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Infection > Session 7 > Flashcards

Session 7 Flashcards

1
Q

What is the colloquial name for Streptococcal pharyngitis?

A

Strep sore throat

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2
Q

What is streptococcal pharyngitis an infection of?

A

Inflammation of the pharynx - the back of the throat including the tonsils

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3
Q

Which bacteria cause streptococcal pharyngitis?

A

Group A streptococci

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4
Q

Name two common symptoms of pharyngitis

A

Sore throat

Fever

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5
Q

Is the cause of pharyngitis most commonly, viral or bacterial?

A

Viral

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6
Q

Name three viruses that are known to cause pharyngitis

A

Adenovirus
Influenza virus
Epstein-Barr virus

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7
Q

What is a fungal cause of pharyngitis?

A

Candida albicans

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8
Q

What is the treatment for most cases of streptococcal pharyngitis?

A

Supportive treatments - usually gets better without antibiotics

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9
Q

Cervical lymph nodes are common in…

A

Children

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10
Q

When may cervical lymph nodes in children enlarge? They usually settle over a few…

A

With either viral or bacterial infection

Weeks

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11
Q

What does EBV in the saliva infect to cause pharyngitis?

A

Epithelial cells and then B cells of the oropharynx

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12
Q

What does EBV trigger in infected B cells?

A

B cell proliferation

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13
Q

Which T cells recognise EBV infected cells and coordinate the response against them?

A

CD4+ T Cells

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14
Q

Which type of T cell destroy infected EBV B/epithelial cells?

A

CD8+ T cells

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15
Q

Which immunoglobulin is produced in the immune response against EBV infected cells in the oropharynx in pharyngitis?

A

IgM

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16
Q

_______________ produced in response to EBV dramcatically activate the immune system

A

Cytokines

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17
Q

The excess TNF and IL-6 produced in the immune response against EBV infected cells causes which symptoms for the patient with pharyngitis?

A

Fever

Fatigue

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18
Q

What makes a host with EBV infected cells infectious?

A

Occasional bursts of lytic infection in oro-pharyngeal B cells

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19
Q

What is endemic disease?

A

The usual background rate of disease

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20
Q

What is an outbreak?

A

Two or mor cases linked in time and place

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21
Q

What is an epidemic?

A

A rate of infection greater than the usual background rate

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22
Q

What is a pandemic?

A

A very high rate of infection spreading across many regions/countries/continents

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23
Q

What is meant by R0?

A

The average number of cases that one case generates over the course of its infectious period, in an otherwise uninfected, non-immune population

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24
Q

What effect will an R0 > 1 have on the number of new cases of a disease?

A

Increase in cases

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25
Q

What effect will an R0 = 1 have on the number of new cases of a disease?

A

Stable number of cases

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26
Q

What effect will an R0 < 1 have on the number of new cases of a disease?

A

Decrease in cases

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27
Q

What are the 4 P’s of infection prevention?

A

Pathogen
Patient
Practice
Place

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28
Q

What are three reasons/causes for outbreaks/epidemics/pandemics?

A

New pathogen
New hosts
New practice

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29
Q

What is meant by the term ‘infectious dose’?

A

The number of microorganisms required to cause an infection

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30
Q

The infection dose of a microorganism varies by… (3)

A

The microorganism itself
Presentation of the microorganism
The immunity of potential host

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31
Q

Epidemic curves show…

A

The number of people infected by a disease at each time interval

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32
Q

Small scale outbreaks have a stochastic nature. What is meant by this?

A

They show a random pattern, so can be analysed statistically but not predicted precisely

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33
Q

Infection prevention related to PATHOGEN factors focuses on…

A

Reduction or eradication of the pathogen

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34
Q

What factors related to the pathogen can help in infection prevention?

A

Antibacterials
Decontamination
Sterilisation

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35
Q

What factors related to the vector can help in infection prevention?

A

Eliminate vector breeding sites

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36
Q

Infection prevention related to PATIENT factors focuses on…

A

Improved health/immunity

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37
Q

Infection prevention related to PRACTICE factors focuses on…

A

Avoidance of the pathogen or its vector

  • Behavioural change
  • Protective equipment
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38
Q

What is PPE?

A

Personal protective equipment involved in infection prevention - e.g. Gowns, Gloves and Masks

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39
Q

Give one example of a ‘PLACE’ factor involved in infection prevention

A

Well designed healthcare facilities - no ‘nightingale’ wards

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40
Q

What is a ‘good’ consequence of infection control/prevention?

A

Decreased incidence or elimination of a disease/organism

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41
Q

Give an example of two diseases which have benefited from a decreased incidence/elimination due to infection control/prevention

A

Smallpox

Polio

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42
Q

Give two ‘bad’ consequences of infection prevention/control

A

Decreased exposure to pathogen —> Decreased immune stimulus —> Decreased antibody —> Increased susceptibilities —> Outbreak

Later average age of exposure —-> Increased severity

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43
Q

Give an example of 3 conditions where a later age of exposure results in increased severity

A

Polio
Hep A
Chicken pox

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44
Q

What is herd immunity?

A

The resistance to the spread of a contagious disease within a population that results if a sufficienctly high enough proportion of individuals are immune to the disease (vaccinated)

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45
Q

What type of bacteria is Staph aureus/MRSA?

A

Gram positive

Cocci

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46
Q

What type of bacteria is Staph epidermis?

A

Gram positive

Cocci

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47
Q

What type of bacteria is Streptococcus pneumoniae?

A

Gram positive

Cocci

48
Q

What type of bacteria is Viridans streptococci?

A

Gram positive

Cocci

49
Q

What type of bacteria is Streptococcus pyogenes?

A

Gram positive

Cocci

50
Q

What type of bacteria is Clostridium difficile?

A

Gram positive

Bacilli

51
Q

What type of bacteria is Neisseria meningitidis?

A

Gram negative

Cocci

52
Q

What type of bacteria is Escherichia coli?

A

Gram negative

Bacilli

53
Q

What type of bacteria is Haemophilus influenzae?

A

Gram negative

Bacilli

54
Q

Epstein-Barr Virus is a member of the __________ family

A

Herpes

55
Q

What is the function of the first lines of defence of the innate immune system?

A

They prevent entry and limit growth of pathogens

56
Q

The first lines of defence of the innate immunity include which 4 types of barriers?

A

Physical barriers
Physiological barriers
Chemical barriers
Biological barriers

57
Q

What is the function of the second lines of defences of the innate immunity?

A

They contain and clear the infection

58
Q

What are two examples of second lines of defence of the innate immunity?

What do both factors lead to?

A

Phagocytes
Chemicals (Complement, Cytokines)

Inflammation

59
Q

Describe the stages of phagocytosis

A

Chemotaxis and adherence of microbe to phagocyte

Ingestion of microbe by phagocyte

Formation of a phagosome

Fusion of the phagosome with a lysosome to form a phagolysosome

Digestion of ingested microbe by enzymes

Formation of residual body containing indigestible material

Discharge of waste materials

60
Q

What is the name given to the phagocytic vesicle that foreign material/microbes are ingested in by the phagocyte?

A

Phagosome

61
Q

In phagocytosis, a phagosome fuses with a _______________ to form a ___________________

A

Lysosome

Phagolysosome

62
Q

Give some examples of ‘general’ investigations for a possible infection

A

FBC
CRP
Imaging
Organ dysfunction tests

63
Q

Give examples of what can be measured when investigating the host response in acute sepsis

A

Lactate

Clotting factors

64
Q

What factors are looked at when investigating organ dysfunction in a possible infection?

A

Liver function
Renal function
Oxygen saturation

65
Q

Give examples of some specific investigations for possible infection

A 
Culture 
Antibiotic sensitivity 
Gram stain 
Antigen test
Antibody test 
PCR for microbial DNA
66
Q

Name two methods of testing antibiotic susceptibility

A

Disk-diffusion method

Minimal inhibitory concentration

67
Q

Treatment for an infection can be either…

A

Supportive

Specific

68
Q

Cefuroxime belongs to which antibiotic class?

What can it be used to treat?

A

Beta-lactams —> Cephalosporins

Bronchitis
Gonorrhoea

69
Q

What are some examples of specific treatments for disease/infection?

A

Surgery

Antibiotics/Antivirals/Antiprotozoal

70
Q

Describe the infection model

A

Pathogen + Patient (+ mechanism of infection) —> Infection —> Management —> Outcome

71
Q

What type of bacteria is Neisseria meningitidis?

A

Gram negative

Diplococcus

72
Q

Neisseria meningitidis can be normally found in the…

A

Nasopharynx

73
Q

What is sepsis?

A

Life-threatening organ dysfunction due to a dysregulated host response to infection

74
Q

What is an important virulence factor of Neisseria meningitidis?

A

LPS (endotoxin)

75
Q

What is a specific treatment for meningitis caused by Neisseria meningitidis?

A

Ceftriaxone

76
Q

What sort of rash can be seen in meningitis? How can it be tested for?

A

Purpuric rash

Tumbler test - doesn’t disappear

77
Q

Name three important virulence factors of Streptococcus pyogenes

A

M protein
Streptokinase
Streptococcal pyrogens exotoxins

78
Q

How does M protein act as a virulence factor for Streptococcus pyogenes?

A

Gives resistance to phagocytosis

79
Q

How do M proteins on Streptococcus pyogenes help in resistance against phagocytosis?

A

Inhibit activation of alternative complement pathway on bacterial cell surface

80
Q

Are there more than one type of M protein on Streptococcus pyogenes?

A

Yes over 150 different serotypes (different antigens)

81
Q

There are over 150 antigenically different serotypes of the M proteins found on Streptococcus pyogenes as a consequence of nucleotide variants of ________ gene

A

emm gene

82
Q

How does streptokinase work as a virulence factor for Streptococcus pyogenes?

A

Dissolves clots through the conversion of plasminogen to plasmin

83
Q

Streptokinase found in Streptococcus pyogenes converts ________________ to ___________

A

Plasminogen

Plasmin

84
Q

How do streptococcal pyrogenic exotoxins act as virulence factors for Streptococcus pyogenes?

A

Cleaves IgG bound to Group A Strep

85
Q

What do the streptococcal pyrogenic exotoxins released from Streptococcal pyogenes cleave?

A

IgG bound to group A strep

86
Q

Antibodies consist of which two regions?

A

Variable region

Fc (Fixed component) region

87
Q

Which types of blood cells produce antibodies?

A

B lymphocytes —> Plasma cells

88
Q

What is the first Ig produced in infection?

A

IgM

89
Q

What is the most abundant Ig found in the body? When is it commonly seen?

A

IgG

Foetal development and in neonates

90
Q

What is the second most abundant Ig in the body?

A

IgA

91
Q

Where is IgA commonly found?

A

In secretions

E.g. Breast milk, mucus, saliva, tears

92
Q

In which secretions is IgA found?

A

Breast milk
Mucus
Tears
Saliva

93
Q

IgE is found in the body at what sorts of levels?

A

Low levels

94
Q

Where are T cells produced? Where do they mature?

A

Bone marrow

Thymus

95
Q

CD8+ T cells bind to antigens presented by which molecules?

A

MHC Class I molecules

96
Q

CD4+ T cells bind to antigens presented by which molecules?

A

MHC Class II molecules

97
Q

CD4 + T cells bound to antigens presented by MHC class II molecules activate B cells through the action of which proteins on which cells?

A

CD40L on CD4+ T cell

CD40 on B cell

98
Q

Give three examples of how mucus can act as a physical barrier against infection

A

Traps bacteria/pathogens
Contains enzymes such as lysozyme to degrade pathogens
Cilia beat away pathogenic mucus

99
Q

Mucus contains antimicrobial enzymes including…

A

Lysozyme

100
Q

Name the leukocytes

A 
Neutrophils 
Monocytes/Macrophages 
Dendritic cells 
Mast cells, basophils, eosinophils 
Lymphocytes
101
Q

Give three examples of lymphocytes

A

T cells
B cells
NK cells

102
Q

Which leukocytes are phagocytes?

A

Neutrophils
Monocytes/Macrophages
Dendritic cells

103
Q

Name 4 types of cytokines

A

Chemokines
Interferons
Interleukins
TNF

104
Q

What is the function of chemokines?

A

They attract via chemical gradients

105
Q

What is the function of interferons?

A

Anti-viral

106
Q

What is the function of interleukins?

A

Modulate behaviour

107
Q

What is the function of TNF?

A

Are pro-inflammatory

108
Q

What is the specific function of IL-2 in an immune response?

A

T cell proliferation

109
Q

What is the specific function of IL-10 in the immune response?

A

Anti-inflammatory

110
Q

What is the common complement protein that all the pathways activating the complement cascade converge to?

A

C3

111
Q

Which complement proteins are involved in the formation of a membrane attack complex?

A

C5-C9

112
Q

How does the classical pathway of activating the complement cascade work?

A

Immune complexes bind to C1

C1->C4->C2->C3

113
Q

How does the MBL pathway of activating the complement cascade work?

A

MBL bind mannose contains residues in proteins on the bacterial cell walls mimicking the binding of immune complexes to C1

C1->C4->C2->C3

114
Q

How are pathogens recognised in the innate immunity?

A

PRRs on immune cells recognise PAMPs on pathogen

115
Q

What does the recognition of PAMPs by PRRs in the innate immunity result in?

A

Activation of mast cells/macrophages and the start of the inflammatory response

116
Q

Once mast cells/macrophages are activated by the binding of PAMPs by PRRs in the innate immunity, what happens to each cell?

A

Mast cells produce histamine, TNF, LTs and chemokines

Macrophages (phagocytes) do phagocytosis

Infection (10 decks)

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