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Host and Defense Test 3 > Test 3 Week 1 > Flashcards

Test 3 Week 1 Flashcards

1
Q

What are the 4 “centor” criteria for pharyngitis diagnosis?

A

Fever
Tonsillar Exudate
Tender enlarged anterior cervical lymph nodes
Absence of Cough

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2
Q

What are 2 common bacterial pathogens that cause pharyngitis?

A

B-hemolytic strep (gas)

Mycoplasma

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3
Q

What can EBV cause? (which then causes pharyngitis)

A

Infectious mononucleosis

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4
Q

Difference between sensitivity and specificity of testing?

A

Sensitive: % of patients with disease tests positive
Specificity: % of patients withOUT disease tests negative

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5
Q

What test is used to detect “heterophile antibodies” in EBV?

A

Monospot

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6
Q

Why is CA (community acquired) pneumonia better than HCAP (hospital care acquired) pneumonia?

A

Because it’s more treatable with less resistance

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7
Q

What do you tell if a sputum bit is acceptable?

A

If there’s less 10 squamous epithelial cells. (means it’s lower respiratory not upper)

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8
Q

What two pathogens would you use urine antigen test for?

A 
Strep pneumo (except for kids)
Legionella (only type 1 pneumophila)
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9
Q

What is empyema?

A

Bacterial organisms seen in pleural fluid on gram stain or PUS aspirated from the pleural space (requires chest tube drainage)

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10
Q

What is thorocentesis?

A

needle in the lung pleura for fluid culture

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11
Q

What’s an “uncomplicated parapneumonic effusion? pleura

A

exudate, increased neutrophils, resolve with treatment of pneumonia

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12
Q

What’s a “complicated parapneumonic effusion”? pleura

A

Exudate, bacterial invasion of pleural fluid, low pH, low Glucose, cultures negative

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13
Q

What is a sputum culture used for?

A

Bacterial diagnostics

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14
Q

What is a bronchoalveolar lavage used for?

A

Viral diagnostics (lower tract)

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15
Q

What is a nasopharyngeal swab used for?

A

Viral diagnostics (upper tract)

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16
Q

What are the two different parts of the Flu virus that distinguish it?

A

HA

NA

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17
Q

Difference in Flu A vs Flu B?

A

Flu A: birds, pigs, humans, seasonal (H and N, Antigenic Drift or Shift)
Flu B: sporadic all year

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18
Q

What are two medications to give flu patients?

A

Oseltamivir (48hours)

Zanamivir

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19
Q

What is RSV?

A

Respiratory Synctial Virus

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20
Q

What would RSV look like in the lungs?

A

Giant cells (they glom together)

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21
Q

What are risk factors for Strep pneumo?

A 
Asplenia
HIV
Smokers
Diabetics
Alcohol
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22
Q

What is the triad of infectious diseases?

A

Host (how well can we fight it off)
Pathogen (what kind is it)
Environment (where did you pick it up from)

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23
Q

What’s acute pneumonia? Typical pneumonia

A 
CAP or HCAP
Hours to days
Fever and cough
Lobar consolidation
Pleuritis
URT colonizing bacteria
Strep Pneumo
24
Q

What drug is used for “atypical” pneumonia? legionella, mycoplasma, chlamydia.

A

Azythromycin

25
Q

What drug is used for Bacterial pneumonia?

A

Ceftriaxone (B-lactam)

26
Q

What gram stain is Klebsiella pneumonia?

A

Gram negative

27
Q

How do people get aspiration pneumonia?

A

They accidentally aspirate bacteria from the oropharynx down into the lungs

28
Q

What gram stain are CAP pneumonias usually?

A

Gram pos

29
Q

What gram stain are HCAP pneumonias usually?

A

Gram Neg

30
Q

What group is viral pneumonia most common in?

A

Children

31
Q

What is a chronic pneumonia like?

A

weeks to months (not days)

Non-infectious diseases cause it

32
Q

What’s the trick behind the mucosal immunity?

A

It has to make immune responses to the right things, and not the good things it’s exposed to (like food)

33
Q

Where’s the repository of most lymphocytes in the body?

A

within the mucosal linings (not the secondary lymphoid tissues)

34
Q

Where does 60-70% of the lymphocytes reside?

A

MALT- (mucosal associated lymphoid tissues)

35
Q

What do M-cells do in the peyers patch?

A

It helps pull in the antigens into the Peyers Patch.

36
Q

Where are B cells taught to make IgA?

A

Peyers patches

37
Q

What can increase mucous production in the mucus linings?

A

Inflammatory cytokines

38
Q

What do paneth cells produce?

A

Defensins: natural antibodies

39
Q

What does the Mcell lack that the surrounding epithelial cells have?

A

Glycocalyx

Mucous

40
Q

How do M-cells get used by disease organisms?

A

The diseases trick the M-cells into letting them into the cell.

41
Q

Which TCR cells have limited diversity?

A

Intraepithelial lymphocytes

42
Q

Where do Gamma Delta Tcells flock to?

A

inflammation (not the lymph nodes)

43
Q

What’s the major job of gamma delta Tcells?

A

secrete cytokines when stimulated

44
Q

What’s the difference in Effector DC’s (CD11b) and Regulatory DC’s (CD103)??

A

Effector: stimulate Effector Tcells. can migrate to MLN
Regulatory: stimulate Treg cells to suppress immunity.

45
Q

What do CCR9 and a4B7 cytokines do?

A

They attract tcells to the gut

46
Q

What does RA (retinoic acid) do? by DC’s

A

holds the Tcells in a anti-inflammatory state, induces Treg cell differentiation

47
Q

Why are TLR’s polarized in the epithelium of the gut?

A

They perform different functions (activate or inactivate) based on which side of the cell the TLR gets ligated.

48
Q

How does a mucosa activated lymphocyte find its way back to the gut?

A

Gut homing integrins and chemokines

49
Q

What is the main Immunoglobulin formed in the gut?

A

IgA (it sticks to the mucus)

50
Q

Why is the IgA (and it’s secretory part) important in the gut?

A

Because the epithelial and Mcells are able to transport IgA back and forth pretty easily.

51
Q

What is the major role of IgA?

A

block adherence of bacteria to epithelial cell surface

52
Q

What are the 3 C’s of measles? (early)

A

cough
Coryza
Conjunctivitis
(late: Rash, koplik)

53
Q

What antibiotic always works for Group A strep pharyngitis?

A

Penicillin

54
Q

How is EBV and spleen enlargement connected?

A

Massive bcell involvement, mono is likely

55
Q

What’s important about Urine antigen test with Strep Pneumo?

A

It doesn’t work with children

56
Q

What is RSV? what does it do? what are symptoms?

A

Respiratory synctial virus

fever, cough, cold symptoms

Host and Defense Test 3 (6 decks)

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