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BMS 615 Cardiovascular > Test 3: Wk11: 4 Cystic Fibrosis and Tuberculosis - Yu > Flashcards

Test 3: Wk11: 4 Cystic Fibrosis and Tuberculosis - Yu Flashcards

1
Q

— activate M1 macrophages

A

microbial TLR-ligands

IFN-gamma

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2
Q

activated M1 macrophage releases

A

ROS, NO, lysosomal enzymes

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3
Q

— activate M2 macrophage

A

IL-13

IL-4

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4
Q

Activated M2 macrophages release

A

IL-10

TGF-Beta

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5
Q

M1 macrophage actions

A

microbicidal actions

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6
Q

M2 macrophage actions

A

anti-inflammatory, wound repair, fibrosis

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7
Q

3 Functions of M1 Macrophages

A
  1. produce ROS, NO, lysosomal enzymes
  2. Cytokine Secretion
  3. Increased expression of B7 MHC molecules
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8
Q

— are antigen presenting cells and activate —

A

macrophages, T cells

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9
Q

Lobar pneumonia is characterized by — and is caused by what organism

A

Inflammatory infiltrates in alveolus

Streptococcus pneumonia

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10
Q

Lobar pneumonia color

A

red/gray hepatization and resolution

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11
Q

Bronchopneumonia is characterized by — and infiltrates in —
caused by what organism

A

patchy inflammation; inflammatory infiltrates in small airways

Staphylococcus aureus,

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12
Q

Interstitial pneumonia is an atypical ammonia with inflammatory infiltrates —. What organisms cause it? Why is it atypical

A

on alveolar walls only.

Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumonia.

caused by virus and bacteria

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13
Q

Causes of Pneumonia Neonates < 4 weeks (2)

A

Group B strep, E. coli

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14
Q

Causes of Pneumonia Children - 4 weeks to 18 yrs (3)

A

) Mycoplasma, Chlamydia, Strep pneumoniae

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15
Q

Causes of Pneumonia Adults

A

Strep pneumoniae
Haemophilus influenza
Atypical pneumonia bacteria

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16
Q

most common cause of pneumonia in adults

A

Strep pneumoniae

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17
Q

Causes of Pneumonia

Adults (hospital-acquired)

A

Gram-negative rods, Klebisella, E. coli, Pseudomonas, in VAP, ICU

S. aureus

Anaerobes

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18
Q

Gene for CF

A

CFTR gene chromosome 7

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19
Q

Most common CF mutation

A

F508 deletion of 3 bases, missing one aa (F) resulting in abnormal protein trafficking

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20
Q

what kind of channel is CFTR

A

chloride

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21
Q

CFTR Channel function

A

Chloride channel uses ATP to pump Cl-out of cells.

Increased Cl ion inside the cells, increased Na ion reabsorption

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22
Q

CFTR mutation causes

A

The mucus on top of the airway, small intestine (meconium ileus), and pancreatic duct become dehydrated and sticky.

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23
Q

Loss of CFTR in sweat glands results in

A

Na pump is called ENaC. Loss of CFTR makes both Na and Cl levels increased extracellularly (hypertonic luminal fluid on apical surface).

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24
Q

Bronchoalveolar lavage (BAL) fluid from a patient with CF

A

see slide 13

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25
Q

CF microbiology (6)

A

–
S. aureus including MRSA (childhood)

Haemophilus influenzae (no capsule)

P. aeruginosa including MDR-PA (adult)

Burkholderia cepacia

Achromobacter

Stenotrophomonas maltophilia

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26
Q

— is a poor prognosticator for lung transplant with a low 5 year survival rate.

A

B. cepacia

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27
Q

— is a poor prognosticator for lung transplant with a low 5 year survival rate.

A

B. cepacia

28
Q

CF antibacterial therapy

A

Anti-Pseudomonas penicillins

4th gen cephalosporins

Combination therapy

Inhaled tobramycin

Monobactams (Aztreonam) or Carbapenems (Meropenem)

29
Q

Anti-Pseudomonas penicillins (2) they have greater

A

Piperacillin and Ticarcillin; greater porin penetration

30
Q

add — to Piperacillin and Ticarcillin

A

β-lactamase inhibitors. e.g, Zosyn and Timentin.

31
Q

4thgen cephalosporins

A

cefepime

32
Q

CF Combination therapy

A

Intravenous administration of ticarcillin or piperacillin, plus an aminoglycoside

33
Q

— is resistant to many antibiotics (MDR).

A

P. aeruginosa

34
Q

Major mechanism of antibiotic resistance in Gram-negative pathogens

A

β-Lactamases

35
Q

It is synthesized in cytoplasm and secreted to in periplasm

A

β-Lactamases

36
Q

Gram-positives synthesize — in cytoplasm which is then secreted extracellularly.

A

β-lactamases

37
Q

Three types of β-lactamases

A
  1. Penicillinases inactivate penicillins
  2. “Extended-spectrum β-lactamases”
  3. Carbapenemases
38
Q

agents inhibit bacterial growth while the agent is present. Rely on the immune system (of an immunocompetent person) to aid the bacteriostatic agent and clear the infection.

A

Bacteriostatic

39
Q

agents kill bacteria but are bacteriostatic under some conditions

A

Bactericidal

40
Q

Tuberculosis is caused by inhalation of

A

aerosolized Mycobacterium spp including M. tuberculosis

41
Q

Mycobacterium are — aerobes

A

Obligate aerobes

42
Q

Primary tuberculosis — intracellular, and infects —

A

Facultative

macrophages

43
Q

Primary tuberculosis culture

A

Difficult to culture, slow growing, doesn’t stain well with Gram stain. Acid fast

44
Q

Primary tuberculosis develops in

A

Develops 2 to 4 weeks after exposure

45
Q

Primary tuberculosis Initial exposure causes

A

the formation of focal caseating necrosis in the lower lobe of lung and hilar lymph nodes

46
Q

Cell mediated immune response controls TB

A

TH1 response, CD4+ T cells, interferon-γsecretion, macrophage activation

47
Q

Secondary TB due to the reactivation of what 2 major risk factors

A

HIV and aging

48
Q

– inhibitors is a risk factor for Secondary TB

A

TNF alpha Etanercept, Infliximab

49
Q

is diabetes a risk factor for reactivation of TB

A

yes

50
Q

Secondary TB due to the reactivation Occurs — and can spread to any tissue

A

at the apex of lung

51
Q

Secondary TB due to the reactivation forms what in the lung

A

cavitary foci of caseous necrosis

52
Q

Secondary TB due to the reactivation symptoms

A

fever and night sweats

cough with hemotypsis

wt loss

53
Q

biopsy of TB granuloma will show

A

AFBpositive bacilli

54
Q

Two subtypes of granuloma

A

Noncaseating granuloma

Necrotizing or caseating granuloma

see image on slide 24

55
Q

Caseating granulomas Bacteria:

A

Mycobacterium tuberculosis
Treponema pallidum
Listeria monocytogenes

56
Q

Caseating granulomas Fungi:

A 
Aspergillus
 Blastomyces
 Coccidioides
 Cryptococcus
 Candida
 Histoplasma
57
Q

Caseating granulomas Helminthic infection

A

Schistosoma mansoni

S. japonicum

the liver granulomas form around the parasite eggs.

58
Q

Noncaseating granulomas are a reaction to what and caused by (5)

A

Reaction to foreign materials

Sarcoidosis

Beryllium exposure

Crohn disease

Cat scratch disease

Mycobacterium leprae

59
Q

TB diagnosis

A

tuberculin skin test (TST), PPD

vitro IFN-γrelease assays

60
Q

TB diagnosis microscopy

A

Acid fast bacilli

61
Q

gold standard of TB dx

A

Culture, takes 3-4 wks

62
Q

TB treatment first 2 months

A

RIF, INH, PZA, EMB

63
Q

2 drug TB treatment 4 months

A

INH and RIF

64
Q

— is important to ensure adherence and resistance in TB Tx

A

Direct observed therapy

65
Q

For LTBI — is used for —

A

INH

9 months

BMS 615 Cardiovascular (49 decks)

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