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MCM > Week 7: Key Terms > Flashcards

Week 7: Key Terms Flashcards

1
Q

Diarrhea

A

3 or more loose watery stools per day OR a change from normal bowel habits

acute: less than two weeks
chronic: greater than two weeks

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2
Q

dysentery

A

diarrhea with blood

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3
Q

gastroenteritis

A

infection of the GI tract by viruses, bacteria or parasites

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4
Q

<5% dehydration

A

well, alert
drinks normally, not thirsty
skin recoils quickly

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5
Q

5-10% dehydration

A

restless, irritable
sunken eyes
thirsty, drinks eagerly
skin recoil slow

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6
Q

> 10% dehydration (severe)

A

lethargic, unconscious
sunken eyes
drinks poorly, unable to drink
very slow skin recoil

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7
Q

norovirus

A

most common cause of acute gastroenteritis in US

short incubation period, self limited, mild mucosal abnormalities

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8
Q

rotavirus

A

common cause of diarrheal mortality in children worldwide

vaccine available

short incubation, destruction of mature enterocytes with loss of absorptive surface

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9
Q

salmonella

A

gram-negative bacilli

nontyphoid salmonella causes salmonellosis

s. thyphi, s. parathyphi causes thyphoid fever

virulence factors: T3SS, flagellin, LPS

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10
Q

camplobacter

A

common cause of traveler’s diarrhea

virulence factors: cytotoxins

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11
Q

shigella

A

gram negative bacilli

resistant to gastric acid

virulence factors: T3SS, Shiga toxin (HUS)

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12
Q

vibrio cholerae

A

“rice water stools”
caused by contaminated water often following natural disasters

virulence factor: cholera toxin

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13
Q

ETEC

A

traveler’s diarrhea (secretory)

minimal mucosal damage

virulence factors: heat labile and heat stable

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14
Q

EPEC

A

diarrhea, particularly infants

superficial mucosal damage with enterocyte effacement

virulence factors: T3SS

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15
Q

EHEC

A

spread through uncooked beef, contaminated milk, vegetables

invade mucosal cells, proliferate, damage mucosa

virulence factors: shiga-like toxin can cause HUS

NO antibiotics, increases risk of HUS

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16
Q

pseudomembranous colitis

A

antibiotic-associated, c. diff

nosocomial spread

treat: vancomycin, fidaxomicin, fecal transplant

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17
Q

giardia

A

non-invasive diarrheaa
treat with oral rehydration and anti protozoan agents
parasite

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18
Q

cryptosporidium

A

water-bourne
resistant to chlorine
parasite

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19
Q

entamoeba

A

parasite causing infectious diarrhea

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20
Q

intussusception

A

telescoping bowel

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21
Q

malabsorption

A

chronic diarrhea

carbohydrate of fat malabsorption, cholestatic disorders, exocrine pancreatic insufficiency, decreased bile circulation

steatorrhea

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22
Q

inflammatory diarrhea

A

chronic diarrhea

IBS, celiac disease, colitis

fecal leukocytes, persists during fasting

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23
Q

hemolytic uremic syndrome

A

microangiopathic hemolytic anemia, thrombocytopenia, renal injury

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24
Q

clinical features HUS

A

diarrhea, bloody stools
weakness, lethargy
pallor, petechiae

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25
Q

laboratory findings HUS

A

anemia with shistocytes
thrombocytopenia
Shiga toxin +

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26
Q

Management HUS

A

supportive
avoid antibiotics and anti diarrheals

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27
Q

prokaryote

A

primitive nucleus
bacteria
small
rigid peptidoglycan cell wall

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28
Q

eukaryote

A

true nucleus
protozoa, fungi, plants, animals
large
evolved from fusion of prokaryotic cells

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29
Q

species definition: eukaryotes

A

members can mate and produce fertile offspring

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30
Q

species definition: bacteria

A

arbitrary, isolates that share many characteristics

97% similarity in 16s rRNA

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31
Q

Linnean binomial system

A

genus and species

Escherichia coli

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32
Q

subspecies classification of bacteria

A

determined by serology

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33
Q

Gram stain

A

Gram-positive: thick PG layer, purple

Gram-negative: thin PG layer, pink

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34
Q

Gram stain technique

A

Crystal violet (stain)
Iodine (fixant for CV)
Wash excess with alcohol
Saffrin (counterstain)

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35
Q

Molecular Koch’s Postulates

A
  1. Gene associated with the pathogenic organism
  2. Isolated by cloning
  3. Specific inactivation= loss in pathogenicity
  4. Complementation= restoration of pathogenicity
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36
Q

Koch’s Postulates

A
  1. Regularly found in lesions of disease
  2. isolated in pure culture
  3. similar disease in experimental animals
  4. recovered from lesions on those animals
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37
Q

prions

A

infectious proteins

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38
Q

virus

A

acellular infectious agents

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39
Q

bacterium

A

prokaryotic infectious agent

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40
Q

fungus

A

eukaryotic infectious agent

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41
Q

parasites

A

eukaryotic infectious agent

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42
Q

protozoan

A

unicellular parasite

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43
Q

helmith

A

multicellular parasite

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44
Q

commensal

A

microorganism in symbiotic relationship with host

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45
Q

colonization

A

ability of a microorganism to persist and multiply

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46
Q

normal flora

A

colonization with commensal microorganisms

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47
Q

pathogen

A

microorganisms that cause disease

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48
Q

virulence

A

degree of pathogenicity

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49
Q

infection

A

colonization by a pathogen

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50
Q

disease

A

result of infectious process leading to host damage

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51
Q

etiology

A

cause of disease

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52
Q

epidemiology

A

factors and mechanism of disease spread

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53
Q

sporadic

A

limited to a small number of isolated cases

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54
Q

endemic

A

continually prevailing in a region

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55
Q

epidemic

A

outbreak

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56
Q

pandemic

A

worldwide outbreak

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57
Q

Stages of infectious disease:

A
  1. incubation
  2. prodrome
  3. specific illness
  4. convalescence
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58
Q

quantitative measures of virulence

A

ID50 and LD50

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59
Q

ID50

A

number of microorganisms needed to infect 50% of host population

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60
Q

LD50

A

number of microorganisms needed to kill 50% of host population

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61
Q

virulence is _________ to ID/LD

A

inversely proportional

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62
Q

lower respiratory tract and upper genitourinary tract are

A

generally sterile

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63
Q

Transmission

A

oral/aerosal
fecal-oral
venereal
vector bourne
zoonotic

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64
Q

portals of entry

A

skin, soft tissue (trauma)
skin, bloodstream (arthropod bite)
respiratory (inhalation)
gastrointestinal (ingestion)
genital (sexual transmission)
transplacental

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65
Q

standard precautions

A

hand hygiene, PPE

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66
Q

contact precautions

A

gloves, gowns, private rooms

norovirus, c.diff

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67
Q

droplet precautions

A

masks, respirators, closed rooms

influenza

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68
Q

airborne precautions

A

N95, isolation room

measles, TB

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69
Q

full barrier precautions

A

airborne + contact + eye protection

SARS, pandemic

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70
Q

adhesins

A

surface virulence factors that confer ability to adhere to host surfaces

pili, fimbriae, protein adhesins, biofilms

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71
Q

Exotoxins

A

bacteria-mediated pathogenesis

enzymes, AB toxins, membrane damaging toxins, superantigens

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72
Q

endotoxin

A

host-mediated pathogenesis

LPS and Gram - only

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73
Q

AB toxin

A

B portion: Binds the surface cell receptor

A portion: is enzymatically Active and is transported to cell interior to be Activated

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74
Q

T3SS

A

syringe secretion system

effector proteins are injected by a needle complex from bacterial cytosol to host cytosol

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75
Q

Lipopolysaccharide

A

endotoxin

released by cell lysis, causes septic shock

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76
Q

pathogenicity island

A

region of DNA encoding for a set of virulence genes

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77
Q

secretory gastroenteritis

A

ETEC

watery diarrhea

proximal small intestine

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78
Q

inflammatory gastroenteritis

A

shigella
EHEC
salmonellosis
campylobacter

dysentery

colon

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79
Q

invasive gastroenteritis

A

salmonella thyphi/parathyphi

enteric fever

distal small intestine

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80
Q

Gram-negative, lactose positive bacteria

A

escherichia
klebsiella
enterobacter

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81
Q

gram-negative, lactose negative, glucose positive bacteria

A

salmonella
shigella
proteus
serratia
yersinia

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82
Q

gram-negative bacteria

A

cocci

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83
Q

Escherichia coli

A

causes diarrhea

ETEC: traveler’s diarrhea, non-invasive
EHEC: hemorrhagic; invasive, shiga-toxin

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84
Q

K:O:H serotyping

A

useful for epidemiology; differentiates virulence factors

K: capsular antigens
O: somatic antigen (LPS)
H: Flagellar antigen

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85
Q

EHEC

A

O157:H7
undercooked Hamburger

adheres to large intestinal cells

HUS

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86
Q

HUS

A

hemolytic uremic syndrome

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87
Q

Shigatoxin

A

causes destruction of endothelial cells

toxemia affecting kidneys

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88
Q

EHEC virulence factors

A

T3SS
LEE pathogenicity island
A subunit binds to rRNA, shutting down protein synthesis in the host cell

89
Q

ETEC

A

Traveler’s diarrhea

adhere to small intestinal mucosa

fimbirae, LT and ST toxins

90
Q

Heat labile toxin (LT-1)

A

AB toxin

B subunit binds to GM1
A subunit locks adenylate cyclase in “on” state, increases cAMP, causes ion imbalance

91
Q

Heat stable toxin (STa)

A

small peptide toxins

affects ion transport

92
Q

EPEC

A

no known toxins

93
Q

EAEC

A

persistent diarrhea in children

stacked bricks

biofilm

94
Q

treatment HUS

A

dialysis and blood transfusions

95
Q

Treatment E Coli

A

fluid/electrolyte maintenance
no antibiotics

96
Q

Is salmonella a lactose fermentor?

A

lactose negative

97
Q

is E Coli a lactose fermentor?

A

Lactose postitive

98
Q

Salmonella enterica

A

S. typhi or S. paratyphi

humans are only host, asymptomatic carriers

protected against stomach acid, SOD, and catalase

99
Q

Salmonella enterica treatment

A

DOCs: ciprofloxacin, levofloxacin

if critically ill, carbapenem then deescalate

100
Q

Shigella dysenteriae

A

most severe

frequent small bloody, mucous stool and tenesmus

HUS

101
Q

Shigella flexneri

A

shigellosis in developing world

102
Q

S.sonnei

A

shigellosis in industrial world

slow lactose fermentor, may get light pink on MacConkey

103
Q

Shigella

A

humans are only reservoir

low ID

fecal-oral route

lactose negative

non-motile

104
Q

Shigella virulence factors

A

T3SS mediated invasion
hemolysin
intracellular spread
shiga toxin

105
Q

Shigella treatment

A

rehydration, antibiotics

DOCs: ciprofloxacin, levofloxacin, ceftriaxone
azithromycin (peds)

106
Q

Campylobacter

A

gram negative
curved rod
single flagellum
oxidase +, catalase +, urease -

107
Q

C. jejuni

A

antecedent to Guillain-Barre

lesions resemble ulcerative colitis or Crohns

animal reservoirs: cows, birds, chickens

108
Q

C. fetus

A

produces a protein capsule (S protein) that is antiphagocytic

109
Q

C. jejuni causes Guillain-Barre

A

cross-reactivity of LOS and GM1 on neural tissue

110
Q

Campylobacter treatment

A

usually self limiting, may require antibiotics

azithromycin

c.fetus: carbapenem, aminoglycoside

111
Q

Humoral immune system

A

liquids and soluble molecules

112
Q

cellular immune system

A

cell

113
Q

innate immune system

A

immediate response, targets large groups of pathogens, no memory

114
Q

acquired immune system

A

gradual response generated over 3-4 days, targets specific pathogens, memory

115
Q

CD (cluster differentiation)

A

surface molecules of immune cells

116
Q

cytokines

A

communicate between cells
adjacent: paracrine
themselves: autocrine
systemically: endocrine

117
Q

Antibody

A

produced by B cells

precise specificity and bind to antigens

composed of two heavy chains and two light chains

118
Q

Fab domain

A

antigen binding

highly variable, highly specific

119
Q

Fc domain

A

binds to cells via FcR and gives antibody its specialized properties

non variable

120
Q

FcR

A

protein found on the surface of certain cells that bind to antibodies attached to infected cells or invading pathogens

important to opsonization, allergies, and antibody-dependent cell-mediated cytotoxicity ADCC

121
Q

lymphocytes

A

t cells
b cells
NK cells

from lymphoid stem cell

122
Q

NK cells

A

important defense against tumors and viruses

kill cells using ADCC
type II hypersensitivity

123
Q

macrophages

A

reside in tissues and are first to encounter pathogen

124
Q

neutrophils

A

reside in blood and need to be recruited to infection site

125
Q

dendritic cells

A

stimulate adaptive immunity

126
Q

mast cells/basophils

A

allergic responses

127
Q

PRR (pattern recognition receptor)

A

TLR found on cell surface and organelles of body cells

dendritic cells and macrophages use these to recognize pathogens

128
Q

TLR-4 interacts with

A

LPS on gram - bacteria

129
Q

PAMPs

A

LPS, peptidoglycan, dsRNA

130
Q

DAMPS

A

uric acid, extracellular DNA, RNA, and ATP

131
Q

IL1 and TNF alpha

A

fever

132
Q

IL8

A

recruits neutrophils

133
Q

IL6

A

pyrexia via PGE2

134
Q

CD19, CD20, CD21

A

b cells

135
Q

CD4+, CD8+

A

t cells

136
Q

BCR

A

two identical heavy chains and two identical light chains linked by several disulfide bridges

“surface bound antibody”

can bind 2 identical antigens

IgA and IgB do signal transduction

137
Q

TCR

A

one alpha chain and one beta chain linked by one disulfide bridge

binds one antigen, never shed

CD3 responsible for signal transduction

138
Q

MHC Class I

A

CD8+ (Tc)

stimulated to kill the presenting cell

expressed on all nucleated cells

HLA-A, HLA-B, HLA-C

activate NKs if missing or altered

139
Q

MCH Class II

A

CD4+ (Th)

expressed on APC

stimulated to control other cells

HLA-DP, HLA-DQ, HLA-DR

derived from foreign materials

140
Q

Hypersensitivity Type I

A

IgE mediated
allergies
immunity to helmiths

141
Q

Hypersensitivity Type 2

A

IgG/IgM cytotoxic
opsonization

142
Q

Hypersensitivity Type 3

A

immunity to bacterial toxins

143
Q

Hypersensitivity Type 3

A

immunity to bacterial toxins

144
Q

Hypersensitivity Type 4

A

immunity to intracellular bacteria, viruses, protozoa
delayed
diabetes, dermatitis

145
Q

Th1

A

Type 4 hypersensitivity

promote CD8+ responses

secrete IFNy, TNF, IL-2

146
Q

Th2

A

Type 1 hypersensitivity
promote antibody responses

147
Q

Treg

A

suppress immune response

148
Q

Th17

A

secrete IL 17
important to immunity to bacteria and fungi

149
Q

Tfh

A

follicular B helper cells

150
Q

IL-12

A

induce Th1

151
Q

IL-4, IL-5, IL-13

A

allergy

Th2 response

152
Q

IL-4, IL-13 lead to IgE production

A

Th 2 response

Type 1 hypersensitivity

153
Q

IL-5

A

stimulates eosinophils

154
Q

anti-sense oligonucleotide (AON)

A

short, synthetic nucleotide chains that can be used as a therapy to “exon skip”

AON masking splice site is inserted slightly upstream of the exon with a premature stop codon to “skip” it

therapy for Duchenne

155
Q

branch point

A

step 1 of lariat structure: 2’-OH of Adenine at the branch point attacks the 5’ G of intron forming the intermediate structure

156
Q

cryptic splice site

A

splice site not normally used in WT but are selected for due to mutation elsewhere

example used in class Beta zero thalassemia: mutation in WT splice site resulted in the use of cryptic splice site in intron 2. Part of intron 2 is then retained in protein causing misfolding and ubiquitination.
No beta chain synthesis.

157
Q

exon

A

part retained for mRNA

158
Q

intron

A

non coding regions spliced out of mRNA

159
Q

lariat

A

splicing intermediate formed by 2 consecutive Sn2 reactions

Step 1: 2’-OH at branch point A attacks 5’ G of intron

Step 2: OH-G at 3’ end of exon 1 attacks 5’-G of exon 2

160
Q

mRNA cap

A

7-methyl guanosine cap

increases stability
identifies rRNA as cellular (vs. viral)
required for translation
export to cytoplasm

161
Q

poly-A signal

A

poly(A) polymerase complex recognizes poly-A signal and cleaves about 25 nucleotides down stream

AAUAA

162
Q

poly-adenylation

A

poly(A) polymerase complex adds 150-200 A residues

no DNA template

marks mRNA as “special”
-translation efficiency
-export to the cytoplasm
-stabilize mRNA

163
Q

pre-mRNA

A

primary transcript of a protein-coding gene before splicing and modifications

164
Q

RNA binding/splicing regulatory factor

A

Bind splicing enhancers/silencers
Specify intron/exon boundaries
Regulate utilization of splice sites/binding of snRNPs
Execute development programs of specific splicing
Recognize defects in binding sites or disease factors

165
Q

small nuclear ribonucleoproteins (snRNPs)

A

set up proper geometry for splicing
hold together exons prior to joining
catalyze cleavage and formation of bonds

antibodies to snRNPs found in systemic lupus (SLE)

only in eukaryotes

166
Q

snRNA

A

associate with snRNP for lariate structure

U1, U2, U4, U5, U6

167
Q

snRNP U1

A

recognizes donor exon/intron boundary

168
Q

snRNP U2

A

recognizes adenosine branch point

169
Q

snRNP U4, U5, U6

A

form spliceosome

170
Q

Base pairing between U1/U2 and pre-mRNA is an important determinant of

A

splice site strength

171
Q

splicing signals

A

conserved nucleotide sequence that are critically important

mutation of splice site=loss of signaling
mutated splice signals often responsible for disease

172
Q

mammalian splice signal

A

(donor site) AG/G (acceptor site)

173
Q

splicing enhancer

A

promote splice site

174
Q

splicing silencer

A

repress splice site

175
Q

splice variant

A

alter activity or regulation of proteins produced
alter stability or translation of mRNA

176
Q

fibrosis

A

excessive extracellular matrix accumulation

177
Q

cirrhosis

A

normal-moderate AST/ALT
increased bilirubin
decreased albumin
decreased clotting factors
increased PTT
abnormal elastography
execessive ECM
regenerating nodules

178
Q

parenchyma

A

hepatocytes

179
Q

non parenchymal cells

A

Kupffer cells, hepatic stellate cells, portal fibroblasts, liver sinusoidal endothelial cells, cholangiocytes

180
Q

bile composition

A

97% water
.7% bile salts
.2% bilirubin
.51% fats
trace inorganic salts

181
Q

bile salts/acids

A

derived from cholesterol
amphipathic: solubilize fats and cholesterol
hormonal activity

182
Q

bilirubin

A

derived from heme breakdown
excreted in the stool

183
Q

stellate cells

A

produce ECM to prevent further scarring to liver

184
Q

Kupffer cells

A

liver macrophages, primarily breakdown RBCs

185
Q

liver sinusoidal endothelial cells

A

provide barrier between sinusoids and parenchyma

186
Q

matrix metalloproteinase (MMP)

A

remodeling proteins
breakdown liver damage, then return after TIMPs to break down collagen

187
Q

Tissue inhibitor of matrix metalloproteinases (TIMP)

A

inhibit MMPs so stellate cells can lay down collagen

188
Q

Prothrombin time (PTT)

A

time it takes to clot

189
Q

liver function tests

A

albumin, bilirubin, PTT

190
Q

liver injury tests

A

ALT, AST, LDH

non specific

191
Q

A site

A

amino acid site on 80s ribosome

incoming aa-tRNA binds here

192
Q

P site

A

peptidyl site on 80s ribosome

holds tRNA bound to nascent position

193
Q

eIF4F (cap binding complex)

A

three subunit complex that binds 7 methyl guanosine cap on mRNAs

ensures only mRNAs are translated

eIF4E is limiting subunit of cap-binding complex

components: eIF4A, G, E

194
Q

eIF2

A

escorts initiator methionyl-tRNA to small ribosomal subunit engaged on mRNA

195
Q

eIF1 and eIF3

A

bind to small ribosome subunit, facilitates binding to eIF4F on mRNA cap

196
Q

Poly A binding protein

A

interacts with poly A tail and eIF4F bound to CAP
circularizes actively translated mRNA, increases efficiency

197
Q

E site

A

exit site on 80s subunit, “nake” tRNA binds here after its aa has been added to the protein

198
Q

EF1

A

elongation factor 1, escorts aa-tRNAs to ribosome

199
Q

EF2

A

elongation factor 2, hydrolyses GTP and causes translocation of the ribosome

modified and inhibited by bacterial toxins

200
Q

RF

A

release factor, catalyzes the release of ribosome and new protein from mRNA at stop codon

201
Q

polysome

A

mRNA covered with multiple, active ribosomes

202
Q

diphtheria toxin (corynebacterium diptheriae) and exotoxin A (psuedomonas aeruginosa)

A

blocks GTP hydrolysis of EF2

shuts down all translation

203
Q

N-glycosylase

A

toxins that inhibit ribosome function and cause loss of protein synthesis

shiga toxin (shigella, e. coli), ricin toxin (castor beans)

204
Q

internal ribosome entry site (IRES)

A

initiation of translation at a site other than mRNA cap

utilized during activation of ER stress response and by RNA viruses to allow some protein translation

205
Q

phosphorylation of eIF2a

A

inhibits translation

most protein translation stops
transcription of specific mRNA into protein increases

206
Q

4 kinases that can phosphorylate eIF2alpha

A

PKR-activated by viral dsRNA
GCN5 activated by low amino acids/glucose
HRI- activated by low heme ONLY in immature RBCs
PERK- activated by ER stress or UPR

207
Q

eIF2alpha is an

A

initiation factor

208
Q

eIF2alpha increases transcription of ATF4 which

A

increases prorecovery transcription to reduce stress: proteases, chaperones, antioxidants

or

CHOP, causing apoptosis

209
Q

eIF4E is the

A

limiting subunit for translation

controlling availability will broadly effect

more=pro growth

210
Q

miRNAs

A

small RNAs that repress translation and cause mRNA degradation

211
Q

post transcriptional gene silencing (PTGS)

A

therapeutic gene silencing = RNAi

repress translation or destabalize target RNAs

have “hairpin structure” for intramolecular base pairing

212
Q

RNA induced silencing complex (RISC)

A

uses miRNA to target mRNAs for silencing in PTGS

213
Q

siRNA

A

short interfering RNA

delivered as drug, processed in cytoplasm, loaded onto RISC, induces mRNA degradation

214
Q

start codon

A

AUG

215
Q

stop codons

A

UAA, UGA, UAG

216
Q

how many antibiotics inhibit translation?

A

1/2

217
Q

aminoglycosides (-mycins)

A

bind to 30s unit of ribosome and elicit premature termination via incorporation of incorrect amino acid

218
Q

untranslated region (UTR)

A

sequence in mRNA that are not translated
often contain conserved sequences that affect translation efficiency, mRNA stability

MCM (2 decks)

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