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Infection > Session 5 > Flashcards

Session 5 Flashcards

1
Q

Is C.difficile an aerobic or anaerobic bacteria?

A

Anaerobic

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2
Q

What antibiotic is commonly used for treatment of C difficile?

A

Metronidazole

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3
Q

C. difficile is a part of the commensals of which pat of the body?

A

Gut

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4
Q

What type of bacteria is Staph aureus?

A

Gram positive

Coccus

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5
Q

Staph aureus is found normally in which parts of the body?

A

Skin

Nasopharynx

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6
Q

Staph aureus is particularly common in causing infections in which part of the body?

A

Skin - e.g. Cellulitis

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7
Q

What antibiotic is common given for Staph aureus infections?

A

Penicillins - e.g. FLUCLOXACILLIN

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8
Q

What is pus composed of? (5)

A 
Dead/dying WBCs 
Cellular debris 
Serous fluid 
Fibrin
Bacteria
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9
Q

What is an abscess?

A

A collection of pus commonly caused by a bacterial infection

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10
Q

Staph aureus commonly results in _____________ formation

A

Abscess

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11
Q

What effect does Staph aureus have on WBCs and RBCs?

A

They lyse WBCs and RBCs in the infection area

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12
Q

What does lysis of neutrophils by staphylococcus aureus result in?

A

The pouring out of large amounts of lysosomal enzymes which damage the surrounding tissue

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13
Q

What does Staphylococcus aureus release to cause the lysis of neutrophils and RBCs?

A

Leukocidin

Haemolysins

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14
Q

What does MRSA stand for?

A

Methicillin resistant Staph aureus

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15
Q

MRSA is resistant to which class of antibiotics?

A

All b-lactam antibiotics

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16
Q

What does MRSA produce that gives it resistance to b-lactam antibiotics?

A

Penicillin binding protein 2a

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17
Q

Is MRSA found in healthy people?

A

Yes, as with other staphylococci - a % of the population is harmlessly colonised by MRSA

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18
Q

How is MRSA usually spread?

A

Skin-to-skin contact

Also through towels, sheets etc. of someone with MRSA

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19
Q

Does MRSA survive for a long time on surfaces (e.g. Door handles)?

A

Yes

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20
Q

What is the recommended treatment for invasive MRSA?

A

Vancomycin

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21
Q

What class of antibiotics does vancomycin belong to?

A

Glycopeptides

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22
Q

Can vancomycin be given intravenously?

A

Yes

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23
Q

What is considered to be the most important measure to reduce the spread of MRSA in the health care setting?

A

Hand hygiene

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24
Q

What type of virus is norovirus?

A

Non-enveloped, single stranded RNA virus

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25
Q

Norovirus is a major cause of which outbreaks?

A

Outbreaks of acute gastroenteritis

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26
Q

What is the treatment for norovirus?

A

No specific treatment - supportive measures

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27
Q

How is norovirus mainly transmitted?

A

Faecal-oral

Also respiratory

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28
Q

Define healthcare infections

A

Infections arising as a consequence of providing healthcare

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29
Q

To be defined as a healthcare infection, onset has to be at least ______ hours after admission

Why is this?

A

48

To allow for the incubation period of the infection

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30
Q

As well as affecting patients, healthcare infections can also affect…

A

Hospital visitors

Healthcare workers

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31
Q

Give an example of common healthcare …

I) Viruses (2)
II) Bacteria (2)
III) Fungi (2)
IV) Parasite (1)

A

Norovirus, Hep B, Hep C, HIV

MRSA, C diff, E. coli

Candida albicans
Aspergillus species

Malaria

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32
Q

Name some patient factors that result in increased risk of acquiring infections

A 
Extremes of age
Diabetes 
Smoker 
Cancer 
Obesity/Malnourished
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33
Q

What are the 4 P’s of infection prevention and control?

A

Patient
Pathogen
Practice
Place

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34
Q

How is antimicrobial prophylaxis administered before surgery?

A

A single dose is given just before surgery - a sufficient concentration required for the length of time the incision is open

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35
Q

What is commonly given as a preventative measure for Staph aureus?

A

Mupirocin nasal ointment

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36
Q

Give an example of a ‘physical barrier’ involved in the isolation of infected patients

A

Positive pressure rooms

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37
Q

All healthcare workers are immunised against _________ as it is very infectious

A

Hep B

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38
Q

What does PPE stand for in regards to infection prevention?

A

Personal protective equipment - e.g. Aprons, gloves

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39
Q

The immune system can recognise/distinguish between which 2 types of microbes…

A

Extracellular microbes

Intracellular microbes

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40
Q

Extracellular microbes divide __________ the cell

Intracellular microbes divide ____________ the cell

A

Outside

Inside

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41
Q

Intracellular microbes are usually…

A

Viruses

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42
Q

Name the three stages of how an APC works

A

Capture

Processing presentation

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43
Q

The main job of APCs is to…

A

Present antigens to the cells of the adaptive immunity (T cells)

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44
Q

APCs are found in strategic locations such as…

4

A

Skin - SALT
Mucous Membranes MALT - GALT, NALT, BALT, GUALT
Lymphoid organs
Blood circulation

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45
Q

Give two examples of lymphoid organs

A

Lymph nodes

Spleen

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46
Q

What is macropinocytosis?

A

Ingestion of soluble particles by cells - e.g. Toxic chemicals released by microbes

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47
Q

Adaptive immunity can be split into…

A

Humoral immunity

Cell dependent immunity

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48
Q

Humoral immunity acts through…

A

Antibodies circulating in the fluid

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49
Q

Cell-mediated immunity acts through…

A

Phagocytosis or cytotoxicity

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50
Q

What is the primary target of the humoral immunity?

A

Extracellular pathogens (bacteria)

51
Q

What is the primary target of the cell mediated immunity?

A

Intracellular pathogens (viruses)

52
Q

Extracellular pathogens are usually…

Intracellular pathogens are usually…

A

Bacteria

Viruses

53
Q

Name 4 APCs

A

Dendritic cells
Langerhans cells
Macrophages
B cells

54
Q

In what locations of the body are dendritic cells usually found?

What type of cells do dendritic cells present to?

A

Lymph nodes
Mucous membranes
Blood

Naive T cells

55
Q

Where are Langerhans cells typically found in the body?

What cells do Langerhans cells usually present to?

A

Skin

Naive T cells

56
Q

Where are macrophages typically found in the body?

Which cells do they present to?

A

In various tissues

Effector T cells

57
Q

Where are B cells typically found in the body?

What cells do they present to?

A

Lymphoid tissues

Effector T cells
Naive T cells

58
Q

What are naive T cells?

A

Cells that have not yet been activated by an APC or exposed to an antigen

59
Q

What are effector T cells?

A

Cells that have already been activated by an APC besides macrophages/B cells

60
Q

What are PAMPs?

What are they recognised by?

A

Pathogen Associated Molecular Patterns

Microbes have PAMPS which can be recognised by the PRRs on APCs

61
Q

How are the APCs processing the different antigens able to activate the right response?

A

Through the action of a set of proteins called MHCs - major histocompatibility complex

62
Q

What does MHC stand for?

A

Major histocompatibility complex

63
Q

Antigen presentation is carried out by which set of proteins?

A

MHC

64
Q

Name three features of the humoral immunity

A

Antibodies
Complement
Phagocytosis

65
Q

Name three features of the cell dependent immunity

A

Cytotoxic T lymphocytes
Antibodies
Macrophages

66
Q

Name two types of MHC molecules

A

Class I molecules

Class II molecules

67
Q

Where are class I MHCs found?

A

Found on all nucleated cells

68
Q

Where are class II MHCs found?

A

Dendritic cells
Macrophages
B cells

ONLY APCs

69
Q

MHC-I is found on all nucleated cells and is central to anti-________ immunity

A

Viral

70
Q

All MHCs are coded for by…

A

The p arm of chromosome 6

71
Q

What features of MHC molecules ensures an increased number of different/diverse MHC molecules?

A

There is co-dominant expression of the genes coding for MHC molecules - both parental genes are expressed

72
Q

The genes coding for MHCs are polymorphic, what is meant by this?

A

Different alleles exist exist among different individuals —> increased presentation of different antigens/microbes

73
Q

MHC class I molecules present peptides from ____________ microbes

MHC class II microbes present peptides from ____________ microbes

A

Intracellular

Extracellular

74
Q

Describe the structure of a MHC class I molecule

A

4 subunits - a1, a2, a3, B2

Peptide binding cleft between subunits a1 and a2

75
Q

Describe the structure of a MHC class II molecules

A

4 subunits - a1, a2, B1, B2

Peptide binding cleft found between a1 and B2 subunits

76
Q

Where is the peptide binding cleft found on…

I) MHC Class I Molecules
II) MHC Class I Molecules

A

Between a1 and a2 subunits

Between a1 and B1 subunits

77
Q

The peptide binding cleft of MHC molecules are variable regions with highly polymorphic residues.

What happens here?

A

Big microbe is processed into small peptides before being presented

78
Q

Are many or few peptides presented by the same MHC molecule?

A

Many peptides

79
Q

Which T cells recognise MHC class I molecules?

A

CD8+ T cells

80
Q

Which T cells recognise MHC class II molecules?

A

CD4+ T cells

81
Q

Which MHC molecule can present slightly shorter peptides?

A

MHC Class I

82
Q

APCs often express which MHCs?

A

Both MHC class I and MHC class I - (they are nucleated)

83
Q

Name two antigen processing pathways

A

Endogenous pathway

Exogenous pathway

84
Q

Which cells carry out the endogenous pathway of antigen presentation?

A

All cells

85
Q

Which microbes are targeted by the endogenous pathway of antigen processing?

A

Intracellular microbes (viruses)

86
Q

Which MHC molecules/T cells are involved in the endogenous pathway of antigen processing?

A

MHC Class I

CD8+

87
Q

What happens in the endogenous pathway of antigen processing?

A

Proteasome degrades any ubiquitin labelled proteins in the cytoplasm (self or non-self)

Proteasome produces small antigenic peptides

Antigenic peptides transported in the ER via TAP1 and TAP2 transporters

MHC class I proteins are produced all the time - once there is the right match between the self antigen/viral peptide and MHC class I molecules

Once there is a match the MHC class I/antigen complex is moved to the cell membrane and expressed

88
Q

Which proteins are degraded by proteasome in the endogenous pathway of antigen processing?

A

Any ubiquitin labelled proteins (self or non-self)

89
Q

How are antigenic peptides produced by the action of proteasome transported into the ER in the endogenous pathway of antigen processing?

A

Via specific transporters - TAP1 and TAP2

90
Q

The exogenous pathway of antigen processing takes place in which cells?

A

APCs

91
Q

The exogenous pathway of antigen processing targets which microbes?

A

Extracellular microbes

92
Q

Which MHC molecules/T cells are involved in the exogenous pathway of antigen presentation?

A

MHC Class II

CD4+ T cells

93
Q

Describe the exogenous pathway of antigen presentation

A

Microbe is engulfed and fuses with lysosome

Degradation of microbe into antigenic peptides

The endosome containing the antigenic peptides fuses with a vesicle containing MHC class II molecules

Match between the antigenic peptide and right MHC class II molecule made

Complex expressed at cell membrane

94
Q

What happens to antigenic peptides that do not find an MHC class II match in the exogenous pathway of antigen processing?

A

They are degraded

95
Q

In the exogenous/endogenous pathways of antigen processing/presentation are both self and non-self peptides presented?

A

Yes

96
Q

Both self and non-self peptides are presented in the endogenous/exogenous pathways.

How do T cells not respond to self proteins?

A

They are trained during their development not to react to self proteins

97
Q

All peptides from the same microbe are presented by _______________ MHC molecules

A

Different

98
Q

In HIV, you will see a reduction in the number of which type of T cell?

A

CD4+ T cells

99
Q

Why can some individuals test positive for HIV but their CD4+ cell count be normal/viral load be low?

A

Some patients are called elite controllers and can control viral replication

100
Q

How is an effective T cell response achieved against HIV in elite controllers?

A

MHC molecules in elite controllers present key peptides that are essential for the survival of the virus

101
Q

Why is there typically a poor T cell response to HIV in most individuals?

A

MHC molecules present mutated peptides of the HIV virus that aren’t critical for the survival of the virus

102
Q

What are two clinical problems associated with MHC molecules

A

Organ transplant rejection

Autoimmune disease

103
Q

What happens to cause organ transplant rejection with regards to MHC molecules?

A

There is a mismatch between donor and recipient MHC molecules

104
Q

Graft-Versus-Host reaction is commonly associated with…

What happens in GVH?

A

Bone marrow transplant

Immune cells in the donated tissue recognise the recipient as non-self

105
Q

Name an autoimmune disease associated with MHC molecules

A

Ankylosing spondylitis

106
Q

Extracellular microbes are dealt with by the ____________ immunity. Microbes are processed via ___________ pathways and presented with __________ molecules which are recognised by ________ T cells

A

Humoral

Exogenous

MHC Class II

CD4+ T cells

107
Q

Intracellular microbes are dealt with by the ________________________ immunity. Microbes are processed by the ____________________________ pathways and presented with ___________ molecules. Which are recognised by ___________ T cells.

A

Cell-dependent

Exogenous/endogenous

MHC Class I/MHC Class II

CD8+ T Cells/CD4+ T Cells

108
Q

Can cytotoxic T cells be activated without CD4+ T cells?

What is evidence for this?

A

No

In patients with HIV - there is a low CD4+ cell count and low action of cytotoxic T cells

109
Q

Where are T lymphocytes produced? Where are they matured?

A

Bone marrow

Thymus

110
Q

How do T cells recognise antigens?

A

Through specific TCRs - T cell receptors

111
Q

CD4+ T cells are also known as…

A

T helper cells

112
Q

CD8+ T cells are also known as…

A

T killer cells

113
Q

T cells are categorised based on…

A

The cytokine they produce

114
Q

Describe the general structure of a TCR

A

Consists of a variable and a constant region

115
Q

Cytotoxic T lymphocytes kill target infected cells by the action of which chemicals?

A

Perforins

Granzymes

116
Q

Eosinophils are involved in the killing of ____________

A

Parasites

117
Q

Mast cells particularly produce which immunoglobulin?

A

IgE

118
Q

Name 4 immune functions of IgG

A

Fc-dependent phagocytosis
Complement activation
Neonatal immunity
Toxin/virus neutralisation

119
Q

Name 1 immune function of IgA

A

Mucosal immunity

120
Q

Name two immune functions of IgE

A

Immunity against Helminths

Mast cell degradation (allergies)

121
Q

Name one function of IgM

A

Complement activation

122
Q

Extracellular pathogens trigger the _____________ immunity

A

Humoral

123
Q

Intracellular pathogens trigger the ______________________ immunity

A

Cell-mediated

Infection (10 decks)

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