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316 Pharmacology > NEED TO FINISH/slide 19 Final: Infection, immunity, antibiotics > Flashcards

NEED TO FINISH/slide 19 Final: Infection, immunity, antibiotics Flashcards

1
Q

Lymphatic system is part of the

A

Circulatory system and also a vital part of the immune system

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2
Q

Lymphatic system is a network of tissues and organs that

A

Help rid the body of toxins, waster, and other unwanted material

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3
Q

Lymph consists primarily of

A

Water and small amounts of dissolved proteins

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4
Q

Lymph also carries two types of immune system cells

A

Lymphocytes and antigen-presenting cells

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5
Q

Lymph nodes do what

A

Produce and store cells that fight infection and disease

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6
Q

How many Lymph nodes are in the human body

A

600-700 LNs

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7
Q

Function of lymph nodes

A

Filter of lymph, catching any debris or cells present in the lymph

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8
Q

Lymph vessels

A

Thin walled, valved structures that carry lymph

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9
Q

Tonsils

A

Large cluster of lymphatic cells found in the pharynx

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10
Q

Thymus =

A

organ where t-cells mature, t-cells help destroy infected or cancerous cells

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11
Q

Spleen

A

Largest lymphatic organ in the body contains WBC that fight infection and disease

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12
Q

Mucosa associated lymphoid tissue

A

a diffuse system of small concentrations of lymphoid tissue found in various sites of the body, such as the GI tract, thyroid, breast, lungs, salivary glands, eyes, and skin.

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13
Q

Innate immunity

A

Rapid responses to a broad range of microbes

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14
Q

Adaptive immunity

A

Slower responses to specific microbes

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15
Q

First line of defense

A

Physical and biochemical barriers and the human microbiome

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16
Q

Examples of first line defense

A

Physical barriers
Epithelial cell-derives chemicals
Normal microbiome

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17
Q

Second line of defense

A

Inflammation

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18
Q

Inflammation occurs in

A

Tissues with a blood supply

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19
Q

Inflammation is activated

A

Rapidly! (Within seconds)

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20
Q

Inflammation depends on

A

Activity of both the cellular and chemical components

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21
Q

Is inflammation specific or non-specific?

A

Non-specific

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22
Q

Inflammations plasma proteins system examples

A

Complement system
Clotting system
Kinin system

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23
Q

Cellular components of inflammation

A 
Platelets 
Leukocytes 
Granulocytes 
Monocytes 
Lymphocytes
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24
Q

Examples of granulocytes

A

Basophils
Eosinophils
Neutrophils

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25
Q

Neutrophils action

A

Phagocytize bacteria, cellular debris, and dead cells

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26
Q

1st leukocyte on the scene of injury

A

Neutrophils

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27
Q

Life span of neutrophils

A

Short (2-5 days)

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28
Q

Phagocytize release

A

Chemotaxic factors that attract macrophages

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29
Q

neutrophils account for ____ of WBC count

A

60-80

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30
Q

Mature neutrophils

A

polymorphonucleocytes (PMNs)
polys
segs
neuts

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31
Q

Immature neutrophils

A

Bands

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32
Q

Are basophils and mast cells the same cell?

A

NO! they are different cells but function in the same way

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33
Q

Basophils circulate

A

Blood

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34
Q

Mast cells are found in the

A

loose connective tissues and mucous membranes, close to blood vessels

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35
Q

Basophils and mast cells function

A
  • Release chemotactic factors that attract eosinophils and neutrophils
  • Please content of granules (degranulation) when stimulated (histamine, serotonin)
  • Involved in allergic rxn
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36
Q

Eosinophils serve as the body’s primary defense against

A

Parasites

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37
Q

Eosinophils play important role in

A

Allergic and hypersensitivity rxn

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38
Q

Are eosinophils phagocytic

A

No, instead they “throw up” and coat to kill cell

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39
Q

Killing mechanisms of eosinophils

A

Binds to and degranulate ONTO parasite, damaging its surface and killing it

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40
Q

eosinophils are natural killer cells which is a components of

A

Innate immunity

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41
Q

A monocyte is an

A

Immature macrophage

42
Q

Monocytes migrate out of the

A

Bloodstream and into the tissues and matures into a macrophage under the influence of chemical mediators released by neutrophils

43
Q

Monocytes/macrophage arrive at the site of inflammation and infection after

A

24 hours and gradually replace neutrophils

44
Q

Main functions of monocyte/macrophage

A

Phagocytosis of invading bacteria and secretion of cytokines

45
Q

Third life of defense is known as

A

Adaptive immunity

46
Q

Adaptive immunity develops

A

More slowly than inflammation

47
Q

Is adaptive immunity Specific?

A

It is exquisitely specific

48
Q

Adaptive immunity has

A

MEMORY

49
Q

Antigens/immunogens of adaptive immunity stimulate antibody/immunoglobulin (IG) production:

A 
igG
igA
igM
igD
igE
50
Q

Lymphocytes that art part of the adaptive immunity

A

B lymphocytes

T lymphocytes

51
Q

B lymphocytes is what kind of immune response

A

Humoral immune response

52
Q

T lymphocytes is what kind of immune response

A

Cell-mediated immune response

53
Q

Examples of T lymphocytes

A

T- helper cells
T- cytotoxic cells
T-regulatory (suppressor) cells

54
Q

Bacteria can be divided into categories depending on

A

Shape
Arrangement
Gram staining characteristics

55
Q

Shape of a bacterium is determined by

A

Its rigid cell wall and will also determine gram staining characteristics

56
Q

Colonization

A

in a healthy state, it is normal to find a permanent population of bacteria and fungi inhabiting various body surfaces

57
Q

Microbiota (normal flora) serves as a

A

Barrier to pathogenic organisms

58
Q

In the immunocompromised, the “normal flora” can become pathogenic

A
59
Q

Pyogenesis

A

Puf formation (pyo=pus)

60
Q

Pyogenic (pus-forming bacteria) are bacteria that are

A

powerful attractants to neutrophils

61
Q

Pyrexia (fever) is an important systemic component of

A

Inflammation

62
Q

fever causing bacteria is known as a

A

Pyrogen

63
Q

A pyrogen resets the

A

Hypothalamic thermostat to a higher setting

  • – Endotoxins of gram negative bacteria
  • – IL-1 (released by macrophages and neutrophils)
64
Q

Bacterial endotoxins lipopolysaccharides are part of the

A

Cell wall of gram negative bacteria

65
Q

Bacterial endotoxinsWhen are bacterial endotoxins released

A

When bacteria are destroyed (cell wall lysed)

66
Q

Bacterial endotoxins produce non-specific responses (do not provoke immune response):

A

Pyrexia
Generalized aches
Bleeding/Clotting
Shock

67
Q

Bacterial exotoxins are proteins secreted by ___ and do what

A

Secreted by live cells and disrupt cellular function of specific cells
—– VERY POWERFUL

68
Q

Bacterial exotoxins stimulate a

A

Humoral response: formation of antitoxins (antibodies)

69
Q

is bacterial exotoxins pyrogenic?

A

No! they are NOT pyrogenic

70
Q

Majority of hospitalized patients receive

A

Antimicrobials

71
Q

Antimicrobials are most often given for 2 major reasons

A

Treat a known infection

Prophylaxis: certain clinical situations require use of antibiotics for PREVENTION rather than for treatment

72
Q

Antimicrobial agents are selected on the basis of several factors:

A
  1. Identity of the organism
  2. Microbial susceptibility to a particular agent
  3. Site of infection
  4. Patient factors
73
Q

Why is identifying the organism is important for effective tx

A

ALWAYS perform culture and sensitivity tests prior to initiating antibiotic therapy
— match the drug with the bug

74
Q

Choice of antibiotic based on bacterial susceptibility to specific drugs. however, immediate empirical therapy may be required in some cases

A
  1. A delay in treatment may be fatal
  2. Clinical judgment considers variables such as patient history & clinical presentation
  3. Broad spectrum therapy may be indicated initially while waiting for laboratory results
75
Q

Patient factors for antimicrobial agents

A 
Immune system function (immunocompetence)
Renal function
Hepatic function
Perfusion to site of infection
Age
Pregnancy and Lactation
76
Q

Indications for prophylactic antimicrobial

A
  • Prevent streptococcal infections in hx of rheumatic heart disease
  • Undergoing dental extractions who have prosthetic devices
  • Prevent TB or meningitis
  • Tx prior to most surgical procedures
  • Pretreating with zidovudine protects in a HIV infected pregnancy
77
Q

Why are antimicrobials effective

A

Selective toxicity

-Injure/kill bacterial cells without harming the host cells!

78
Q

How is selective toxicity possible

A

B/c biochemical differences between the cells of the host and the infecting organisms

79
Q

Is selective toxicity of antimicrobials absolute?

A

NO! not absolute, selective toxicity is relative

80
Q

Antibiotics are either

A

Bacteriostatic or bactericidal

81
Q

Bacteriostatic antibiotics reset the

A

growth cycle of bacteria, thereby limiting spread of infection & allowing the host immune system to eliminate remaining organisms

82
Q

Bactericidal antibiotics kill

A

All infecting pathogens

83
Q

Narrow spectrum antibiotics

A

Acts on single or limited group of bacteria

84
Q

Extended spectrum antibiotics

A

Effective against G+ and a significant number of G- bacteria

85
Q

Broad spectrum antibiotics

A

target both G+ and G- bacteria

86
Q

Different antimicrobials have different MOA

A 
Inhibit cell wall synthesis
Inhibit protein synthesis
Inhibit nucleic acid synthesis
Disrupt cell membrane permeability
Work as an antimetabolite
87
Q

Issues with antibiotic therapy

A 
Hypersensitivity 
Direct toxicity 
Superinfection 
Antibiotic-associated colitis 
Steven's Johnson syndrome 
Acquired drug resistance
88
Q

Hypersensitivity example

A

rx to penicillins may range form urticaria to anaphylaxis

89
Q

Direct toxicity examples

A

Renal and ototoxicity from high serum drug levels of ahminoglycosides

90
Q

Superinfections

A

Alterations in normal flora may cause overgrowth of opportunistic organisms (yeast) or resistant bacteria

91
Q

Antibiotic associated colitis

A

destruction of anaerobic bacteria in gut (antibiotic-assiciated pseudomembraneous colitis (AAPMC)/C. difficile-associated disease (CDAD)

92
Q

Clinical manifestations of anaphylaxis

A 
Bronchospasm
Laryngeal edema
Inspiratory stridor
Hypotension
Circulatory shock
Wheal & flare reactions
Flushing
Pruritus
Urticaria
Angioedema
Facial swelling
93
Q

C. diff produces

A

Enterotoxins that result in inflammation, hemorrhage, necrosis (of colon)

94
Q

Pseudomembrane

A

Inflammatory lesion composed of thick, adherent exudates

95
Q

C.diff and AAPMC causes

A

profuse diarrhea & possible toxic megacolon (distended & inflamed colon under influence of bacterial toxins; possible perforation; sepsis; shock; sometimes fatal)

96
Q

TX of CDAD and AAPMC

A

d/c abx; address F/E balance; administer metronidazole or vancomycin

97
Q

What can cause CDAD and AAPMC

A

Antibiotics alter normal flora of GI tract, allowing for pathogen to proliferate and attack

98
Q

Stevens johnson syndrome

A
  • Occasionally fatal (15%) rash of skin and mucosa (usually on trunk, face, mucous membranes [eyes, mouth, genitals])
  • Lesions painful and itchy
  • Often precipitated by exposure to certain drugs, especially antibiotics
99
Q

Steven’s Johnson syndrome rash

A

red/papular -> vesicles on erythematous or dusky purple base -? Bullae (fluid filled lesions >5 mm)

100
Q

Tx of Steven’s Johnson syndrome

A

d/c abx; pain management, meticulous hygiene, corticosteroids

316 Pharmacology (19 decks)

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