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IDPH > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Does innate immunity have memory?

A

no

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2
Q

According to Steele, what triggers viral fusion with host DNA entry into cells?

A

acidification of lysosome

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3
Q

What type of virus does bile destroy?

A

Enveloped

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4
Q

Which two types of interferon do virus infected cells produce?

A

alpha and beta

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5
Q

What are the two anti-viral interferons?

A

alpha and beta

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6
Q

Which type of interferon do leukocytes produce?

A

Alpha

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7
Q

Which type of interferon do fibroblasts produce?

A

beta

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8
Q

What does interferon do to MHC One levels?

A

increase

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9
Q

By which two mechanisms does interferon inhibit protein synthesis?

A

RNA degradation

inhibiting eIF2

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10
Q

What activates NK cells on a potential target cells?

A

down-regulation/absence of MHC one

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11
Q

By what mechanism can NK cells undergo ADCC?

A

Fc receptors are cross-linked by IgG bound to target cell

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12
Q

Through which two cytokines can macrophages kill viruses?

A

TNF-alpha

nitric oxide

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13
Q

What site of the body has short-lived immunity?

A

mucosal sites

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14
Q

Is humoral protection more important in early or late part of an infection?

A

early

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15
Q

According to Steele, which two bacteria can survive in macrophages?

A

Listeria and Mycobacteria

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16
Q

Which cells produce IL12? What is the function of IL12?

A

macrophage

NK cells to produce interferon-gamma

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17
Q

Interferon-gamma can induce a macrophage to produce which antimicrobial cytokine?

A

nitric oxide

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18
Q

What is the function of IL4?

A

mediate a TH2 response

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19
Q

Is the formation of a granuloma a TH1 or TH2 response?

A

TH1

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20
Q

How do mycobacteria invade the immune system?

A

inhibit fusion of phagosome and lysosome

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21
Q

Is tuberculoid leprosy a TH1 or TH2 response?

A

TH1

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22
Q

Is lepromatous leprosy a TH1 or TH2 response?

A

TH2

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23
Q

Which immunoglobulin isotype can compensate for IgA during IgA deficiency?

A

IgM

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24
Q

Which bacteria can make C3 Protease?

A

S. pneumoniae

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25
Q

Which bacteria has a Type 3 Secretion System?

A

Salmonella typhi

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26
Q

What gene is turned down by a bacteria that has a T3SS? What cytokine is subsequently turned down?

A

NFKB

TNF

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27
Q

Which two cytokines mediate septic shock?

A

TNF and IL1

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28
Q

Which two proteins are linked by superantigens?

A

MHC II and TCR

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29
Q

Which organelle is targeted during Rheumatic Fever?

A

Sarcolemma

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30
Q

Is a TH1 or TH2 response better at clearing Syphillis?

A

TH1

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31
Q

Is a TH1 or TH2 response better at clearing Borrelia?

A

TH1

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32
Q

Which two human components may syphillis possess molecular mimmicry with?

A

fibronectin and collagen

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33
Q

Is a TH1 or TH2 process better for clearing fungi?

A

TH1

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34
Q

What does histamine do to lymph flow?

A

increase

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35
Q

What amino acid can be decreased due to IFN? Protect against?

A

tryptophan

Parasites

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36
Q

Is a TH1 or TH2 process better for clearing Schistosoma?

A

TH1

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37
Q

IL12 can be downregulated by what parasite?

A

Leishmania

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38
Q

Which cytokine is a bad prognostic indicator for a P. falciparum infection?

A

TNF

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39
Q

Filarial worms lodged in lymphatic channels induce what sort of immunity?

A

TH1

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40
Q

Are more cases of otitis media caused by viral or bacterial origins?

A

viral

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41
Q

What are treatment for otitis media?

A

Amoxicillin

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42
Q

What antibiotic is used for H. flu?

A

ampicillin

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43
Q

What antibiotic is used for recurrent otitis media?

A

Amoxicillim/Clavulanate

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44
Q

What must be used to diagnose serous otitis media?

A

pneumoscopy

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45
Q

What is used for treatment of fungal otitis externa?

A

azole

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46
Q

What three drugs are used to treat bacterial otitis externa?

A

neomycin

polymyxin B

hydrocortisone

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47
Q

What drug is used to treat otitis externa if worried about tissue penetration?

A

cipro

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48
Q

What drug is not used to treat acute sinusitis?

A

anti-histamines

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49
Q

What antibiotic is used for acute sinusitis?

A

amoxicillin

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50
Q

What drug does Benzoni say is used to treat pseudomonas sinusitis?

A

Cipro

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51
Q

What are the two gamma-hemolytic bacteria?

A

Enterococcus

Peptostreptococcus

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52
Q

What drug is used to treat Strep throat?

A

Penicillin

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53
Q

Antibiotics decrease the risk of what post-streptococcal complication? Which one doesnt decrease?

A

decrease = rheumatic fever

doesnt decrease = glomerulonephritis

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54
Q

Are antibiotics used to treat Salmonella?

A

no

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55
Q

What are the three non-lactose fermenting, oxidase-negative gram-negative rode?

A

Shigella

salmonella

Proteus

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56
Q

Is ribavirin used for tolerated RSV?

A

no

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57
Q

Is herpes painful or painless?

A

painful

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58
Q

Does HIPPA apply to public health?

A

no

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59
Q

What pathogen is the most common cause of fungal esophagitis?

A

Candida

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60
Q

What appearance would candida esophagitis have imaging?

A

“cobblestone”

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61
Q

What specific drug is used to treat oral candidiasis?

A

Fluconazole

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62
Q

What two drugs are used to treat oral candidiasis is fluconazole fails?

A

IV echinocandin

Amphotericin B

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63
Q

What is the common suffix for echinocandins?

A

-fungin

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64
Q

What drug is used to treat herpes esophagitis?

A

acyclovir

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65
Q

What two drugs are used to treat CMV Esophagitis?

A

gangciclovir or valgangciclovir

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66
Q

Why doesnt serology work for H. pylori?

A

cant distinguish acute vs. chronic infection

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67
Q

Raspberries from Guatamala may be indicative of what bug?

A

Cyclospora

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68
Q

Are fecal leukocytes present in inflammatory or non-inflammatory diarrhea?

A

non-inflammatory

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69
Q

Which three bacteria are known to cause inflammatory diarrhea?

A

Shigella

Salmonella

Campylobacter

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70
Q

What is the best tool for C. difficile?

A

stool sample

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71
Q

What drug is used for C. difficle with a white count over 15K?

A

oral vancomycin

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72
Q

What drug is used for C. difficle with a white count under 15K?

A

metronidazole

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73
Q

What drugs are not included in the treatment of C. difficile?

A

rifampin or rifaximin

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74
Q

What type of vancomycin treatment is equal in efficacy for C. difficile?

A

low or high dose oral

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75
Q

What is the time-frame for Metronidazole treatment for C. diff?

A

only for first occurrence

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76
Q

What drug is used for recurring C. diff?

A

vancomycin

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77
Q

What is the preferred imaging modality for meningitis?

A

MRI

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78
Q

What is the most important parameter in choosing an agent for CNS infections?

A

penetration

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79
Q

Bactericidal or bacterostatic for CNS infections?

A

cidal

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80
Q

Would an antibiotic with low or high protein binding be better for CNS infections?

A

low

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81
Q

When are surgeons called for a CNS infection?

A

abscess

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82
Q

What are the two most common bacterial causes of CNS infections in the elderly?

A

S. pneumo and Neisseria

83
Q

What is measured during a Cryptococcal infection?

A

opening pressure

84
Q

What two drugs are used to treat Cryptococcus infection?

A

Fluconazole and Ampho B

85
Q

What can complicate chronic meningitis?

A

hydrocephalus

86
Q

Are UTIs more common in male or female neonates?

A

male

87
Q

What is the occurence for UTIs in individuals over 50?

A

equal

88
Q

Treat asymptomatic UTI in elderly?

A

no

89
Q

Treat a UTI with a foley in?

A

no

90
Q

What type of ratio cannot be relied on for a urinalysis regarding Epi/WBC?

A

equal

91
Q

How is chlamydia found during a UTI?

A

PCR

92
Q

Two drugs for STDs?

A

Ceftriaxone

Azithromycin

93
Q

According to Benzoni, foley with pyelonephritis?

A

no

94
Q

What temperature for SIRS criteria?

A

> 38C or

95
Q

What is the respiratory rate and PCO2 for SIRS?

A

> 20 or less than 32 PCO2

96
Q

What is the HR for SIRS?

A

greater than 90

97
Q

What are the two white cell counts for SIRS?

A

> 12K or less than 4K

98
Q

What is the bandemia for SIRS?

A

> 10%

99
Q

How many SIRS criteria are required for sepsis? With what else?

A

2/4

suspicion of infection

100
Q

How much liquid should be given to a person before we diagnose them with septic shock?

A

30 mL/Kg

101
Q

What is done before antibiotics regarding sepsis?

A

cultures

102
Q

What is the test for Rhabdomyolysis?

A

Creatinine kinase

103
Q

What mean arterial pressure is maintained during sepsis?

A

65

104
Q

What is the formula for MAP regarding sepsis?

A

(systolic)(2xDBP)/3

105
Q

What is the fluid of choice for sepsis?

A

Crystalloids

106
Q

What is the first-line pressor?

A

NorE

107
Q

What is the first alternative for NorE?

A

epinephrine

108
Q

Which pressor can decrease NorE requirements? What else does this pressor do?

A

Vasopressin

raise MAP

109
Q

Antibiotics should be administered within how long of a suspicion of septic shock?

A

one hour

110
Q

Narrow or broad spectrum antibiotics for sepsis? Do what as soon as possible?

A

broad

de-escalate

111
Q

What is urine output goal for sepsis?

A

> 0.5 mL/Kg/Hr

112
Q

Is Rectal temperature higher or lower than oral?

A

higher

113
Q

Broad spectrum antibiotic for age 3-36 months with fever of unknown origin?

A

Ceftriaxone

114
Q

What does Listeria to do the phagosome of macrophages?

A

disrupt it

115
Q

Does tuberculoid or lepromatous Mycobacteria infection have disseminated bacteria?

A

Lepromatous

116
Q

Bacteria express what nucleic acid antigen to activate macrophages?

A

unmethylated CpG dinucleotide

117
Q

What does complement do to gram-negatives?

A

lyse

118
Q

What does complement do to gram-positives?

A

opsonize

119
Q

Which two bacteria express M-protein?

A

Strep pneumo

Strep pyogenes

120
Q

What are the two cytokines to induce DIC?

A

TNF and IL1

121
Q

Adaptive immunity clears what fungal pathogen?

A

Candida

122
Q

What is the normal CSF/Serum glucose ratio ?

A

0.6

123
Q

A CSF/Serum glucose ratio less than what is suspicious?

A

0.5

124
Q

Steroids could be administered during meningitis to target inflammation in what area?

A

Subarachnoid space

125
Q

Dexamethasone can be used to target which bacteria causing meningitis? Which broad class?

A

Strep pneumo

gram-positive cocci

126
Q

What drug for all patients with encephalitis?

A

Acyclovir

127
Q

WHo can be treated for a UTI based on symptoms?

A

sexually active females

128
Q

What does pyelonephritis with a stone equal?

A

intra-abdominal abscess

129
Q

According to Aoki, what are the three most common causes of sepsis?

A

UTI

pneumonia

GI infection

130
Q

Fluids should be continued to be administered to a patiet in shock as long as?

A

there is hemodynamic improvement

131
Q

What is superior for gram-negative sepsis, combination therapy or monotherapy?

A

combination

132
Q

What would be the bandemia for SIRS?

A

greater than 10%

133
Q

What infection may cause patients to be leukopenic?

A

Neisseria Meningitidis

134
Q

What are the four catergories for Fever of Unknown Origin?

A

Neutropenic

Nosocomial

HIV-associated

classical

135
Q

Which type of patient may require trials of antibiotics with an FUO?

A

Neutropenic

136
Q

Would quarantine or isolation be used if someone was suspected of having the disease?

A

Isolation

137
Q

Would quarantine or isolation be used if someone was exposed to the disease?

A

quarantine

138
Q

What does complicated mean?

A

involvement of tissue structures

139
Q

What does recurrence mean regarding a UTI?

A

3 or more per year

140
Q

What does relapse mean regarding a UTI?

A

treatment failure

141
Q

What does reinfection mean?

A

new organism

142
Q

According to Benzoni, does UTI in a male neonate correlate with hypospadias or epispadias?

A

hypospadias

143
Q

What is a gold UTI specimen?

A

catheter

144
Q

Concentrated urine will have a specific gravity higher than what?

A

1.010

145
Q

What is better, a urethral wash or a urethral swab?

A

urethral wash

146
Q

Does pyelonephritis get a foley?

A

no

147
Q

What is systolic pressure under for severe sepsis?

A

90

148
Q

What is MAP under for severe sepsis?

A

70

149
Q

Creatinine above what for severe sepsis?

A

2.0

150
Q

PT/INR above what for severe sepsis?

A

1.5

151
Q

Platelet count under what for severe sepsis?

A

100,000

152
Q

According to Aoki, what doesn venous oxygen saturation have to be greater than to be considered adequate ?

A

70%

153
Q

What two areas dont have major physical barriers to infection?

A

eye and genito-urinary

154
Q

What immune cell is the first defense against virus infected cells?

A

NK cells

155
Q

Where do plasma cells reside?

A

bone marrow

156
Q

What causes a memory Bcell to differentiate into a plasma cells?

A

reencountering antigen

157
Q

When are CTLs needed in a virus infection?

A

established infection

158
Q

What cytokine is produced by CTLs to interfere with viral replication?

A

TNF-alpha

159
Q

Which cell is constantly active, memory Bcell or memory Tcell?

A

memory Bcell

160
Q

Would lepromatous of tuberculoid leprosy have hypergammaglobulinemia?

A

Lepromatous

161
Q

Which amino acid sequence can be recognized by phagocytes?

A

Arg-Gly-Aspartate

162
Q

Phagocytic cells have receptors for which opsonization proteins?

A

C3b and IgG

163
Q

What is the only thing the alternative pathway of complement requires?

A

microbial surface

164
Q

Would humoral or cell-mediated response predominate for bacterial infections?

A

Humoral

165
Q

Which three bacteria would a neonate have increased susceptibility to after disappearance of maternal antigens?

A

S. pneumo

HiB

Neisseria men.

166
Q

Which spirochete can be killed by complement?

A

Borrelia

167
Q

Which spirochete coats itself with host proteins? What does this help it evade?

A

Borrelia

Phagocytosis

168
Q

Do fungi elicit humor, CTL or both?

A

both

169
Q

Is cryptococcus cleard by TH1 or TH2?

A

TH1

170
Q

Is Histo cleard by TH1 or TH2?

A

TH2

171
Q

According to Steele, which two parasites survive in macrophages?

A

Leishmania

Trypanosoma

172
Q

According to the GI guy, what species of Candida is most concerning?

A

Candida cruzii

173
Q

Repeat urea breath test and stool antigen how long after quadruple therapy?

A

6-8 weeks

174
Q

What bug for home canned foods?

A

Clostridium perfringens

175
Q

What bug for caesar salad?

A

Salmonella

176
Q

Which virus can be from shellfish?

A

Hep A

177
Q

What three bugs have preformed toxins?

A

C. perfringens

S. aureus

B. cereus

178
Q

Is vibrio inflammatory or non-inflammatory?

A

non-inflammatory

179
Q

Is stool testing required to measure treatment of C. diff?

A

no

180
Q

What drug is the three drugs for C. diff?

A

Metronidazole/Vancomycin/Fidoximycin

181
Q

IV or oral vancomycin for C. diff?

A

oral

182
Q

What is the normal CSF cell count?

A

0-5

183
Q

What condition can produce a transient increase in CSF white count that is non-infectious?

A

Seizure

184
Q

Would fungal or bateria have a higher WBC white count?

A

bacteria

185
Q

Draw serum glucose before or after spinal tap?

A

before

186
Q

CSF protein above what is abnormal?

A

50

187
Q

Drug for S. epi meningitis?

A

vancomycin

188
Q

Drug for pseudomonas meningitis?

A

Ceftazadime

189
Q

What drug usually used for sepsis does not cross the BBB?

A

Piperacillin

190
Q

What drug for neuro Lyme?

A

Ceftriaxone

191
Q

What is normal opening pressure?

A

50-180

192
Q

How long must chronic meningitis last?

A

four weeks

193
Q

What are the three bugs for chronic meningitis?

A

Borrelia

T. pallidum

M. TB

194
Q

Where are the temperature sensors in the body?

A

skin and muscle

195
Q

What are the two non-classical neoplastic causes of unknown fever?

A

RCC

Hepatoma

196
Q

Does lepromatous leprosy have present or absent Tcell responses?

A

Absent

197
Q

What is used to correctly Dx Serous Otitis Media?

A

Pneumoscopy

198
Q

Who did the analysis and didnt like Snow?

A

Farr

199
Q

How long on bactrim for UTI?

A

3 days

200
Q

Is cystitis usually afebrile or febrile?

A

afebrile

201
Q

What correlates with severity of sepsis?

A

Lactate

202
Q

Two drugs for empirical coverage in suspected acute bacterial meningitis?

A

Ceftriaxone

Vanc

203
Q

What cause hyperthermia?

A

insufficient dissipation

IDPH (2 decks)

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