Session 4 Flashcards

1
Q

What is a healthcare infection?

A

An infection arising as a consequence of providing healthcare

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2
Q

What are some implications of healthcare infections?

A

Longer LOS for patients, damage to healthcare providers reputation, costly to treat.

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3
Q

How can healthcare infections be treated?

A

Eradicate the pathogen, prevent clinical manifestation of the infection, prevent transmission of the infection, screen for infection on admission, ensure proper cleaning and hygiene procedures.

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4
Q

What are the 4 Ps of infection prevention and control?

A

Place, practice, patient and pathogen.

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5
Q

What are the key features of antigen presenting cells?

A

Strategically located to allow a good response, act to capture the pathogen, illicit an immune response against the pathogen, several types of APC to allow best response to be elicited.

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6
Q

Where are class I MHC molecules found?

A

In all nucleated cells.

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7
Q

What do class I MHC molecules present?

A

Peptides from intracellular molecules.

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8
Q

Where are class II MHC molecules found?

A

On dendritic cells, macrophages and B cells.

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9
Q

What do class II MHC molecules present?

A

Peptides from extracellular molecules.

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10
Q

What features of MHC molecules make them effective?

A

MHC genes have co-dominant expression so diverse genetic makeup from both parents; genes are polymorphic so several different MHC molecules are created from the MHC genes.

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11
Q

Briefly describe the structure of MHC molecules.

A

Attached to the cell membrane; peptide binding cleft present with highly polymorphic residues for peptide to present to; class I peptide binding cleft is between alpha1 and alpha2 domains, class II peptide binding cleft is between alpha1 and beta1 domains.

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12
Q

What cells do class I MHCs present peptides to?

A

CD8+ T lymphocytes.

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13
Q

What cells do class II MHC molecules present peptides to?

A

CD4+ T lymphocytes.

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14
Q

Describe the endogenous antigen processing pathway.

A

Virus enters the cell and is exposed to degradation by proteasomes; antigenic peptide is produced by degradation which enters the ER of the cell; in the ER it forms an MHC which migrates to the cell surface; presents to CD8+ T cells at the cell surface.

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15
Q

Where does the endogenous antigen presenting pathway occur?

A

In all cells.

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16
Q

Briefly describe the exogenous antigen presenting pathway.

A

Microbes enter the cell and are digested; endosomes containing the digested bacteria fuse with larger vesicles containing partially formed MHC molecules; bacterial proteins fuse with the MHC molecules and migrate to the cell surface; present to CD4+ cells at the cell surface.

17
Q

In which cells does the exogenous antigen recognition pathway occur?

A

Antigen presenting cells.

18
Q

How is the chance of a T cell recognising a microbe increased?

A

All peptides from one microbe are presented by different MHC molecules.

19
Q

How are T cells activated?

A

Via costimulation: must bind to two separate receptors to cause activation.

20
Q

What occurs in intracellular adaptive responses?

A
  • TH1 CD4+ cells are activated which causes CD8+ cell activation to kill virally infected cells
  • B cells are activated to produce antibodies
  • Macrophages are activated to kill opsonised microbes
21
Q

What occurs in extracellular adaptive immune responses?

A

TH2 CD4+ cells are activated to recruit several other cells:

  • Eosinophils to kill parasites
  • B cells to phagocytose pathogens
  • Mast cells to cause local inflammation
  • Neutrophils to phagocytose pathogens
22
Q

What is the antibody response at first encounter with a pathogen?

A

Main antibody response is from IgM with little IgG present. Over time this is replaced with IgG.

23
Q

What is the antibody response at second exposure to a pathogen?

A

IgG is much more abundant than IgM due to the isotope switch mediated by TH2 CD4+ cells.

24
Q

What features of IgG make it more effective in a secondary response than IgM?

A

Faster, stronger, longer acting, higher affinity response.

25
Q

What are the functions of IgG antibodies?

A

Fc-dependent phagocytosis, complement activation, neonatal immunity, toxin/virus neutralisation.

26
Q

What are the functions of IgE antibodies?

A

Immunity against helminths and mast cell degranulation.

27
Q

What are the functions of IgA antibodies?

A

Mucosal immunity.

28
Q

What are the functions of IgM antibodies?

A

Complement activation.