgG
61
in type __ hypersensitivity, the antigen antibody interactions form immune complexes that become trapped along vascular walls damaging BV's from phagocytosis by reticuloendothelial system
3
62
Arthus reaction (injecting antigen into patient with high IgG already in blood), serum sickness (injection of drug serum/antigens), Rheumatoid arthritis, systemic lupus are all type __ hypersensitivity reactions
type 3
63
erythroblastosis fetalis and blood transfusion can cause type __ hypersensitivity reactions
type 2
64
there are NO antibody mediators in which type of hypersensitivity reaction
type 4.
65
in type 4 delayed cell mediated hypersensitivity reactions, __ are the main mediators
Helper T cells (CD4) think CD4 = type 4
66
List the antibody mediators:
1. type 1 hypersensitivity
2. type 2 hypersensitivity
3. type 3 hypersensitivity
4. type 4 hypersensitivity
1. type 1 hypersensitivity = IgE (think asthma)
2. type 2 hypersensitivity = IgG and IgM (think 2 means 2 antibodies)
3. type 3 hypersensitivity = IgG
4. type 4 hypersensitivity = no antibody. helper T cells
67
Bruton's agammaglobulinemia =
1. deficiency/low levels of ____
2. ___ immunity is unaffected
3. these patients get recurrent __ infections
4. treatment is
1. low antibodies
2. cell mediated not affected. It is a failure of B cells to differentiate = low level of plasma cells and antibody production
3. bacterial/pyogenic
4. administer IgG
think Bruton's = B cell problem
68
Transient hypogammaglobulinemia =
1. seen in infants/adults
2. decreased amount of __
3. treatment is
1. infants
2. antibodies bc slow production of antibody
3. administer IgG after the first 6 months
69
Di George's Syndrome:
1. deficiency in __ cells
2. results from a failure of the __ brachial (pharyngeal pouches) to develop
3. symptoms include
1. T cells
2. 3rd and 4th = leads to a lack of thymus and parathyroid development. mandibular development is also affected.
3. tetany
recurrent viral and fungal infections
70
What disease is characterized by a deficiency in both T and B cells, severe, recurrent opportunistic infections common in infants. Treatment bone marrow transplant/gene therapy
severe combined immunodeficiency (SCID)
71
what disease causes microstomia of the mouth (decreased opening of the mouth), abnormal deposition of collagen leading to development of fibrosis in certain organs which can result in organ failure.
Scleroderma
| systemic sclerosis
72
what disease is characterized by the presence of antinuclear antibodies (ANA). These ANA's include anti-DNA, anti-RNA, and anti-Sm antigen.
Systemic lupus erythematous (SLE)
73
most significant problems with SLE
1. kidney = most sig bc can lead to kidney failure
2. skin - butterfly rash along the malar and nose area
3. heart - increased risk of endocarditis due to vegetations found on heart valves
4. joints - causing arthritis like symptoms
74
what disease causes butterfly rash
Lupus
75
most ___ plaque made of aerobes and facultative anaerobes
suprgingival
76
most __ plaque made of anaerobes
subgingival
77
Bacteria shapes:
1. cocci =
2. streptococci
3. staphylococci
4. diplococcic
1. round/circular
2. circular and appear in chains
3. circular and appear in clusters
4. circular and occur in pairs
78
bacteria shape:
| bacilli are
rods
79
spirochetes are __ shape
spiral shaped
80
pleomorphic bacteria
appear with different inconsistent shapes
81
gram ____ bacteria stain blue
positive (thick) holds stain
82
gram __ bacteria stain red
negative
83
gram staining is used for what 2 purposes
determining what antibiotic to use and for identification purposes
84
How we gram stain:
1. we stain with ___. this causes ALL bacteria to turn blue
2. we use a __ solution- all bacteria retain the blue color
3. we then rinse with __ or __
4. when we rinse with the alcohol/acetone gram ___ will lose it's color because it is thin
5. then we stain with ___
1. crystal violet
2. iodine
3. acetone or alcohol
4. negative (gram positive stays blue bc thick)
5. safranin - gram - turn red (take up color), gram + stay blue
85
How we acid-fast stain:
1. used for __
2. stain with ___ all bacteria stain red
3. wash with __
4. stain with ___
5. mycobacteria will be what color
1. mycobacteria which cant be gram stained
2. carbolfuchsin
3. acid alcohol
4. methylene blue
5. mycobacteria will stain red (retain the carbolfucshin color). all others will stain blue
86
In the first step of ___stain we use crystal violet.
| in the first step of __ stain we us carbolfuchsin
1. gram stain (all bacteria turn blue)
| 2. acid fast stain (all bacteria turn red)
87
After we wash the bacteria we use safranin in ___ stain
| and use methylene blue in ___stain
gram stain
| acid fast stain
88
all bacteria are surrounded by a cell wall except:
mycoplasma
mycobacteria?
MYCOPLASMA! Don't confuse with mycobacteria (TB)
89
Cell wall of gram +/- bacteria contains teichoic acid. what is the purpose?
positive (think + = t-eichoic = thick peptidoglycan)
it is an antigen.
it is outside the Thick peptidoglycan wall)
90
1. The periplasm is a space bordered by two selective permeable barriers, the inner membrane (i.e., cytoplasmic membrane) and the outer membrane in Gram-___ bacteria.
negative:
inner cytoplasmic membrane ==> cell wall in the periplasmic space ==> outer membrane ==> LPS attached to outer membrane
91
there is no periplasmic space in Gram-positive bacteria because there is only
1 biological membrane, the cytoplasmic membrane.
92
some gram ___ bacteria have ____ in the periplasmic space that will degrade penicillins
beta lactaminases
93
LPS is found in the ___ of gram negative bacteria (endotoxin).
outer membrane
94
the toxicity of LPS is attributed to the presence of
lipid A
95
the outer membrane of the LPS contains the __antigen
O
96
LPS is found in dental __ and inflammation
plaque
97
Mycolic acid in acid-fast bacteria are able to resist __
decolorization with acid alcohol therefore they can't be gram stained.
98
name a bacteria that can't be gram stained
mycobacterium tuberculosis
99
Capsule: gelatinous layer surrounds the cell walls of certain bacteria. generally made of polysaccharides, functions:
antiphagoctyic, identification purposes (when treated with antiserum they swell - allowing identification) and adherence to
tooth surfaces (caries)
100
spore forming bacteria include the genus
bacillus and clostridium
101
nucelocapsid are seen in
viruses: NUCLEO: viral genome nucleic acid DNA OR RNA, CAPSID (protein coat)
102
some viruses have envelopes. which one are more sensitive to environmental conditions
enveloped more sensitive bc can dry out and pop. non enveloped (naked) are hardy
103
the virus binds to the host via ___
specific surface proteins
104
the virus enters the host cell by __
receptor-mediated endocytosis, or by fusing its viral envelope with the host membrane, or translocation of the entire virus across host membrane
105
detection of viral growth:
1. ___ This lasts for 10-12 hours, and it corresponds to the period during which the input virus becomes uncoated. As a result, no infectious virus can detected during this time. no progeny virons are assembled. The period of time between infection by a virus and the appearance of the mature virus within the cell
eclipse
106
___ period is the time bw the initial viral infection to when the virus can be detected
latent
107
fungi are dimorphic meaning they can exist as
mold or yeast
108
mold/yeast:
1. __ grows as long filaments in a free living state at ambient temperature (room temp)
2. __ grow as single cells in host tissue at body temperature
1. mold
| 2. yeast
109
Some fungi are spore producing. Medically significant spores:
1. blastospores formed by
2. chlamydospores have thick walls making them resistant to environment changes
3. arthrospores-formed from the ends of __
4. sporangiospored formed by __
1. budding
3. hyphae
4. mold
110
Penicillins are bactericidal and inhibit what enzyme that catalyzes the final crosslinking in peptidoglycan cell wall
transpeptidase
111
fungal infections generally initiate a type __hypersensitivity reaction
IV delayed (cell mediated)
112
formation of ___ is common in response to fungal infections
granulomas
113
adverse reactions to what antibiotic include allergic (hypersensitivity), seizures, and platelet dysfunction
penicillin
114
___ penicillin is effective against gram + bacteria and gram - cocci. limited aeffect against gram negative bacilli bacteria
natural penicillins
115
penicillin G and V are what type of penicillin
natural (good for gram +) and (gram - cocci)
116
which penicillin would you use for gram negative bacilli because they are more effective.
extended spectrum penicillins
| ex. amoxicillin and ampicillin
117
1. Penicillin V and G are ___ penicilins
| 2. ampicillin and amoxicillin are __ penicilins
1. natural (gram + and gram - cocci)
| 2. extended spectrum (gram - bacillus)
118
are natural and extended spectrum penicillin susceptible to beta lactaminase?
yes
119
penicillin resistant penicilins are called
antistaphylococcal penicillins - resistant to degradation by beta lactaminases.
120
penicillin resistant penicillins are used to treat
staph aureus (produce penicillinase)
121
name the penicillin resistant penicilins
cloxacillin, dicloxacillin, methicillin nafcillin oxacillin
122
1. Penicillin V and G are ___ penicilins
2. ampicillin and amoxicillin are __ penicilins
3. cloxacillin, dicloxacillin, methicillin nafcillin oxacillin
1. natural (gram + and gram - cocci)
2. extended spectrum (gram - bacillus)
3. penicillin resistant penicilins (bacteria that make penicillinase) -staph aureus
123
cephlasporins are __ cidal like penicillin
bactericidal
124
cephlasporins are __ spectrum
broad
125
cephlasporins action?
similar to penicillin but more resistant to beta lactaminases than penicilin
126
adverse rxn w/cephlasporins
with alcohol - disulfiram-like rxn
127
can patient who are allergic to penicillin be cross allergic to cephlasporins
yes. 10% are
128
name cephlasporins
cephalexin, cefadroxil, and cefazolin
129
Bacitracin is inhibitor of
cell wall synthesis (like cephlasporins and penicillin)
130
Bacitracin can only be used
topically because highly nephrotoxic if given systemically
131
what bactericidal antibiotic is produced by streptococcus orientalis
Vancomycin
132
Vancomycin is effective against gram _ bacteria
positive (think V - positiVe)
133
Vancomycin has limited effect on gram negative bacteria except
Flavobacterium
134
which antibiotic is used for multi-drug resistant bacteria like methicillin-resistant Staph aureus or treatment of endocarditis
Vancomycin
135
1. Penicillin V and G are ___ penicilins
2. ampicillin and amoxicillin are __ penicilins
3. cloxacillin, dicloxacillin, methicillin nafcillin oxacillin
4. vancomycin
5. all of them are inhibitors of __
1. natural (gram + and gram - cocci)
2. extended spectrum (gram - bacillus)
3. penicillin resistant penicilins (bacteria that make penicillinase) -staph aureus
4. gram + - MRSA and endocarditis
5. cell wall synthesis
136
1. Aminoglycosides are antibiotics that inhibit
2. they are effective against aerobic/anaerobic bacteria
3. they are also useful for many gram __ rods and enterococci
protein synthesis of bacteria (block 30S)
2. aerobic, ineffective against anaerobic
3. negative (tuberculosis)
137
the aminoglycoside named Streptomycin is used for
TB
138
the aminoglycoside named gentamicin is used for
enterococci
139
Aminoglycosides are administered by
IM injection or IV
140
adverse reactions to aminoglycosides may be
ototoxicity = toxic to the ear(via damage to CN 8) = may cause deafness
nephrotoxicity - kidney damage
141
1. penicillin, cephalosporins, aminoglycosides are all bacteri___
2. tetracycline is bacteri
1. cidal
| 2. static
142
tetracycline blocks
30S protein synthesis
143
tetracycline is __ spectrum and targets
broad (like cephlasporins)
| gram + and - and other organisms such as Rickettsia, mycoplasma and chlamydiae
144
tetracycline should be avoided in
pregnant women and young children
145
adverse tetracycline reaction to
liver - hepatotoxic
146
1. MRSA give
2. TB give
3. Rickettsia, chlamydiae, mycoplasma
4. staph aureus
5. endocarditis
1. Vancomycin
2. aminoglycoside = streptomycin
3. tetracycline (think to treat all 3) c and r in the name
4. oxacillin/methicillin/dicloxacillin/cloxacillin/naflacillin (CD-MON)
5. vancomycin
147
Someone with liver failure, pregnant, or young child don't give
tetracycline
148
for someone with kidney failure don't give
aminoglycosides (streptomycin = TB), gentamicin
149
1. erythromycin and clarithromycin are ___ and are bacteriostatic
2. for gram
1. macrolides.
| 2. positive
150
don't give an alcoholic
cephlasporin
151
which antibiotics treat both gram positive and gram negative
1. penicillin, tetracycline, chloramphenicol
152
only gram positive antibiotics
erythromycin, clarithromycin, vancomycin (except flavobacterium is gram -),
153
1. which antibiotic is effective against aerobic bacteria
| 2. which is for anaerobic
1. aminoglycosides: gentamicin, streptomycin
| 2. clindamycin
154
clindamycin is for gram
positive and negative anaerobic bacteria
155
clindamycin is bacteriostatic/cidal
both. cidal at higher concentrations
156
which would you give to treat Bacteriodes Fragilis and Fusobacterium
clindamycin
157
pseudomembranous colitis is caused by what bacteria
clostridium difficile in the gut
158
which antibiotic has an adverse reaction that may cause pseudomembranous colitis
clindamycin (C = clindamycin, clostridium difficile)
159
Chloramphenicol is broad spectrum against
gram positive and negative aerobic and anaerobic
160
chloramphicol is used as a last resort bc
severe adverse reactions and toxicity: anemia, aplastic anemia, reversible anemia, gray baby syndrome which can lead to death
161
both bacteria and humans require __ for DNA synthesis
folate
162
unlike bacteria humans cant make their own folate. we rely on exogenous folate. This is why __ drugs have affect on bacteria and not our cells
sulfa drugs block metabolic folic acid synthesis in bacteria
163
Sulfonamides (sulfa drugs) are bacterio__
static
164
quinolones inhibit __ and are bacterio__
inhibit DNA replication. static. inhibit DNA gyrase (topoisomerase) include
165
ciprofloxacin is a
quinolone
166
the only FDA approved mouthwash that has been shown to decrease __ and __ associated with gingivitis is Chlorhexidine
supragingival plaque and gingival inflammation = antimicrobial affect
after rinsing some stays in mouth and is gradually released over time.
