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Keele Medics - Infection & Immunity > Unit 2: Week 1 > Flashcards

Unit 2: Week 1 Flashcards

1
Q

What is the outer most layer of the epidermis called?

A

Stratum corneum

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2
Q

What provides the tight junctions between the outmost skin cells?

A

Desmosomes

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3
Q

What is different about Gram Negative bacterial structure compared to Gram Positive?

A

Gram negative has a THIN peptidoglycan cell wall with a 2nd outer plasma membrane

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4
Q

What colour do Gram negative bacteria stain in Gram staining?

A

Pink

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5
Q

What are the 4 cardinal signs of inflammation?

A

Rubor (Redness), Calor (Heat), Tumor (Swelling), Dolor (Pain)

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6
Q

Identify 6 defenses in the body’s barriers.

A

Tight epithelial layer sloughing off every 14 days, defensins, antimicrobial enzymes, flow of blood/air, normal microbiota in GI, low pH of stomach.

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7
Q

What are the proinflammatory cytokines?

A

IL-1Beta, IL-6, TNF-alpha

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8
Q

Name the 5 phagocytic receptors (PRRs).

A 
C type lectin 
Scavenger
Mannose
Fc (antibody)
Complement
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9
Q

What transcription factor is expressed by toll like receptor recognition of a pathogen external to the cell?

A

NF kappa B

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10
Q

What is the main function(s) of IL-1beta?

A

Activate vascular endothelium and upregulates adhesion molecules.

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11
Q

What is/are the main function(s) of IL-6?

A

Increases chemokine production; early warning signal of danger to neighbouring cells.

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12
Q

What is the main function of TNF-alpha?

A

Activates vascular endothelium; stimulates NOS production –> increased vascular permeability.

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13
Q

What colour do Gram Positive bacteria stain in Gram staining?

A

Purple

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14
Q

What does external TLR 5 recognise?

A

Flagellin on bacteria

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15
Q

What do scavenger receptors recognise?

A

Bacterial lipoproteins which make up the cell walls of bacteria.

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16
Q

What do c-type lectin receptors recognise?

A

Fungal beta-glucan component of fungal cell walls.

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17
Q

What are the proteins involved in neutrophil recruitment?

A

TNF-alpha increases vascular permeability. IL-1beta upregulates ICAM-1 on vascular endothelium which binds LFA-1 on the neutrophil. CXCL8 chemokine attracts neutrophils which follow a C3a gradient to the pathogen.

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18
Q

What is the physiological cause of tumor/swelling?

A

Weakening of tight junctions between cells causes vascular permeability leading to fluid leak into the tissue.

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19
Q

Which cytokines activates macrophages?

A

TNF-alpha

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20
Q

What does the intracellular TLR 9 recognise?

A

DNA with unmethylated CpG (bacteria and herpesvirus)

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21
Q

What secretion does the transcription factor IRF-3/IRF-7 cause?

A

IFN-alpha, IFN-beta

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22
Q

What are the two main types of cytosomal receptors?

A

NOD and RIG

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23
Q

What transcription factor is release by PAMP recognition on NOD receptor?

A

NF-kappa-B

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24
Q

What extracellular machinery is needed to break down pathogen for fusion with MHC1?

A

Proteasome

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25
Q

Where is the source of the pathogen for MHC1 presentation?

A

Inside the cell

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26
Q

What type(s) of cell(s) present antigen on MHC1?

A

All nucleated cells

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27
Q

Explain cross presentation.

A
  1. Partially degraded antigen leaves the phagolysosome and enters the cytosine.
  2. The dendritic cell fuses vesicles containing MHC1 to the antigen.
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28
Q

Identify 3 factors that contribute to the social construction of illness.

A
  1. Cultural meaning
  2. Experiential level
  3. Medical knowledge
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29
Q

What is “illness behaviour”?

A

The way symptoms are differentially perceived, evaluated and acted/not acted upon by different people.

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30
Q

What social model is T.Parsons associated with?

A

The “sick role”.

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31
Q

Identify 2 rights of the sick role.

A
  1. Excused from normal activities/responsibilities.

2. Access to care and concern

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32
Q

Name 2 obligations of the sick role?

A
  1. Desire to get better.

2. Seek professional advice.

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33
Q

Identify 2 criticisms of the sick role.

A

Any 2 of:

Only applies to short term illness.

People can be blamed for illness (smoking & lung cancer).

Does not consider rejection of the sick role e.g busy mother cannot take time off.

There are other means of dealing with illness besides seeking medical advice.

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34
Q

Name the 3 sectors of healthcare.

A
  1. Popular (self medicate/self diagnose)
  2. Folk (alternative medicine)
  3. Professional (formal healthcare)
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35
Q

What is the lay referral system?

A

The process of seeking help from a network of potential consultants, starting at the immediate nuclear family, gradually extending until the healthcare professional is reached.

36
Q

What are the 5 social triggers to consultation?

A
  1. Occurrence of interpersonal crisis.
  2. Perceived interference with vocation/ physical activity.
  3. Perceived interference with social or personal relations.
  4. Sanctioning - “I didn’t want to bother you but…insisted I come”
  5. Temporalizing - “if this is still bad Monday I’ll go in then”
37
Q

Identify 4 aspects of Delay Behaviour.

A
  1. Lack of awareness of symptoms
  2. Competing social demands
  3. Poor doctor-patient interaction
  4. Structural barriers e.g. Transportation
38
Q

What is “normalisation”?

A

Tendency to normalise symptoms.

39
Q

What are the 6 steps of cell-to-cell communication?

A
  1. Make the signal
  2. Release the signal
  3. Transport to target
  4. Detection by receiver
  5. Change
  6. Remove the signal
40
Q

What is the main “big picture” function of a kinase?

A

Put a phosphate group on a protein. (Phosphorylate)

41
Q

What is the main “big picture” function of a phosphatase?

A

Remove a phosphate group from a protein.

42
Q

What is the Gs receptor and effector?

A

Beta-1/ Beta-3 (receptor); adenyl cyclase (effector)

43
Q

What 3 ways regulate enzyme concentration?

A
  1. Gene expression
  2. Proteolytic enzymes
  3. Recruiting pre-existing enzymes
44
Q

Is change to enzyme synthesis fast or slow?

A

Slow.

45
Q

What effector does Gq protein activate?

A

Phospholipase C

46
Q

Explain the Gq protein activation cascade.

A

Gq protein completes GDP/GTP “ping-pong” activation of Phospholipase C. This cleaves PIP2 into DAG and IP3. DAG resides in the membrane. IP3 facilitates Calcium ion release from ER. Increased calcium ion levels cause Protein Kinase C to migrate and bind to DAG. This causes a conformational change in Protein Kinase C so that is can now phosphorylate substrates.

47
Q

What is the main point of cell signal transduction?

A

Amplification of the signal integrated into a response.

Tiny initial concentration causes large relative product

48
Q

A bacteria is identified as Gram Positive, catalase positive and coagulase positive. What is it likely to be?

A

Staphylococcus aureus

49
Q

A bacteria is found to be Gram Positive, catalase positive and coagulase negative. What 2 organisms could it be?

A

Staphylococcus epidermidis

Staphylococcus saprophyticus

50
Q

Identify the 4 stages of infection.

A

Exposure -> Adhesion -> Invasion -> Colonisation & Toxicity

51
Q

What is the mechanism of Beta Lactam antibiotics?

A

Inhibit cell wall synthesis by binding to the penicillin binding proteins of the glycine bridge. Cell dies as a result of osmotic instability in cell wall.

52
Q

What do Macrolide antibiotics target in bacteria?

A

P site of the large 50S subunit of the bacterial ribosome

53
Q

Name the layers of the epidermis from superficial to deep.

A 
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum 
Stratum basale
54
Q

What is pus?

A

Dead neutrophils

55
Q

What is predominantly responsible for staining Gram negative bacteria pink?

A

Safranin

56
Q

Why does crystal violet not stain Gram Negative bacteria?

A

The thin peptidoglycan wall allows the crystal violet dye to be washed away by the decolouriser.

57
Q

What is the hallmark of a positive catalase test? What group of bacteria would this suggest is being tested?

A

O2 bubbles indicating Staphylococcus

58
Q

In blood agar, what colour would alpha-haemolytic bacteria turn the agar? What is happening to cause this?

A

Brown-green because RBCs are being destroyed and haemoglobin is being exposed to the agar

59
Q

What would happen to a blood agar plate with gamma-haemolytic bacteria on it.

A

Nothing. No colour change.

60
Q

What colour do beta-haemolytic bacteria turn blood agar plates? What is happening to cause this?

A

White-yellow because RBCs and haemoglobin is being digested by the bacteria.

61
Q

Give examples of 2 major groups of beta-haemolytic bacteria.

A

Group A streptococci

Group B streptococci

62
Q

Where is the cysterna chyli?

A

Inferior end of thoracic duct; inferior to diaphragm; posterior to abdominal aorta and anterior to the vertebrae L1 & L2

63
Q

Where are the lymph nodes that drain the majority of the breast?

A

Axilla

64
Q

What is a sentinel lymph node?

A

The 1st lymph node an area/region drains into.

65
Q

Give 3 functions of the spleen.

A

Any 3 of:

  1. Reservoir of monocytes
  2. Reservoir of blood
  3. Renews RBCs
  4. Synthesises antibodies
66
Q

State 3 functions of the lymphatic system.

A

Any 3 of:

  1. Draining tissue space of excess ECF
  2. Filtration
  3. Role in immune response
  4. Transport digested lipids & lipid soluble vitamins from the gut to the blood
67
Q

Which lymphatic trunks drain in the right lymphatic duct?

A

Right jugular
Right subclavian
Right bronchomediastinal

68
Q

Which lymphatic trunks drain into the thoracic duct?

A 
Left jugular
Left subclavian
Left bronchomediastinal
Right & Left lumbar
Intestinal
69
Q

Where is the venous angle located and what is its significance?

A

Where the subclavian vein meets the internal jugular. Returns lymph to blood.

70
Q

What is the name of the lymph node region on the anterior elbow?

A

Epitrochlear

71
Q

Which region of the lymph node would you find the majority of T-cells?

A

Paracortical area

72
Q

What do NOD receptors detect?

A

Elements of the bacterial cell wall.

73
Q

What is the weak binding component allowing neutrophils to “crawl” along the vascular endothelium?

A

E-selectin

74
Q

What is the medical definition of disease?

A

Biological part or process functioning below normal; an abnormality in a structure

75
Q

What is the medical definition of illness?

A

The feeling of being unwell for individual concerned

76
Q

What is the medical definition of sickness?

A

The role the diseased play in society

77
Q

Is the WHO definition of health positive or negative?

A

Positive.

“State of complete physical, mental and social well-being, not just the absence of disease.”

78
Q

Describe the “seen” portion of the symptom iceberg and state what fraction of the population this accounts for.

A

Those receiving care + those waiting for care; accounts for 1/3 of population

79
Q

Identify the “unseen” sections of the symptom iceberg and state their relative proportions of the population.

A

Ill but not seeking help (1/3)

Healthy (1/2)

80
Q

Explain the symptoms of impetigo.

A

Bacteria such as Staphylococcus aureus or Staphylococcus pyogenes invade a break in the skin.

The break is not deep so the bacteria reside in the upper layers of the epidermis where there is no blood supply and immune cells struggle to get to.

Bacteria multiply faster than immune cells can reach the area. Pus forms and goes back out the the surface and drys in a yellow scab.

81
Q

Name the cell types found in the epidermis.

A

Keratinocytes
Langerhans cells (dendritic cells)
Merkel cells
Melanocytes

82
Q

Describe the function of Merkel cells.

A

Perception of light touch and discrimination of shapes and textures.

83
Q

What are the 3 layers of the basement membrane zone joining the epidermis to the dermis?

A

Lamina lucida
Lamina densa
Sublamina densa

84
Q

Identify the layers of the dermis from superficial to deep.

A

Papillary layer
Reticular layer
Cutaneous plexus

85
Q

What are the main TLR external to the cell?

A

TLR 1+2
TLR 2+6
TLR 5 (flagellin)
TLR 4 (Lipopolysaccharides in Gram Negative; lipoteichoic acid in Gram positive)

Keele Medics - Infection & Immunity (2 decks)

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