Week 102 - Swollen finger Flashcards
What are the three functions of the complement system?
1) Destroys pathogens through membrane-attack-complexes.
2) Inflammatory mediation (C3a and C5a attract immune cells)
3) Opsonise pathogens (C3b)
What are the three pathways of the complement cascade?
1) Classical pathway
2) Lectin pathway
3) Alternative pathway
What is the classical pathway of the complement system?
- C1 binds to antibodies on the pathogen surface
* C1 catalyses breakdown of C2 and C4 to form C3 convertase.
What is the lectin pathway of the complement system?
- ‘Mannose binding lectin’-MASP protein complex binds to mannose on the pathogen surface.
- This complex acts as C3 convertase.
What is the alternative pathway of the complement system?
- This is spontaneous cleaving of C3 in the circulation.
* C3b then binds to the pathogen and acts as a C3 convertase.
What are the three main stages of the complement cascade?
• C3 splits - C3a Inflammatory mediator - C3b opsonises and acts as C5 convertase and C3 convertase. • C5 splits - C5a Inflammatory mediator - C5b - Catalyst of further cascade • Membrane attack complex forms - C6, C7, C8 and 5xC9
What are the three safeguards of the complement system to prevent self-attack?
- C3 inactivated by blood proteins unless bound to a pathogen.
- C3 convertase inactivation is accelerated by human cell surface proteins.
- MAC is kicked off human cell surfaces by surface proteins.
What are the two methods of chemokine action?
- Autocrine - Feedback loop, to amplify response.
* Paracrine - Act on other cells, communication.
Which interleukin is responsible for activation of T-cells?
IL-12
What are the four main mechanisms of action of antibiotics?
- Disruption of the cell wall.
- Inhibition of nucleic acid synthesis.
- Inhibition of protein synthesis.
- Antimetabolite activity.
What is the difference in the structure of the bacterial wall between gram +ve / -ve?
Gram -ve have a membrane on the outside of the peptidoglycan, whilst in gram +ve the peptidoglycan is the most outerly layer.
Give some examples of Beta-lactams and describe their mechanism of action.
- Penicillins, cephalosporins, carbapenems.
* Form covalent bonds with proteins in the cell wall preventing final cross-linking, thus disrupting the wall.
Give some examples of Glycopeptides and describe their mechanism of action.
- Vancomycin, Teicoplanin
- They inhibit the release of the building block part of the membrane, they prevent addition to the growing end of the peptidoglycan.
Give three antibiotics that work by inhibiting the production of nucleic acids in antibiotics.
- Quinolones.
- Metronidazole
- Rifampicin
Give some examples of Quinolones, and describe their mechanism of action.
- Ciprofloxacin, levofloxacin.
* They inhibit the DNA gyrase enzyme, which stops supercoiling of bacterial DNA.
What is the mechanism of action of metronidazole?
Damages DNA, which prevents DNA synthesis.
What is the mechanism of action of Rifampicin?
Inhibits the action of RNA polymerase.
Which three families of antibiotics work by inhibiting protein synthesis? Give the stand-alone antibiotic which also acts in this way.
- Tetracyclines
- Aminoglycosides
- Chloramphenicol
- Macrolides
What is the mechanism of Tetracyclines? Give some examples.
• Inhibits protein synthesis by binding to the 30s subunit of the ribosome.
Give some examples of Aminoglycosides, and describe their mechanism of action.
- Gentamicin, Amikacin.
* Binds to the 30s subunit of the ribosome, leading to misreading of codon on mRNA.
Give some examples of macrolides, and describe their mechanism of action.
- Clarithromycin, Erythromycin.
* Binds to the 50s subunit of the ribosome and prevents translocation. (Where tRNA is moved along ribosome).
What are the two most likely bacteria found on the skin? Give an antibiotic for the treatment of each.
- Steptococcus - Penicillin V
* Staphylococcus - Flucloxacillin
What type of bacteria is most likely to be found within an abscess? Give an antibiotic that will treat it.
Anaerobes - Metronidazole
How do anti-Beta-lactamases work?
• They widen the spectrum of the drug, by adding to the molecule a subunit that will irreversibly bind to the beta-lactamases.
Give two examples of what can be added to an anti-biotic to add beta-lactamase resistance, give an example antibiotic for each.
- Clavulanic Acid - Co-Amoxiclav (Augmentin)
* Tazobactam - Tazocin
Week 102 - Swollen Finger: Which cytokine is responsible for T-cell activation?
IL-12
Week 102 - Swollen Finger: Which cytokines (four) are responsible for vasodilation, vascular permeability, fever, macrophage and lymphocyte activation?
- Il-1ß
- TNF-å
- IL-6
- IL-8
Week 102 - Swollen Finger: What are the four main mechanisms through which antibiotics work?
- Disruption of cell wall
- Inhibition of nucleic acid synthesis
- Inhibition of protein synthesis
- Antimetabolite activity
Week 102 - Swollen Finger: What is the difference between gram-negative and gram-positive bacteria in terms of cell wall composition?
The gram -ve bacteria have an outer membrane that covers the peptidoglycan layer, whilst gram +ve bacteria have the peptidoglycan layer exposed.
Week 102 - Swollen Finger: Give examples of some Beta-lactams and describe their mechanism of action.
- Penicillins, cephalosporins, carbapenems.
* Form covalent bonds with penicillin-binding proteins to inhibit final formation of cross-links.
Week 102 - Swollen Finger: Give examples of glycopeptides and describe their mechanism of action.
- Vancomycin, Teicoplanin.
- Inhibits the release of the building block unit from the cell membrane. Prevent addition to growing end of peptidoglycan.
