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Sheet4-表格 1 Flashcards

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1
Q

Define hyperacute transplant rejection.

A

Antibody-mediated due to the presence of preformed anti-donor antibodies in the transplant recipient. Occurs within minutes after transplantation.

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2
Q

Define Ig allotype.

A

Ig epitope that differs among members of the same species (on light or heavy chain)

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3
Q

Define Ig idiotype.

A

Ig epitope determine by the antigen-binging site (specific for a given antigen-binding site)

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4
Q

Define Ig isotype.

A

Ig epitope common to a single class of Ig (5 classes, determined by the heavy chain)

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5
Q

Give 3 classic examples of bacteria with antigen variation.

A

(1) Salmonella (2 flagellar variants)
(2) Borrelia (relapsing fever)
(3) Neisseria gonorrhoeae (pilus protein)

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6
Q

Give 3 examples of possibly causes for SCID?

A

(1) failure to synthesize class II MHC antigens
(2) defective Il-2 receptors
(3) adenosine deaminase deficiency

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7
Q

Goodpasture’s syndrome is associated with what kind of autoantibodies?

A

anti-basement membrane antibodies.

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8
Q

Helper T cells have CD(?) which binds to class (?) MHC on antigen-presenting cells.

A

CD4 binds to class II MHC

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9
Q

How does Bruton’s agammaglobulinemia usually present?

A

as bacterial infections in boys after about 6 months of age, when levels of maternal IgG antibody decline

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10
Q

How is active immunity acquired?

A

Active immunity is induced after exposure to foreign antigens. There is a slow onset with long-lasting protection.

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11
Q

How is passive immunity acquired?

A

by receiving preformed antibodies from another host. Antibodies have a short life span, but the immunity has a rapid onset.

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12
Q

IL-4 promotes the growth of B cells and the synthesis of what 2 immunoglobulins?

A

IgE and IgG

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13
Q

In what immune deficiency do neutrophils fail to respond to chemotactic stimuli?

A

Job’s syndrome

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14
Q

In what T-cell deficiency do the thymus and parathyroids fail to develop owing to failure of development of the 3rd and 4th pharyngeal
pouches?

A

Thymic aplasia (DiGeorge syndrome)

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15
Q

Job’s syndrome is associated with high levels of what immunoglobulin?

A

IgE

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16
Q

MHC I Ag loading occurs in __(1?)__ while MHC II Ag loadingoccurs in __(2?)__?

A

(1) in rER (viral antigens)

(2) in acidified endosomes.

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17
Q

Primary biliary cirrhosis has what kind of autoantibodies?

A

anti-mitochondrial antibodies

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18
Q

Role of TH1 cells?

A

produce IL-2 (activate Tc cells and further stimulate TH1 cell) and g-interferon (activate macrophages)

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19
Q

Role of TH2 cells?

A

produce IL-4 and IL-5 (help B cells make Ab)

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20
Q

Sensitized T lymphocytes encounter antigen and then release lymphokines which
leads to macrophage activation’ in what hypersensitivity reaction?

A

Type IV

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21
Q

TB skin test, transplant rejection, and contact

dermatitis are examples of what type of hypersensitivity reaction?

A

Type IV

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22
Q

The 3 kinds of MHC class I genes are…

A

A, B, and C

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23
Q

The 3 kinds of MHC class II genes are…

A

DP, DQ, DR

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24
Q

The Fc portion of immunoglobulins are at the __?__ terminal.

A

The carboxy terminal

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25
Q

What 2 cytokines are secreted by macrophages?

A

IL-1 and TNF-a

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26
Q

What 2 kinds of autoantibodies are specific for systemic lupus?

A

Anti-dsDNA and anti-Smith

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27
Q

What 3 cytokines are classified as ‘acute phase cytokines’?

A

IL-1, IL-6, and TNF-a

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28
Q

What 3 ways do interferons interfere with viral protein synthesis?

A

(1) alpha and beta interferons induce production of a second protein that degrades viral mRNA
(2) gamma interferons increase MHC class I expression and antigen presentation in all
cells
(3) activates NK cells to kill virus-infected cells.

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29
Q

What affect do the acute phase cytokines have on fat and muscle?

A

mobilization of energy reserves to raise body

temperature

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30
Q

What affect do the acute phase cytokines have on the bone marrow?

A

Incr. Production of Colony stim. Factor (CS) which leads to leukocytosis

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31
Q

What affect do the acute phase cytokines have on the hypothalamus?

A

increase body temperature

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32
Q

What antibody isotype can cross the placenta?

A

IgG

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33
Q

What are 3 types of antigen-presenting cells?

A

macrophages, B cells, and dendritic cells

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34
Q

What are the maim symptoms of serum sickness an at what period of time following Ag exposure?

A

fever, urticaria, arthralgias, proteinuria, lymphadenopathy 5-10 days after Ag exposure

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35
Q

What are the major symptoms of graft-vs-host disease?M

A

maculopapular rash, jaundice, hepatosplenomegaly, and diarrhea.

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36
Q

What B- and T- cell deficiency, assoc. with IgA deficiency, presents with
cerebellar problems and spider angiomas?

A

ataxia-telangiectasia

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37
Q

What causes the tissue damage associated with Serum sickness?

A

formation of immune complexes of foreign

particles and Abs that deposit in membranes where they fix complement

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38
Q

What class of MHC proteins are the main determinants of organ rejection?

A

class II MHC

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39
Q

What complement components can cause

anaphylaxis?

A

C3a and C5a

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40
Q

What components of the alternative complement pathway make the C3
convertase?

A

C3b, Bb

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41
Q

What components of the alternative complement pathway make the C5
convertase?

A

C3b, Bb, and 3b

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42
Q

What components of the classic complement pathway make the C3 convertase?

A

C4b, C2b

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43
Q

What components of the classic complement pathway make the C5 convertase?

A

C4b, 2b, and 3b

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44
Q

What components of the complement pathway are deficient in Neisseria sepsis?

A

The MAC complex–(C5b, C6, C7, C8, C9)

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45
Q

What cytokines attract and activate neutrophils?

A

TNF-a and B

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46
Q

What disease is associated with a X-linked defect in a tyrosine-kinase gene associated with low levels of all classes of immunoglobulins?

A

Bruton’s agammaglobulinemia

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47
Q

What disease is associated with anti-epithelial cell autoantibodies?

A

Pemphigus vulgaris

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48
Q

What disease is associated with anti-microsomal autoantibodies?

A

Hashimoto’s thyroiditis

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49
Q

What does a deficiency of C1 esterase inhibitor cause (in the complement cascade)?

A

angioedema because of overactive complement

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50
Q

What does a deficiency of C3 cause (in the complement cascade)?

A

can lead to severe, recurrent pyogenic sinus and respiratory tract infections.

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51
Q

What does deficiency of decay-accelerating factor (DAF) in the complement cascade cause?

A

leads to paroxysmal nocturnal hemoglobinuria

PNH

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52
Q

What does Job’s syndrome classically present with?

A

recurrent ‘cold’ (noninflamed) staphylococcal abscesses

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53
Q

What does TNF-a stimulate dendritic cells to do during the acute phase response?

A

TNF-a stimulates their migration to lymph nodes and their maturation for the initiation of the adaptive immune response.

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54
Q

What elements of the complement cascade made the Membrane Attack Complex (MAC)?

A

C5b, C6, C7, C8, and C9

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55
Q

What Ig is found in secretions as a monomer or a dimer?

A

IgA

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56
Q

What Ig is found in secretions as a monomer or a pentamer?

A

IgM

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57
Q

What immune deficiency disease has an autosomal-recessive defect in phagocytosis that results from microtubular and lysosomal defects of phagocytic cells?

A

Chediak-Higashi disease

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58
Q

What immune deficiency is associated with elevated IgA levels, normal IgE levels, and
low IgM levels?

A

Wiskott-Aldrich syndrome

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59
Q

I L U~

A

I M U~

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60
Q

What immune deficiency presents with tetany owing to hypocalcemia, congenital defects of the heart and great vessels, and recurrent viral, fungal, and protozoal infections?

A

Thymic aplasia (DiGeorge syndrome)

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61
Q

What immunoglobulin isotype has the lowest concentration in serum?

A

IgE

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62
Q

What immunoglobulin isotype is involved in type-I hypersensitivity reactions?

A

IgE

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63
Q

What immunoglobulin isotype is produced in the primary response to an antigen and is
on the surface of B cells?

A

IgM

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64
Q

What immunoglobulin isotype mediates immunity to worms?

A

IgE

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65
Q

What immunoglobulin isotype prevents the attachment of bacteria and viruses to mucous membranes?

A

IgA

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66
Q

What immunoglobulins bind and activate the classic complement pathway?

A

IgG and IgM (the Fc portion)

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67
Q

What interleukin induces naive helper T-cells to become TH1 cells?

A

IL-12

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68
Q

What interleukin induces naive helper T-cells to become TH2 cells?

A

IL-4

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69
Q

What interleukin stimulates the growth of both helper and cytotoxic T-cells?

A

IL-2

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70
Q

What is Chronic mucocutaneous candidiasis?

A

T-cell dysfunction specifically against Candida albicans.

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71
Q

What is important about the CD3 complex?

A

It is a cluster of polypeptides associated with a T-cell receptor and is important in signal transduction.

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72
Q

What is the cellular process that causes type I hypersensitivity?

A

Ag cross-links IgE on presensitized mast cells and basophils, triggering the release of vasoactive amines.

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73
Q

What is the cellular process that causes type II hypersensitivity?

A

IgM, IgG bind to Ag on ‘enemy’ cell, leading to lysis (by complement) or phagocytosis (its cytotoxic).

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74
Q

What is the main antibody in the secondary immune response?

A

IgG

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75
Q

What is the most abundant immunoglobulin isotype?

A

IgG

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76
Q

What is the most common selective immunoglobulin deficiency?

A

selective IgA deficiency

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77
Q

What is the rise in temperature during the acute phase response help do (3 things?)

A

(1) increase specific immune response
(2) increase antigen processing
(3) decrease viral and bacterial replication

78
Q

What is the triad of symptoms seen with Wiskott-Aldrich syndrome?

A

recurrent pyogenic infections, eczema, and

thrombocytopenia

79
Q

What kind of autoantibodies are associated with CREST/Scleroderma?

A

anti-centromere antibodies

80
Q

What kind of autoantibodies are known as rheumatoid factor?

A

anti-IgG antibodies

81
Q

What kind of immunity (antibody-mediated or cell mediated) is involved in autoimmunity?

A

antibody-mediated immunity (B cells)

82
Q

What kind of immunity (antibody-mediated or cell mediated) is involved in graft and tumor rejection?

A

cell mediated immunity (T cells)

83
Q

What kind of transplant rejection is reversible with immunosuppressants such as cyclosporin and OKT3?

A

acute transplant rejection

84
Q

What kinds of adjuvants are included in human vaccines?

A

aluminum hydroxide or lipid

85
Q

What kinds of cells have class II MHC proteins?

A

antigen-presenting cells (e.g. macrophages and dendritic cells)

86
Q

What parasites have antigen variation?

A

trypanosomes (programmed rearrangement)

87
Q

What symptoms characterize the Arthus reaction and what causes them?

A

edema, necrosis, and activation of complement due to the Ag-Ab complexes that
form in the skin following intradermal injection of Ag.

88
Q

What type of cell secretes IL-3?

A

activated T-cells

89
Q

What type of cells does gamma interferon stimulate?

A

macrophages

90
Q

What type of hypersensitivity reaction is the Arthus reaction?

A

type III

91
Q

Where does the alternative complement pathway occur?

A

On microbial surfaces

92
Q

Where does the classic complement pathway occur?

A

antigen-antibody complexes

93
Q

Where is the defect in SCID?

A

the defect is in early stem-cell differentiation, leading to B- and T-cell deficiency

94
Q

Which interleukin causes fever?

A

IL-1

95
Q

Which interleukin enhances the synthesis of IgA?

A

IL-5

96
Q

Which interleukin stimulates the production and activation of eosinophils?

A

IL-5

97
Q

Which interleukin supports the growth and differentiation of bone marrow stem cells?

A

IL-3

98
Q

Which is the only type of cell-mediated hypersensitivity reaction, and thus not transferable by serum?

A

Type IV

99
Q

Wiskott-Aldrich syndrome is a defect in the ability to mount what immune response?

A

an IgM response to capsular polysaccharides of bacteria.

100
Q

With what disease are anti-histone autoantibodies associated?

A

drug-induced lupus

101
Q

With what disease are anti-nuclear antibodies

associated?

A

systemic lupus

102
Q

Aspiration pneumonia is usually caused by…

A

Anaerobes

103
Q

Atypical pneumonia is usually caused by…

A
  • Mycoplasma
  • Legionella
  • Chlamydia
104
Q

Bug Hints: Branching rods in oral infection =

A

Actinomyces israelii

105
Q

Bug Hints: Currant jelly sputum =

A

Klebsiella

106
Q

Bug Hints: Dog or cat bite =

A

Pasteurella multocida

107
Q

Bug Hints: Pediatric Infection =

A

H. influenzae (including epiglottitis)

108
Q

Bug Hints: Pneumonia in CS, burn infection =

A

P. aeruginosa

109
Q

Bug Hints: Pus, Empyema, Abscess =

A

S. aureus

110
Q

Bug Hints: Sepsis/Meningitis in Newborn =

A

Group B strep

111
Q

Bug Hints: Surgical wound =

A

S. aureus

112
Q

Bug Hints: Traumatic open wound =

A

C. perfringens

113
Q

Incidence of what cause of mengitis has decreased with a vaccine?

A

Incidence of H. influenze meningitis has decreased greatly with introduction of H.
influenzae vaccine in the last 10-15 years

114
Q

Most osteomyelitis occurs in what age group?

A

children

115
Q

Neonatal pneumonia is usually caused by…

A
  • Group B streptococci

- E. coli

116
Q

Nosocomial pneumonia is usually caused by…

A
  • Staphylococcus

- gram-negative rods

117
Q

PID includes what disorders in the body?

A

salpingitis, endometritis, hydrosalpinx, tubo-ovarian abscess

118
Q

PID is likely caused by what two organisms? What are the characteristics of the disease
caused by each organism?

A
  • Chlamydia trachomatis: subacute, often undiagnosed

- N. gonorrhoeae:acute, high fever

119
Q

Pneumonia in immunocompromised

patients is caused by…

A
  • Staphylococcus
  • gram-negative rods
  • fungi
  • viruses
  • Pnemumocystis carinii (with HIV)
120
Q

Pneumonia in the alcoholic/IV drug user is usually caused by…

A
  • S. pneumoniae
  • Klebsiella
  • Staphylococcus
121
Q

Postviral pneumonia is usually caused by…

A
  • Staphylococcus

- H. influenzae

122
Q

Salpingitis is a risk factor for…

A
  • ectopic pregnancy
  • infertility
  • chronic pelvic pain
  • adhesions
123
Q

UTIs are found in men in which 2 age groups?

A

Babies with congenital defects and Elderly with enlarged prostates

124
Q

UTIs are mostly caused how?

A

by ascending infections

125
Q

What’s the likely cause of osteomyelitis in a pt where you have no other information?

A

S. aureus

126
Q

What 2 pathogens likely cause nosocomial infections associated with urinary catherization?

A

E. coli, Proteus mirabilis

127
Q

What 2 pathogens likely cause nosocomial infections in the newborn nursery?

A

CMV, RSV

128
Q

What 3 UTI-causing organisms are often

nosocomial and drug-resistant?

A
  • Serratia marcescens
  • Enterobacter cloacae
  • Klebsiella pneumoniae
  • Proteus mirabilis
  • Pseudomonas aeruginosa
129
Q

What 7 organisms are associated with UTIs?

A
  • Serratia marcescens
  • Staphylococcus saprophyticus
  • E. coli
  • Enterobacter cloacae
  • Klebsiella pneumoniae
  • Proteus mirabilis
  • Pseudomonas aeruginosa
    [HINT: SEEKS PP]
130
Q

What abnormal lab result is often seen in osteomyelitis patients?

A

elevated ESR

131
Q

What are 4 clinical findings of Pyelonephritis?

A
  • fever
  • chills
  • flank pain
  • CVA tenderness [c/c with UTI]
132
Q

What are 4 clinical findings of UTIs?

A
  • diysuria
  • frequency
  • urgency
  • suprapubic pain [c/c with pyelonephritis]
133
Q

What are the 2 most common causes of nosocomial infections?

A
  • E. coli causes UTI

- S. aureus causes wound infection

134
Q

What are the 3 most common causes of UTI in young ambulatory women?

A
  1. E. coli (50-80%)
  2. Staphylococcus saprophyticus (10-30%)
  3. Klebsiella (8-10%)
135
Q

What are the common causes of hospital-acquired UTIs?

A
  • E. coli
  • Proteus
  • Klebsiella
  • Serratia
  • Pseudomonas
136
Q

What are the common causes of meningitis in 6-60y/o?

A
  • N. MENINGITIDIS
  • Enteroviruses
  • S. pneumoniae
  • HSV
137
Q

What are the common causes of meningitis in 60+ y/o?

A
  • S. PNEUMONIAE
  • Gram-negative rods
  • Listeria
138
Q

What are the common causesof meningitis in children (6mo-6y/o)?

A
  • S. pneumoniae
  • N. meningitidis
  • H. influenzae B
  • Enteroviruses
139
Q

What are the common causes of meningitis in HIV pts?

A
  • Cryptococcus
  • CMV
  • toxoplasmosis (brain abscess) JC virus (PML)
140
Q

What are the common causes of meningitis in newborns (0-6mos)?

A
  • GROUP B STREPTOCOCCI
  • E. COLI
  • Listeria
141
Q

What are the common causes of osteomyelitis in those with prosthetic replacements?

A

S. aureus and S. epidermidis

142
Q

What are the common causes of pneumonia in adults 18-40 y/o?

A
  • Mycoplasma
  • C. pneumoniae
  • S. pneumoniae
143
Q

What are the common causes of pneumonia in adults 40-65 y/o?

A
  • S. pneumoniae
  • H. influenzae
  • Anaerobes
  • Viruses
  • Mycoplasma
144
Q

What are the common causes of pneumonia in children (6wk-18y)?

A
  • Viruses (RSV)
  • Mycoplasma
  • Chlamidia pneumonia
  • S. pneumoniae
145
Q

What are the common causes of pneumonia in the elderly?

A
  • S. pneumoniae
  • Anaerobes
  • Viruses
  • H. influenzae
  • Gram-neg. rods
146
Q

What are the CSF findings in bacterial meningitis (pressure, cell type, protein and sugar levels)?

A
  • Pressure: incr.
  • Cell type: incr. PMNs
  • Protein: incr
  • Sugar: decr
147
Q

What are the CSF finings in bacterial meningitis (pressure, cell type, protein and sugar levels)?

A
  • Pressure: nl or incr.
  • Cell type: incr. lymphocytes
  • Protein: nl - Sugar: nl
148
Q

What are the CSF finings in fungal/TB meningitis (pressure, cell type, protein and sugar levels)?

A
  • Pressure: incr.
  • Cell type: incr. lymphocytes
  • Protein: incr
  • Sugar:decr.
149
Q

What are the dominant normal florae in the colon?

A

B fragilis > E. coli

150
Q

What are the dominant normal florae in the vagina?

A

Lactobacillus, colonized by E. coli and group B strep

151
Q

What are the predisposing factors of UTIs?

A
  • flow obstruction
  • kidney surgery
  • catherization
  • gynecologic abnormailities
  • diabetes
  • pregnancy
152
Q

What infections are dangerous in pregnancy?

A
  • Toxoplasma
  • Rubella
  • CMV
  • HSV/HIV
  • Syphilis
    [HINT: ToRCHeS]
153
Q

What is chandelier sign?

A

Cervical motion tenderness associated with PID

154
Q

What is the 2nd leading cause of community-acquired UTI in sexually active women?

A

Staphylococcus saprophyticus

155
Q

What is the characteristic of Trichomonas on a slide?

A

motile on wet prep

156
Q

What is the common cause of osteomyelitis in drug addicts?

A

Psudomonas aeruginosa

157
Q

What is the common cause of osteomyelitis in most people?

A

S. aureus

158
Q

What is the common cause of osteomyelitis in sickle cell pts?

A

Salmonella

159
Q

What is the common cause of osteomyelitis in the sexually active?

A

N. gonorrhoeae

160
Q

What is the common cause of osteomyelitis in the vertebra?

A

M. tuberculosis

161
Q

What is the dominant normal flora contributes to dental plaque?

A

S. mutans

162
Q

What is the dominant normal flora in the nose?

A

S. aureus

163
Q

What is the dominant normal flora in the oropharynx?

A

viridans streptococci

164
Q

What is the dominant normal flora on the skin?

A

S. epidermidis

165
Q

What is the most common STD in the U.S.?

A

Chlamydia trachomatis causes 3-4 million cases per year

166
Q

What organism can you presume is causing a

nosocomial infection if respiratory equipment or burns are involved?

A

Psudomonas aeruginosa

167
Q

What organism is the leading cause of UTI and shows a metallic sheen on EMB agar?

A

E. coli

168
Q

What pathogen is associated with hyperalimentation?

A

Candida albicans

169
Q

What pathogen is associated with water (ie. aerosols)?

A

Legionella

170
Q

What pathogen likely causes nosocomial infections in the renal dialysis unit?

A

HBV

171
Q

What population does not have any flora?

A

Neonates delivered by csarean section have no flora but are rapidly colonized after birth

172
Q

What ratio is UTIs found more in women vs. men? Why?

A

10 to 1 because women have short urethrae more likely to be colonized by fecal flora

173
Q

What STD is associated with Argyll-Robertson pupil?

A

3’ Syphilis

174
Q

What STD is associated with clue cells?

A

Garnerella

175
Q

What STD is associated with Genital warts and loilocytes?

What is the causative agent?

A
  • Condylomata acuminata

- HPV 6 and 11

176
Q

What STD is associated with jaundice? What is the causative agent?

A
  • Hepatitis B

- HBV

177
Q

What STD is associated with opportunistic infections, Kaposi’s sarcoma, lymphoma? What is the causative agent?

A
  • HIV
178
Q

What STD is associated with painful penile, vulvar or cervical ulcers? What’s the causative agent?

A
  • Genital Herpies - HSV-2
179
Q

What STD is associated with painful ulcers,

lymphadenopathy, rectal structures? What is the causative agent?

A
  • Lymphogranuloma venereum

- Chlamydia trachomatis

180
Q

What STD is associated with urethritis, cervicitis, conjuntivitis, Reiter’s syndrome PID? What is the causative agent?

A

Chlamydia - Chlamydia trachomatis

181
Q

What STD is associated with vaginitis? What is the causative agent?

A
  • Trichomoniasis

- Trichomonas vaginalis

182
Q

What STD is characterized by painful genital ulcer? What is the causative agent?

A
  • chancroid

- Haemophilus ducreyi

183
Q

What STD is likely in a patient with a painless chancre? What causes it?

A
  • 1’ Syphilis

- Treponema pallidum

184
Q

What STD is likely in a patient with fever, lymphadenopathy, skin rashes, condylomata
lata? What causes it?

A
  • 2’ Syphilis

- Treponema pallidum

185
Q

What STD is likely in a patient with gummas, tabes dorsalis, general paresis, aortitis, Argyll-Robertson pupil? What causes it?

A
  • 3’ Syphilis

- Treponema pallidum

186
Q

What STD is likely in a patient with urethritis, cervicitis, PID, prostatitus, epididymitis, arthritis? What organism causes it?

A
  • Gonorrhea

- Neisseria gonorrhoeae

187
Q

What UTI-causing organism has a bue-green pigment, fruity odor and is usually nosocomial and drug-resistant?

A

Pseudomonas aeruginosa

188
Q

What UTI-causing organism is characterized by a large mucoid capsule and viscous
colonies?

A

Klebsiella pneumoniae

189
Q

What UTI-causing organism is mobile, causing ‘swarming’ on agar and also produces urease and is associated with struvite stones?

A

Proteus mirabilis

190
Q

What UTI-causing organism sometimes produces a red pigment, is often nosocomial
and drug-resistant?

A

Serratia marcescens

Microbiology & Immunology (4 decks)

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