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Host and Defense > Week 15 > Flashcards

Week 15 Flashcards

1
Q

___ developed during the primary response provide protective immunity for the first few weeks. This prevents the activation of the adaptive immune response

A

Antibodies (but the antibody levels decline with age)

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2
Q

What are the 3 types of memory cells

A

memory B cells

Memory plasma cells

Memory T cells (both central and effector)

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3
Q

When a T cell is activated and proliferates, does it produce more effector T cells or memory cells?

A

Effector T cells outnumber memory cells

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4
Q

Which, primary effector cells or memory cells have a broad antigen response?

A

Primary effector

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5
Q

Which, primary effector or memory cells are easily activated (the dont require costimulatory signals or cytokines)?

A

Memory cells

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6
Q

Which, primary effector cells or memory cells must undergo target refinement by somatic hypermutation and class switching?

A

Primary effector cells

Memory cells may undergo somatic hypermutation

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7
Q

How long can immune memory cells persist for?

A

Decades

Antibodies are produced at a steady state

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8
Q

The secondary immune response activates ___ but inhibits ___. Why?

A

Memory B cells

Naive B cells

It does this so that energy is only spent producing the high-affinity IgGs instead of spending unnecessary energy

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9
Q

Activated memory B cells replicate into ___ and ___

A

Plasma cells

More memory cells

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10
Q

True or false… memory T cells do not require CD-28 co-stimulation

A

True, they do not

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11
Q

Describe how highly mutable pathogens erode immune memory

A

If first viral infection is ABCD, then later you are infected with ABCE, the ABC memory cells inhibit the naive B cells to produce memory against the E antigen.

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12
Q

Name 7 different types of vaccines

A

Live-attenuated

Inactivated

Subunit

Conjugate

Toxoid

DNA

Recombinant vector

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13
Q

What was the first live attenuated virus vaccine? Explain how live attenuated vaccines work?

A

Cowpox

This is a virus raised in a different species. For example, there are some similarities in the antigens of cowpox and smallpox viruses. When you are infected with a smallpox virus, the cowpox antibodies will neutralize it

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14
Q

What is an attenuated virus (not live)?

A

Pathogenic human virus is isolated, then grown in another species. The virus gains mutations that allow it to infect the other species. Then, the mutated virus is used for a vaccine as it shares viral components with the pathogen but is unable to infect human host

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15
Q

Define adjuvant

A

A compound that incites an adaptive immune response

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16
Q

Explain how adjuvants can be used to broaden vaccine targets and improve efficacy

A

If the adjuvant is paired with a typically non-reactive antigen, it enhances the immune response so that it recognizes the antigen as pathogenic

Many vaccines include adjuvants

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17
Q

In regards to recombinant protein vaccines… normally bacterial ____ binds factor ___ to inactivate ___ deposited on the bacterial surface. However, in the presence of specific anti-___, ___ cannot bind factor ___, causing ___ to be fixed and target the bacteira for destruction

A

Lipoprotein fHbp

H

C3b

FHbp

FHbp

H

C3b

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18
Q

Name 5 ways pathogens can evade the immune system

A

Stereotype diversity

Antigenic drift

Antigenic shift

Gene conversion

Latency

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19
Q

Name 6 ways pathogens can subvert (take advantage of) the immune system

A

Endocytic hijacking

Protein mimicry

Humoral inhibition

Inflammation inhibition

Immunosuppression

Superantigens

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20
Q

What is stereotype diversity and how can it allow pathogens to evade the immune system?

A

A serotype is an antigenically different strain of the same pathogen.

This means that you can be infected with one serotype of a bacteria, but then be infected with another serotype of the same species, giving you the same infection. You must develop completely new antibodies for the new serotype

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21
Q

True or false… stereotypes are formed from high mutation

A

False! Serotypes have high genetic variability, they are not necessarily due to mutations.

These are useful for tracking outbreaks

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22
Q

What is antigenic drift and how does it allow pathogens to evade the immune system?

A

Antigenic drift - mutation in the viral genome driven by selective pressure as the virus infects a population

Viral genomes are highly mutable, thus are tied to memory erosion

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23
Q

Antigenic drifts are responsible for viral ___ whereas antigenic shifts are responsible for viral ___

A

Epidemics

Pandemics

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24
Q

What is an antigenic shift?

A

Genetic recombination that leads to significant change in viral antigens.

Usually involves recombination with multiple species (bird flu, swine flu, human flu).

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25
Q

What is gene conversion and how does it allow pathogens to evade the immune system?

A

VSG (variable surface glycoprotein) is altered by trypanosomes to evade antibodies. V

VSG genes are rearranged to express one dominant VSG at a time

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26
Q

What is latency?

A

A viral dormant state in host tissue

This allows the virus to persist with a reduced viral load and with an absent/reduced interferon response and MHC-1 expression.

Also allows NK and CD8 T cell evasion

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27
Q

What are some common viruses with latent periods?

A

Cytomegalovirus

Varicella zoster

Epstein Barr

Herpes

Paroviruses

Adenoviruses

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28
Q

What is endocytic hijacking? How is it used to subvert the immune system?

A

Utilizes endocytosis to enter cells. Here, it prevents prevents lysosome fusion, escapes the phagosome, or survive the autolysosomal envionrment of lysosome

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29
Q

What is antigen mimicry? How is it used to subvert the immune system? What pathogens do this commonly?

A

Pathogens coat themselves with host proteins to evade the immune system (since it uses host factors, it is considered subversion)

Worms do this a lot

-surface antigens are regularly shed

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30
Q

What are superantigens? How are they used to subvert the immune system?

A

It binds to MHC 2, so that when it binds to TCR it activates the T cell, yet hides the antigen. This causes an enormous, nonspecific CD4 response.

  • this can lead to autoimmunity
  • will also inactivate antibodies and complement
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31
Q

What bacteria have superantigens?

A

Staphylococcus

Streptococcus

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32
Q

By binding ___ to ___ and ___, it prevents the host from recognizing the Fc fragment of antibodies, preventing phagocytosis. Thus the pathogen subverts the immune system

A

SSLP7

IgA

C5.

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33
Q

What is primary immunodeficiency?

A

Genetically caused immune system deficiency

can be dominant, recessive, X-linked

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34
Q

What is secondary immunodeficiency? What can cause it?

A

Immune deficiency caused by environmental factors

Caused by...
Chronic disease
Immunosuppressive drugs
Viral (HIV)
Environmental toxins
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35
Q

What is an example of an X-linked immunodeficiency disorder? Describe it.

A

Agammaglobulinemia

BTK (bruton’s tyrosine kinase is necessary for B cell signaling

BTK on the X chromosome

BTK negative males or BTK homozygous negative females do not develop B cells

Note that heterozygous females will have less B cell development, but not noticibly, they are carriers

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36
Q

What are the 5 classes of primary immunodeficiency ? What percentage of primariy immunodeficieny are of each type?

A

Humoral immunity - 60%

Cellular immunity - 10%

Combined - 20%

Phagocytic cells - 10%

Complement - <2%

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37
Q

Name four examples of primary cellular immunodeficiencies.

A

Digeorge syndrome

ZAP-70 deficiency

X-linked lymphoproliferative syndrom

Chronic mucocutaneous candidiasis

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38
Q

Name three examples of phagocytic immunodeficiencies

A

Chronic granulomatic disease

Leukocyte adhesion deficeincy

Chediak-higashi syndrome

39
Q

In the immune response to HIV, you see a spike in the level of virus within the 4-8 weeks. Then it goes down, fluctuating for a while, but then it rises up again after how long?

A

2-12 years

40
Q

Name the three bacteria that cause STDs

A

Gonorrhea

Syphilis

Chlamydia

41
Q

Name one protozoan that causes an STD

A

Trichomonas vaginalis

42
Q

Name two Arthropoda that cause STDs

A

Lice

Scabies

43
Q

Name three viruses that cause STDs

A

HIV

HPV

HSV

44
Q

Name 7 syndromes associated with STDs

A

Urethritis

Cervicitis

Genital ulcers

Epididymititis

Procititis

Vaginitis

Pelvic inflammatory disease (PID)

45
Q

What three groups of people get screened for STDs?

A

People who have had sexual contacts of persons with proven STDs

Symptomatic persons

Persons concerned about having an STD

46
Q

What is urethritis?

A

Visible drip from the penis or WBCs seen on a urethral gram stain

47
Q

What is cervicitis?

A

Vaginal discharge or friable cervix on exam

Asymptomatic infections are common in both sexes (neither urethritis nor cervicitis)

48
Q

Chlamydia is most prominent in what population?

A

Young women in urban areas

49
Q

What is the most common reportable STD in utah?

A

Chlamydia trachomatis

50
Q

What is the epidemiology of mycoplasma genitalia?

A

Urethritis, cervicitis, PID, endometritis

51
Q

How do you diagnose gonorrhea for males and females?

A

Symptoms: white/green/grey purulent discharge, can disseminate

Male: urethral gram stain, nucleic acid amplification testing

Female: nucleic acid amplification testing

52
Q

True or false… you only do a gram stain for males for gonorrhea

A

True

53
Q

Is gonorrhea more prevalent in males for females?

A

Males

54
Q

What are two symptoms from STDs that can cause infertility?

A

Epididysis - males

PID - females

55
Q

What are the symptoms of PID (pelvic inflammatory disease)?

A

Vaginal discharge

Cervical motion tenderness

Uterine tenderness

Adnexal tenderness

56
Q

True or false… PID is an underdiagnosed syndrome

A

True, many cases are missed and therefore go untreated often with serious consequences.

57
Q

What is bacterial vaginosis?

A

White vaginal discharge

Presence of clue cells

PH>4.5

Frisky odor with KOH

58
Q

What are the symptoms of genital herpes? How do you diagnose it?

A

Bumps/blisters
Dysuria
Vaginitis

PCR with typing as HSV-1 or HSV-2

59
Q

Syphilis is caused by ___. Most cases are __ patients that are ___+. How do you diagnose it?

A

Treponema pallidum

MSM

HIV

Diagnosis - unculturable agent!

60
Q

What is secondary syphilis?

A

Syphilis can disseminate to other parts of the body causes a rash (spots on palms).

Note that it is still contagious!

61
Q

What is another name for HHV-8?

A

Kaposi’s sarcoma herpesvirus

62
Q

HHV-6 creates a specific pattern called ___

A

Roseola

63
Q

Primary latency of HHV6 and HHV7 reside in ___

A

CD4 lymphocytes

64
Q

Kaposi’s sarcoma (HHV-___) primary infection via ___ contact, especially in ___. Primary infection is ___.

A

8

Sexual

Homosexual males

Asymptomatic

65
Q

What does the primary infection look like for HSV-1

A

80% are asymptomatic

Occurs at a young age

66
Q

In the case of symptomatic primary HSV-1 infections, age affects the clinical presentation. Describe this difference

A

Young = gingivostomatitis

18+ = pharyngotonsillitis

67
Q

Describe acute herpetic gingivostomatitis

A

Primary HSV-1 infection

90% due to HSV-1

Most cases occur before age 5

Both movable and attached oral mucosa affected

Affected mucosa develops pinhead vesicles. Rapidly collapse and form small, red lesions. Initial lesions enlarge and develop central areas of ulceration covered by yellow fibrin. Adjacent ulceration coalesce

68
Q

Describe primary herpes- pharyngotonsillitis

A

Initial symptoms - sore throat, fever, headache

Numerous small vesicles develop on tonsils posterior pharynx. Rapidly rupture to form shallow coalesce. Diffuse grey-yellow exudate forms

Can be due to HSV-1 or HSV-2

69
Q

Describe recurrent herpes simplex

A

AKA secondary herpes

Can occur anywhere along the surface epithelium supplied by the involved ganglion

Most common site of recurrence for HSV-1 is vermilion border

70
Q

Recurrent herpes simplex intraoral lesions almost always occur where?

A

Keratinized, bound mucosa

Symptoms are less intense

71
Q

What are the histopathology features of HSV?

A

Multinucleation

Ballooning degeneration

Tzanck cells

72
Q

What does it mean If you see shingles at the tip of the nose?

A

It is a sign that ocular infection may occur

73
Q

What is Ramsay hunt syndrome? What is it caused by?

A

Cutaneous lesions of the external auditory canal. May involve facial paralysis, hearing deficits, vertigo

Caused by VSV (shingles)

74
Q

What virus causes infectious mononucleosis?

A

EBV

75
Q

What kind of virus may cause herpangina, hand-foot-and-mouth disease, or acute lymphonodular pharyngitis

A

Coxsackie virus

Which is a type of enterovirus

76
Q

What virus causes rubeola (measles)?

A

Paramyxovirus

77
Q

Which hypersensitivity reactions are humoral and which are cell-mediated?

A

Humoral - 1, 2, 3

Cell-mediated - 4

78
Q

True or false.. hypersensitivity reactions are mutually exclusive, meaning that you only have one type of reaction per allergin

A

False, they cross over

79
Q

As part of a type 1 hypersensitivity reaction, ___ are Th2 effectors in parasite immunity

A

Granulocytes

80
Q

In a type 1 hypersensitivty reaction, ____ degranulation drives inflammation. It’s toxic mediators are ___ and ___which function to…

A

Mast cell

Histamine

Heparin

Poison parasites, increase vasculature permeability, cause smooth muscle contraction (it increases fluid secretion and peristalsis in the GI tract, decreases diameter in airways, and increases blood flow)

81
Q

True or false… Eosinophils degranulation is toxic. They are activated/recruited by mast cells and Th2 cytokines.

A

True

82
Q

What is the hygiene hypothesis?

A

Reduced early developmental immune pressure causes poor immune education and an inappropriate pathogen identification, leading to allergy and autoimmune disorders

83
Q

Allergic reactions occur in two phases. Describe these phases

A

Immediate: occurs within an hour and causes a deep drop in their expiratory flow rate

In the late phase, eosinophils are involved

84
Q

What are the symptoms of anaphylactic shock?

A

Due to mast-cell degranulation and release of inflammatory mediators

Causes significant drop in arterial blood pressure, constriction of airways, contraction of smooth muscel in GI tract

85
Q

___ halts anaphylactic shock

A

Epinephrine

86
Q

What is hyposensitization?

A

Repeated exposure to escalating dosages of allergens to reduce type 1 responses

87
Q

What is a type 2 hypersensitization reaction?

A

Antibody-mediated

IgG response to small molecules bound to cell surfaces.

88
Q

Type ___ hypersensitivity causes newborn hemolytic disease. Describe how.

A

Rh- mother carries a Rh+ fetus so the mother develops anti-Rh+ IgG. Next pregnancy with Rh+ child is attacked by the anti-Rh+.

Rhogam prevents this from occurring (erythroblastis fatalis)

89
Q

Describe type 3 hypersensitivity reactions.

A

Inefficient immune complex clearance.

Complexes are deposited in blood vessels and tissues

Innate inflammatory response

Inflammatory lesions occur (clot formation, fever, skin rash, rheumatoid arthritis)

90
Q

Type ___ hypersensitivity is considered the delayed type hypersensitivy. It is cell mediated, not humoral. Primarily CD4 and macrophage mediated. Two phases: sensitization and effector

A

4

91
Q

Name three keystone pathogens in periodontitis

A

P. Gingivalis

Treponema denticola

Tannerella forsythia

92
Q

Type three hypersensitivity involves what two immunoglobulins?

A

IgG and IgM

93
Q

True or false… T cells need a costimulatory signal in order to recognize the allergin as pathogenic to create memory

A

True

Host and Defense (17 decks)

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