Week 1 Flashcards
Most common infections in CVID?
Sinus
Pulmonary
What immune system rejects skin transplants?
Adaptive (memory)
What are autologous transplants?
Same person gives and receives transplants
What are syngeneic transplants?
Donor and recipient are genetically identical
What are allogeneic transplants?
Donor and recipient are genetically different but same species
What are Xenogeneic transplants?
Donor and recipient are genetically different and of different species
How many tcells can react to foreign antigens?
a lot! (1 in 10)
What is direct alloantigen recognition?
Tcell recognizes unprocessed allogeneic MHC molecule on transplant APC
What is indirect alloantigen presentation?
Presentation of processed peptide of allogeneic MHC molecule bound to self MHC molecule
What MHC does the tcell bind more tightly to….direct or indirect?
Direct (it binds to the MHC directly and doesn’t need the peptide alone)
How many MHC class 1 do we have?
6 (three on each chromosome)
What is hyperacute rejection?
pre-existing antibodies that reject a transplant (ABO blood types)
How do mothers have Rh/HLA problems with pregnancy?
They get introduced to the babies (fathers) HLA during birth and it creates antibodies against it for the second pregnancy
What is chronic rejection mediated by ? and what happens?
CD4 t-cells
The smooth muscle in the vessels proliferates a lot and plug the vessel.
What does cyclosporin do?
It inhibits calcineurin (which inhibits Tcell activation) Immunosuppression
What type of tissue graft is GVHD (graft vs host disease)?
Bone marrow
What does IL-2 do?
growth factor stimulates proliferating of Th cells
What is acute rejection?
Primarily caused by infiltration of Tcells into the allograft
What is chronic rejection?
interactions between allograft and cytokines, cell-to-cell interactions, CD4 and CD8 tcells
What is induction therapy?
Lots of immunosuppression in the early transplant period
What are the 4 drug classes for immunosuppression?
- Glucocorticoids
- Calcineurin inhibitors
- Antimetabolites/Anti-proliferative
- Biologicals (antibodies)
What do glucocorticoid drugs do?
block cytokine activation (IL-2, IL-1, IL-6, IFN-g, IL-3)
What are two calcineurin inhibitors?
Cyclosporine
Tacrolimus
What do calcineurin inhibitors do?
Blocks Calcineurin (which activates IL-2)
What are the most common Salt Lake STD’s?
Chlamydia (then gonorrhea)
What is Urethritis?
Visible dripping
WBC’s seen on a urethral gram stain
What is cervicitis?
Vaginal discharge
Friable cervix
What is Mycoplasma genitalium?
associated with urethritis, cervicitis, endometritis, PID
How to diagnose Gonorrhea?
Gram Neg Diplococci
NAAT (nucleic acid amplification test)
What drugs are glucocorticoids? and what are the Toxicities?
Prednisone….Methylprednisolone
Cushings syndrome, osteoporosis, Hyper things
What are complications of gonorrhea and chlamydia?
Infertility
Epididymitis
PID
Reactive arthritis
What are the two Calcineurin Inhibitor drugs? Toxicities?
Cyclosporine….Tacrolimus
Nephrotoxic
What are the three Antimetabolites drugs? toxicities
Mycopheollate Mofetil (myelosuppression)
Azathioprine (myelosuppression)
Sirolimus…Everolimus (anemia, leukopenia, hyperlipidemia)
What makes up Bacterial Vaginosis?
White vaginal discharge
Fishy smell with KOH
Metronidazole
What’s a trichomonas?
anaerobic flagellated protozoa
What bacteria would cause UTI after a honeymoon?
Staph Saprophyticus
What type of bacteria causes a UTI with stones (staghorn)?
Proteus
Which type of HPV causes warts?
6 or 11
Which type of HPV causes cancer?
16 or 18
What do HPV cells look like?
raisins with lots of air space around them (6 or 11)
How is vaginal candidiasis treated?
Nystatin (pore forming)
Fluconazole
What does Trichomonas Vaginalis?
Green and Frothy
What does vaginal candidiasis look like?
White and Cheesy
HAART
Highly Active Anti Retroviral Therapy
What are the 5 genes important in HIV?
Gag Pol Env Tat Rev
What are gp120 and gp41?
HIV antigens that show up.
What are the 5 steps of HIV entry and maturation?
- entry
- Reverse transcriptase (RNA to be DNA)
- Integration
- Assembly, budding, release
- Maturation