Test 27: Immunology/Microbiology Flashcards
acute hemolytic transfusion reaction is what type of hypersensitivity? Caused by
Type II
pre-existing anti-ABO antibodies
what is the clinical presentation for acute hemolytic transfusion reaction
- fever and chills
- Chest and/or back pain
- hemoglobinuria
hemoglobinuria
red-to-brown colored urine
Acute hemolytic reactions occur within what timeframe
minutes to hours of staring blood transfusion
What do you do if you realize a patient has acute hemolytic reactions
immediate cessation of transfusion
Type II hypersensitivity activates what process
complement
role of C3a and C5a
vasodilation and symptoms of shock
role or MAC (C5b-C9)
complement-mediated cell lysis
Humoral component for Type I Hypersensitivity
IgE
Humoral component for Type II Hypersensitivity
IgG
IgM
Humoral component for Type III hypersensitivity
antibody-antigen complexes
Humoral component for Type IV hypersensitivity
NONE
Cellular component: T-cell & macrophages
Major adaptive immune mechanisms that prevent reinfection with influenza virus include what?
anti-hemagglutinin antibodies
What is the function of meningococcal pili (fimbriae)
bacterial attachment to epithelial surfaces
Meningococci (Niesseria meningitidis) attach to and conolize where
pharynx via pilus-mediated adherence to mucosal epithelial cells
What allows Niesseria Meningititidis to destroy mucosal antibodies
produced IgA protease
- inhibits bacterial attachment and penetration
What is the impact of Epstein-Barr virus on B cells
- infect them
- proliferate B cells continuously (immortalization)
- Then infected B cells maintain ability to secrete immunoglobulins
How do you test for EBV
Monospot test: heterophile IgM antibodes detected by agglutination of sheep or horse RBC
What are cryoglobulins? It can detect what virus
cold-precipitable serum proteins that contain Igs
-Hep C infection
What is Hemadsorption
hemagglutinins or glycoproteins with high affinity for erythrocytes expressed on the host cell surface.
Papanicolaou test is used to screen what
cervical cytology specimens for dysplasia caused by oncogenic strains of human papillomavirus
How do you use Tzanck smear
scrape ulcer base, prepare with Wright-Giemsa stain
When are interferons alpha and beta produced
by most human cells in response to viral infections
Role of interferon alpha and beta
suppress viral replication by halting protein synthesis and promoting apoptosis of infected cells
Interferon gamma is produced by who
T cells and NK cells
Role of interferon gamma
- promotes Th1 differentiation
- increases expression of class II MHC molecules
- improves intracellular killing ability of macrophages
Streptococcus gallolyticus former name
Strep. bovis
Strep. gallolyticus causes what? associates with what
bacteremia and subacute endocarditis (no preexisting valvular abnormality)
-associated with colon cancer
How is Strep. viridans impact the heart
subacute bacterial endocarditis following dental work
how does staph aureus impact heart
right-sided endocarditis
onset of acute transplant rejection
weeks to months
What is used to prevent acute transplant rejection
calcineurin inhibitors
-cyclosporine or tacrolimus
What is used to treat acute transplant rejection
systemic corticosteroids
What is the pathogenesis for hyperacute transplant rejection
Preformed antibodies against graft in recipient’s circulation
What happens to the organ in acute transplant rejection
- mononuclear infiltrate on histopathology
- graft dysfunction
What is the cellular component of acute transplant rejection
host T-lymphocytes sensitization against graft (foreign) MHC antigens
What is graft T-cell sensitization against Host MHC antigens
graft vs. host disease
- after bone marrow transplant
Chronic renal allograft rejection is characterized in the patient as ( kidney transplant)
- worsening hypertension
- progressive rise in serum creatinine
Chronic renal allograft rejection is characterized in kidney as
- fibrous intimal thickening
- tubular atrophy
- interstitial fibrosis
Vascular fibrinoid necrosis and neutrophil infiltration of the arterioles, glomeruli, and peritubular capillaries are characteristic of what type of organ transplant rejection
hyperacute
achlorhydria
inadequate gastric acid production to maintain the normal gastric pH of less than 4
Pregnant women with HIV do what for prevention? how does this work
antiretroviral therapy
- reverse transcriptase inhibitor
What are baby symptoms for mother-to-child vertical transmission of HIV-1
- oral thrush
- interstitial pneumonia
- severe lymphopenia
during first year of life
Patient with central vascular catheter and receipt of parenteral nutrition is at risk for
candidemia
what is the morphology/shape of candida
branching pseudohyphae with blastoconidia
morphology/shape of blastomyces
borad-based budding
morphology/shape of coccidiodies
spherules with endospores
morphology/shpae of cryptococcus
capsule
morphology/shape of histoplasma
small oval yeast within macrophages
Where do T cells reside in lymph nodes
paracortex
agammaglobulinemia prevents what from forming in lymph nodes
- primary lymphoid follicles
- germinal centers
In order, the pathogens most often responsible for secondary bacterial pneumonia are
strep. pneumoniae
Steph aureus
H. Flu
Localized bony back pain, low-grade fever, and recent staphylococcal bacteremia suggests what
vertebral osteomyelitis
What is the most common way bacteria can reach in the spin in adults
hematogenous
What diagnosis tools should be used if vertebral osteomyelitis is suspected
blood culture
MRI
What are 3 major causes of neonatal meningitis
- Group B strep
- E. Coli
- listeria monocytogenes
What strain of e. coli causes neonatal meningitis ? how does it work
K1 capsular antigen
- allows survival in bloodstream
In older infants ( greater than 3 months) and adults, most common pathogens for meningitis
Strep. pneumoniae
Neisseria meningitidis
verotoxin is what type of toxin
Shiga-like toxin
Lipid A unit in lipopolysaccharides is similar for all enteric bacteria, what does it cause
activation of macrophages
- release IL-1 and TNF-alpha
- septic shock
Primary infection with vericella-zoster typically occurs in who and as what
children
chickenpox
Where does herpes zoster reside in body
dorsal root ganglia
Vericella IgG antibodies have immunity against what? and what does it now have immunity against
immunity for chickenpox
not- herpes zoster
Classical complement cascade begins with binding of what
C1 complement component to either
-2 IgG or 2 IgM
Which immunoglobulin is a better activator of complememtn
IgM
C1 molecule of complement binds to thwat region of the immunoglobulin chain
Fc region of heavy immunoglobulin chain in region near the hinge point
Who get rubella vaccine and what type of vaccine is it
- children and non-pregnant females of childbearing age
- live, attenuated rubella virus vaccine
A patient gets a blunt abdominal trauma and then dies. See Step. pneumo on blood cultures. What happened
Spleen did not work
Characterize Mononucleosis-like syndrome? seen in what
fever malaise myalgia atypical lymphocytosis elevated liver transaminases -CMV
What is severe combined immune deficiency
combined T and B cell dysfunction
Patient comes in with
- Severe bacterial and viral infections in infancy
- chronic diarrhea
- mucocutaneous candidiasis
SCID
Severe combined immunodeficiency
Patient comes in with
- congenital heart disease
- dysmorphic facies
- hypocalcemia
DiGeroge sydnrome
Neisseria is grown on what media? what is special about this media
Thayer-Martin VCN (vancomycin/colistin/nystatin)
- inhibits gram +, gram - other than neisseria and fungi
Name a selective media for growth
Thayer-Martin agar
how does differential media help identify cultured oragnisms
metabolic and biochemical properties
type I hypersensitivity what immunoglobin and cells are used
IgE bound to basophils and mast cells
what process activates type I to release histamine and heparin
cross-linking of surface IgE molecules, signals cell to degranulate
initial symptoms of malaise and fever and then bone pain/abscesses. What is this
osteomyelitis
most common cause is staph aureus
Immunity against Neisseria meningitids is provided by antibodies against what virulance factor
polysaccharide capsules
What is the primary virulence factor of Strep. pneumoniae
polysaccharide capsule–> inhibits phagocytosis
Name a bacteria that is positive diplococci and is alpha-hemolytic
Strep. Pneumo
What bacteria causes atypical pneumonia
Mycoplasma pneumoniae
Chlamydophila pneumoniae
legionella
What is the agent that can cause hepatic abscesses via hematogenous seeding of the liver
Staph aureus
What agents cause hepatic abscesses by ascending the biliary tract, portal vein pyemia, or direct invasion from adjacen area
Enteric bacteria
presence of fluid-filled cavity in liver in conjunction with fevers, chills, and right upper abdominal pain
hepatic abscess
what causes hepatic abscess in underdeveloped countries and developed countries
underdeveloped countries: parasitic infection
developed: bacterial infection
how can staph aureus gain acess to the liver
biliary tract infection
portal vein pyemia
parotitis
inflammation of parotid gland
What does the parotid gland release
amylase
what is the most common bacterial etiology for acute parotitis
staph aureus
what diagnostic tools determine acute bacterial parotitis
- elevated amylase levels
- imaging
Bacterial genetics: transformation
direct uptake of naked DNA
Bacterial genetics: conjugation
one-way transfer of material
what do donor cells have in conjugation
F factor: codes for sex pilus
Bacterial genetics: transduction
transfer of DNA from one bacterium to another by means of a bacteriopahge
