Test 1 Flashcards
Does innate immunity have memory?
no
According to Steele, what triggers viral fusion with host DNA entry into cells?
acidification of lysosome
What type of virus does bile destroy?
Enveloped
Which two types of interferon do virus infected cells produce?
alpha and beta
What are the two anti-viral interferons?
alpha and beta
Which type of interferon do leukocytes produce?
Alpha
Which type of interferon do fibroblasts produce?
beta
What does interferon do to MHC One levels?
increase
By which two mechanisms does interferon inhibit protein synthesis?
RNA degradation
inhibiting eIF2
What activates NK cells on a potential target cells?
down-regulation/absence of MHC one
By what mechanism can NK cells undergo ADCC?
Fc receptors are cross-linked by IgG bound to target cell
Through which two cytokines can macrophages kill viruses?
TNF-alpha
nitric oxide
What site of the body has short-lived immunity?
mucosal sites
Is humoral protection more important in early or late part of an infection?
early
According to Steele, which two bacteria can survive in macrophages?
Listeria and Mycobacteria
Which cells produce IL12? What is the function of IL12?
macrophage
NK cells to produce interferon-gamma
Interferon-gamma can induce a macrophage to produce which antimicrobial cytokine?
nitric oxide
What is the function of IL4?
mediate a TH2 response
Is the formation of a granuloma a TH1 or TH2 response?
TH1
How do mycobacteria invade the immune system?
inhibit fusion of phagosome and lysosome
Is tuberculoid leprosy a TH1 or TH2 response?
TH1
Is lepromatous leprosy a TH1 or TH2 response?
TH2
Which immunoglobulin isotype can compensate for IgA during IgA deficiency?
IgM
Which bacteria can make C3 Protease?
S. pneumoniae
Which bacteria has a Type 3 Secretion System?
Salmonella typhi
What gene is turned down by a bacteria that has a T3SS? What cytokine is subsequently turned down?
NFKB
TNF
Which two cytokines mediate septic shock?
TNF and IL1
Which two proteins are linked by superantigens?
MHC II and TCR
Which organelle is targeted during Rheumatic Fever?
Sarcolemma
Is a TH1 or TH2 response better at clearing Syphillis?
TH1
Is a TH1 or TH2 response better at clearing Borrelia?
TH1
Which two human components may syphillis possess molecular mimmicry with?
fibronectin and collagen
Is a TH1 or TH2 process better for clearing fungi?
TH1
What does histamine do to lymph flow?
increase
What amino acid can be decreased due to IFN? Protect against?
tryptophan
Parasites
Is a TH1 or TH2 process better for clearing Schistosoma?
TH1
IL12 can be downregulated by what parasite?
Leishmania
Which cytokine is a bad prognostic indicator for a P. falciparum infection?
TNF
Filarial worms lodged in lymphatic channels induce what sort of immunity?
TH1
Are more cases of otitis media caused by viral or bacterial origins?
viral
What are treatment for otitis media?
Amoxicillin
What antibiotic is used for H. flu?
ampicillin
What antibiotic is used for recurrent otitis media?
Amoxicillim/Clavulanate
What must be used to diagnose serous otitis media?
pneumoscopy
What is used for treatment of fungal otitis externa?
azole
What three drugs are used to treat bacterial otitis externa?
neomycin
polymyxin B
hydrocortisone
What drug is used to treat otitis externa if worried about tissue penetration?
cipro
What drug is not used to treat acute sinusitis?
anti-histamines
What antibiotic is used for acute sinusitis?
amoxicillin
What drug does Benzoni say is used to treat pseudomonas sinusitis?
Cipro
What are the two gamma-hemolytic bacteria?
Enterococcus
Peptostreptococcus
What drug is used to treat Strep throat?
Penicillin
Antibiotics decrease the risk of what post-streptococcal complication? Which one doesnt decrease?
decrease = rheumatic fever
doesnt decrease = glomerulonephritis
Are antibiotics used to treat Salmonella?
no
What are the three non-lactose fermenting, oxidase-negative gram-negative rode?
Shigella
salmonella
Proteus
Is ribavirin used for tolerated RSV?
no
Is herpes painful or painless?
painful
Does HIPPA apply to public health?
no
What pathogen is the most common cause of fungal esophagitis?
Candida
What appearance would candida esophagitis have imaging?
“cobblestone”
What specific drug is used to treat oral candidiasis?
Fluconazole
What two drugs are used to treat oral candidiasis is fluconazole fails?
IV echinocandin
Amphotericin B
What is the common suffix for echinocandins?
-fungin
What drug is used to treat herpes esophagitis?
acyclovir
What two drugs are used to treat CMV Esophagitis?
gangciclovir or valgangciclovir
Why doesnt serology work for H. pylori?
cant distinguish acute vs. chronic infection
Raspberries from Guatamala may be indicative of what bug?
Cyclospora
Are fecal leukocytes present in inflammatory or non-inflammatory diarrhea?
non-inflammatory
Which three bacteria are known to cause inflammatory diarrhea?
Shigella
Salmonella
Campylobacter
What is the best tool for C. difficile?
stool sample
What drug is used for C. difficle with a white count over 15K?
oral vancomycin
What drug is used for C. difficle with a white count under 15K?
metronidazole
What drugs are not included in the treatment of C. difficile?
rifampin or rifaximin
What type of vancomycin treatment is equal in efficacy for C. difficile?
low or high dose oral
What is the time-frame for Metronidazole treatment for C. diff?
only for first occurrence
What drug is used for recurring C. diff?
vancomycin
What is the preferred imaging modality for meningitis?
MRI
What is the most important parameter in choosing an agent for CNS infections?
penetration
Bactericidal or bacterostatic for CNS infections?
cidal
Would an antibiotic with low or high protein binding be better for CNS infections?
low
When are surgeons called for a CNS infection?
abscess
What are the two most common bacterial causes of CNS infections in the elderly?
S. pneumo and Neisseria
What is measured during a Cryptococcal infection?
opening pressure
What two drugs are used to treat Cryptococcus infection?
Fluconazole and Ampho B
What can complicate chronic meningitis?
hydrocephalus
Are UTIs more common in male or female neonates?
male
What is the occurence for UTIs in individuals over 50?
equal
Treat asymptomatic UTI in elderly?
no
Treat a UTI with a foley in?
no
What type of ratio cannot be relied on for a urinalysis regarding Epi/WBC?
equal
How is chlamydia found during a UTI?
PCR
Two drugs for STDs?
Ceftriaxone
Azithromycin
According to Benzoni, foley with pyelonephritis?
no
What temperature for SIRS criteria?
> 38C or
What is the respiratory rate and PCO2 for SIRS?
> 20 or less than 32 PCO2
What is the HR for SIRS?
greater than 90
What are the two white cell counts for SIRS?
> 12K or less than 4K
What is the bandemia for SIRS?
> 10%
How many SIRS criteria are required for sepsis? With what else?
2/4
suspicion of infection
How much liquid should be given to a person before we diagnose them with septic shock?
30 mL/Kg
What is done before antibiotics regarding sepsis?
cultures
What is the test for Rhabdomyolysis?
Creatinine kinase
What mean arterial pressure is maintained during sepsis?
65
What is the formula for MAP regarding sepsis?
(systolic)(2xDBP)/3
What is the fluid of choice for sepsis?
Crystalloids
What is the first-line pressor?
NorE
What is the first alternative for NorE?
epinephrine
Which pressor can decrease NorE requirements? What else does this pressor do?
Vasopressin
raise MAP
Antibiotics should be administered within how long of a suspicion of septic shock?
one hour
Narrow or broad spectrum antibiotics for sepsis? Do what as soon as possible?
broad
de-escalate
What is urine output goal for sepsis?
> 0.5 mL/Kg/Hr
Is Rectal temperature higher or lower than oral?
higher
Broad spectrum antibiotic for age 3-36 months with fever of unknown origin?
Ceftriaxone
What does Listeria to do the phagosome of macrophages?
disrupt it
Does tuberculoid or lepromatous Mycobacteria infection have disseminated bacteria?
Lepromatous
Bacteria express what nucleic acid antigen to activate macrophages?
unmethylated CpG dinucleotide
What does complement do to gram-negatives?
lyse
What does complement do to gram-positives?
opsonize
Which two bacteria express M-protein?
Strep pneumo
Strep pyogenes
What are the two cytokines to induce DIC?
TNF and IL1
Adaptive immunity clears what fungal pathogen?
Candida
What is the normal CSF/Serum glucose ratio ?
0.6
A CSF/Serum glucose ratio less than what is suspicious?
0.5
Steroids could be administered during meningitis to target inflammation in what area?
Subarachnoid space
Dexamethasone can be used to target which bacteria causing meningitis? Which broad class?
Strep pneumo
gram-positive cocci
What drug for all patients with encephalitis?
Acyclovir
WHo can be treated for a UTI based on symptoms?
sexually active females
What does pyelonephritis with a stone equal?
intra-abdominal abscess
According to Aoki, what are the three most common causes of sepsis?
UTI
pneumonia
GI infection
Fluids should be continued to be administered to a patiet in shock as long as?
there is hemodynamic improvement
What is superior for gram-negative sepsis, combination therapy or monotherapy?
combination
What would be the bandemia for SIRS?
greater than 10%
What infection may cause patients to be leukopenic?
Neisseria Meningitidis
What are the four catergories for Fever of Unknown Origin?
Neutropenic
Nosocomial
HIV-associated
classical
Which type of patient may require trials of antibiotics with an FUO?
Neutropenic
Would quarantine or isolation be used if someone was suspected of having the disease?
Isolation
Would quarantine or isolation be used if someone was exposed to the disease?
quarantine
What does complicated mean?
involvement of tissue structures
What does recurrence mean regarding a UTI?
3 or more per year
What does relapse mean regarding a UTI?
treatment failure
What does reinfection mean?
new organism
According to Benzoni, does UTI in a male neonate correlate with hypospadias or epispadias?
hypospadias
What is a gold UTI specimen?
catheter
Concentrated urine will have a specific gravity higher than what?
1.010
What is better, a urethral wash or a urethral swab?
urethral wash
Does pyelonephritis get a foley?
no
What is systolic pressure under for severe sepsis?
90
What is MAP under for severe sepsis?
70
Creatinine above what for severe sepsis?
2.0
PT/INR above what for severe sepsis?
1.5
Platelet count under what for severe sepsis?
100,000
According to Aoki, what doesn venous oxygen saturation have to be greater than to be considered adequate ?
70%
What two areas dont have major physical barriers to infection?
eye and genito-urinary
What immune cell is the first defense against virus infected cells?
NK cells
Where do plasma cells reside?
bone marrow
What causes a memory Bcell to differentiate into a plasma cells?
reencountering antigen
When are CTLs needed in a virus infection?
established infection
What cytokine is produced by CTLs to interfere with viral replication?
TNF-alpha
Which cell is constantly active, memory Bcell or memory Tcell?
memory Bcell
Would lepromatous of tuberculoid leprosy have hypergammaglobulinemia?
Lepromatous
Which amino acid sequence can be recognized by phagocytes?
Arg-Gly-Aspartate
Phagocytic cells have receptors for which opsonization proteins?
C3b and IgG
What is the only thing the alternative pathway of complement requires?
microbial surface
Would humoral or cell-mediated response predominate for bacterial infections?
Humoral
Which three bacteria would a neonate have increased susceptibility to after disappearance of maternal antigens?
S. pneumo
HiB
Neisseria men.
Which spirochete can be killed by complement?
Borrelia
Which spirochete coats itself with host proteins? What does this help it evade?
Borrelia
Phagocytosis
Do fungi elicit humor, CTL or both?
both
Is cryptococcus cleard by TH1 or TH2?
TH1
Is Histo cleard by TH1 or TH2?
TH2
According to Steele, which two parasites survive in macrophages?
Leishmania
Trypanosoma
According to the GI guy, what species of Candida is most concerning?
Candida cruzii
Repeat urea breath test and stool antigen how long after quadruple therapy?
6-8 weeks
What bug for home canned foods?
Clostridium perfringens
What bug for caesar salad?
Salmonella
Which virus can be from shellfish?
Hep A
What three bugs have preformed toxins?
C. perfringens
S. aureus
B. cereus
Is vibrio inflammatory or non-inflammatory?
non-inflammatory
Is stool testing required to measure treatment of C. diff?
no
What drug is the three drugs for C. diff?
Metronidazole/Vancomycin/Fidoximycin
IV or oral vancomycin for C. diff?
oral
What is the normal CSF cell count?
0-5
What condition can produce a transient increase in CSF white count that is non-infectious?
Seizure
Would fungal or bateria have a higher WBC white count?
bacteria
Draw serum glucose before or after spinal tap?
before
CSF protein above what is abnormal?
50
Drug for S. epi meningitis?
vancomycin
Drug for pseudomonas meningitis?
Ceftazadime
What drug usually used for sepsis does not cross the BBB?
Piperacillin
What drug for neuro Lyme?
Ceftriaxone
What is normal opening pressure?
50-180
How long must chronic meningitis last?
four weeks
What are the three bugs for chronic meningitis?
Borrelia
T. pallidum
M. TB
Where are the temperature sensors in the body?
skin and muscle
What are the two non-classical neoplastic causes of unknown fever?
RCC
Hepatoma
Does lepromatous leprosy have present or absent Tcell responses?
Absent
What is used to correctly Dx Serous Otitis Media?
Pneumoscopy
Who did the analysis and didnt like Snow?
Farr
How long on bactrim for UTI?
3 days
Is cystitis usually afebrile or febrile?
afebrile
What correlates with severity of sepsis?
Lactate
Two drugs for empirical coverage in suspected acute bacterial meningitis?
Ceftriaxone
Vanc
What cause hyperthermia?
insufficient dissipation
