Term
| What category of bacteria have LPS on their outer layer? |
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Definition
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Term
| What complement molecules can either bind to the surface of bacteria via the alternative pathway and which can bind to the Fc portion of antibody marked sufaces to induce the classical pathway? |
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Definition
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Term
| Name this antigen presenting cell - Sometimes a Langerhans cell. Very good at engulfing small antigens and presenting them. Can be infected by some viruses. Already expressed high levels of MHC-II and even 2nd signal B7, so it is the best antigen-presenting cell. |
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Definition
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Term
| Name this antigen presenting cell - Engulfs whole bacteria and viruses. Takes external pathogens and presents them on MHC-II to activate TH2 cells to make Ab. Can be infected intracellularly by some bacteria, activating TH1 cells. Has LPS receptor on its cell surface. |
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Definition
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Term
| Name this antigen presenting cell - Binds to particulate antigens such as proteins, antigenic fragments, parts of viruses. Will process and internalize these and present them on MHC-II. Will activate TH2 cells to get help to make antibodies. |
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Definition
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Term
| Which MHC is HLA/B/C and which is DP/DQ/DR? |
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Definition
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Term
| Which class of immungoglobin binds to complement better than IgG? |
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Definition
| IgM because it is a large pentamer |
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Term
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Definition
| It is when a T-cell won’t recognize a presented MHC bound antigen and respond if the HLA class doesn’t match its receptor, or if the HLA matches and the bound antigen doesn’t match the TCR |
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Term
| T or F: One APC will present antigens on 6 MHC-1 molecules and 6 MHC-II molecules. This will result in clonal activation and expansion of naïve T cells. |
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Definition
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Term
| Name this organism - gram +, encapsulated, lancet shaped in pairs, anaerobe, a-hemolytic, most common cause of CA-pneumonia and meningitis, Asymptomatic carriage (5-10% adults, 40-60% toddlers). |
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Definition
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Term
| How does the efficiency of phagocytosis of strep pneumonia differ if there is a polysaccharide capsule or not? |
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Definition
| If there isn’t a capsule then the alternative pathway is activates; if there is a capsule then antibodies must be generated first in order to stim the classical pathway |
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Term
| Which of the following vaccines is available for pneumococcus - 23 valent capsular polysaccharide vaccine or 7 valent conjugate vaccine called Prevnar? |
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Definition
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Term
| T or F: diagnosis of pneumococcal disease must consider the high rate of asymptomatic infection in the general population. |
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Definition
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Term
| Name this organism - Gram-negative diplococci, fastidious, ~80% homologous, Habitat: human mucosal surfaces, poor environmental survival, nasopharyngeal colonization, Symptomatic and asymptomatic infections, endemics and epidemics especially in Africa of meningitis. |
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Definition
| Neisseria meningitides, epidemics are local in developed countries but widespread in undeveloped |
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Term
| Name this major mechanism in the pathogenesis of Neisseria species that involves moving across mucus and cell layers to access submucosa. |
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Definition
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Term
| Which of the following are virulence factors of meningococcus - pili that bind to epithelial cells, lipooligosaccharide LOS endotoxin, antiphagocytic capsule, IgA1 protease. |
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Definition
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Term
| Since Meningococcemia and meningitis are the two most serious invasive diseases caused by N. meningitides, what is one of the characteristic clinical signs of the disease? |
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Definition
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Term
| T or F: Extensive shedding of LOS may be partly responsible for the severity of pneumococcal infections. |
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Definition
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Term
| T or F: There is a 4 valent capsular vaccine for meningococcal disease but there isn’t a conjugate vaccine available yet. |
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Definition
| False, it was created in 2005 |
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Term
| Name this organism - gram neg, coccobacillis, aerobe, fastidious, slow-growing, habitat only in human respiratory tract, whooping cough with complications of pneumonia. |
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Definition
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Term
| There are 4 phases involved in the classical whooping cough, describe them. |
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Definition
| Incubation for 7-14 days, a catarrhal phase for 7 days with cold llike symptoms, a paroxysmal phase with intense periods of coughing for 1-4 weeks with complications of pneumo/seizures/apnea, then convalescence phase for recovery |
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Term
| Pertussis has 3 different binding proteins that allow it to adhere to respiratory cilia - pertactin, fimbriae, Filamnetous HA - which is the primary adhesion molecule and which ones are immunogenic? |
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Definition
| Filamentous HA is primary, and all of them are immunogenic |
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Term
| Pertussis has 3 different toxins that allow it to breach respiratory cilia - Adenylate cyclase toxin, pertussin toxin, and tracheal cytotoxin - what do they each do? |
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Definition
| Adcyclase toxin super-increases cAMP in phagocytes and leukocytes inhibiting their function, Pertussis toxin inhibits G-proteins that turn off the cAMP pathway increasing cAMP and does the same thing, tracheal cytotoxin is a cell wall fragment that induces ciliostasis and kills ciliated cells. |
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Term
| What is different about newer vaccines that causes reduced reactogenicity? |
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Definition
| The vaccines are acellular and are only purified toxins or components like Ptx, FHA, Prn, and Fim |
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Term
| Name this organism - gram neg, coccobaccillus, requires hemin and NAD, some encapsulated strains, habitat is human respiratory tract, tranx via respiratory drops, most serious disease is meningitis, most common disease is otitis media. |
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Definition
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Term
| In hem. Influenza what strain type is responsible for the most virulent forms of disease such as meningitis, epiglottitis, and pneumonia? |
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Definition
| Type B, due to the capsule composed of polyribosylribitol phosphate PRP; the non-encapsulated forms are responsible for otitis media |
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Term
| Which 3 organisms have a conjugate vaccine available? |
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Definition
| H.Influ B, pneumococcal, N. meningitides |
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Term
| Which of these are observational and which are experimental - case series, case control, cohort, clinical trial, RCT. |
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Definition
| First 3 observational, last two experimental. |
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Term
| Give the equations for determining risk, RR, RRR, AR, ARR, NNT. |
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Definition
| Those who had outcome over those that could have, treatment risk/control risk, control-treat/control, control - treat, 1/ARR |
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Term
| Give the equations for odds and odds ratio. |
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Definition
| Patients who had an outcome of therapy/ patients who didn’t have the outcome, treat odds/control odds |
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Term
| If a 95% confidence interval does not contain the null value of the estimator does that give value to study results or not? |
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Definition
| Yes, : if the 95% confidence interval does not contain the null value of the estimator, then the p value will be less than 0.05 (and if the 90% C.I. doesn’t contain the null, p is less than .1, 99% /p,.01, etc, etc. |
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Term
| Name this organism - gram neg. curved rod, single flagellum, endemic/epi/pandemic, diarrhea, transient human and watery environ habitat, fecal-oral. |
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Definition
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Term
| What are the causes of whether the diarrhea caused by cholera is secretory or bloody? |
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Definition
| Secretory is due to colonization + toxin or pre-formed toxin, whereas bloody is due to invasion + inflammation |
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Term
| What is the treatment for cholera and what type of vaccine can be used? |
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Definition
| Dx is via stool and epidemiology then Oral rehydration plus antibios, there is no vaccine |
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Term
| Which of the following are virulence factors that allow the cholera toxin to breach the gastric acid barrier and attach to small bowel - TCP pilus, ACF Adhesin, Flagellum, Proteases, Neuraminidase, Cholera Toxin? |
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Definition
| First 3 are motility and adhesion, rest allow cellular access |
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Term
| How does the cholera toxin work? |
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Definition
| A phage encoded virulence factor is expressed into the lumen and is then absorbed by cells and keeping AC is active state via G-protein pathways and keeping cAMP levels high and causing cells to secrete CL- causing watery flow |
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Term
| Name this organism - spiral gram neg rods, motile, urease production, infection rates increase with age, associated with gastritis/ulcers/cancer. |
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Definition
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Term
| Which of the following are virulence factors for H. pylori - flagellum, urease (increase pH), VacA cytotoxin, CaG islands. |
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Definition
| All of them, CaG islands induce proteins causing IL-8 secretion causing inflammation |
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Term
| How do you diagnose and treat H. pylori infection? |
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Definition
| Dx - biopsy and stain, urease breath test, stool antigen; Tx - amoxi, clarithromycin, PPi |
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Term
| Ampicllin is an aminopenicillin that has enhanced activity against what type of bacteria due to its amino group? |
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Definition
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Term
| What drug has the following features - IV, Extremely broad activity, including S.aureus and other gram positives, Pseudomonas, and anaerobic organisms, Toxicities: hypersensitivity/seizures, Induces beta-lactamases in many gram negatives, given with cilastatin to inhib nephrotox. |
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Definition
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Term
| Name this drug - IV, Very narrow coverage: limited to aerobic gram negatives but Pseudomonas species seldom susceptible, resistant to b-lactamases, Toxicities: can be used in patients with penicillin hypersensitivity, Utility limited, usually used for gram negative UTI. |
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Definition
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Term
| Name this drug - IV normally, tricyclic glycopeptide that inhibs cell walls, Very narrow coverage: limited to gram positive organisms, Second rate as an anti-Staphylococcal agent and resistant in enterococci, Some infections clear more slowly than with penicillin, Toxicities: can be used in patients with penicillin hypersensitivity. |
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Definition
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Term
| Name this drug - polypeptide that inhibs cell wall, good against a wide variety of gram +, used topically due to nephrotoxicity. |
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Definition
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Term
| Name this organism - motile, gram neg bacilli, causes enteritis or enteric fever, either a typhoid or non-typhoid type, trans via food and contaminated surfaces. |
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Definition
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Term
| Describe the difference between the typhiodal and non-typhoidal types of salmonella including reservoir, carrier state, transmission, and resulting disease. |
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Definition
| Typhoidal - humans, symptomatic or chronic, food and contact, enteric fever; Non-typhoidal - any animal, GI commensal (asym), meat/eggs/dairy, gastroenteritis. |
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Term
| T or F: Prophylactic antimicrobial therapy can increase the frequency of salmonellosis among travelers. |
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Definition
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Term
| What is the difference in treatment of enteric fever versus gasrgtoenteritis from salmonella? |
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Definition
| Gastro you treat with rehydration and antibios are not recommended, enteric fever is treated with fluoroquinolones and 3rd generation cephalosporins |
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Term
| T or F: the pathogenesis of Salmonella invasion involves invasion of intestinal epithelium causing IL-8 secretion, PMN recruitment and fluid secretion, macrophage uptake and survival, replication in peyer’s patches, and for enteric fever there is a migration of infected macros to the gut. |
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Definition
| False, infected macros go to the spleen and liver and reticulo-endothilal organs via lymphatics and blood. |
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Term
| Does salmonella use the SopE or SptP protein via tyoe 3 secretion to control G-protein coupled actin polymerization in cells? |
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Definition
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Term
| Name this organism - non-motile, gram neg. bacilli, humans only, causes dysentery (invasive, bloody) which is self-limiting, spread via people/food/water, uses Shiga toxin. |
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Definition
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Term
| Name this organism - gram pos. rods, motile, non-spore, non-encapsulated, habitat is soil and large animal reservoir, trans via contaminated dairy/meat, most frequent outcome is febrile gastroenteritis. |
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Definition
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Term
| Match the listeria mono enzymes that allows it propel from cell to cell with the descriptions of what they do- 1. InlAB, 2. Hly, 3. ActA, 4. PlcB ; A. Phospholipase lysis of secondary cell vacuole, B. polymerizes actin to move to next cell, C. Hemolysin allows escape from primary entry vacuole, D. Internalin proteins allow primary cell invasion. |
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Definition
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Term
| Name this organism - normal intestinal flora, opportunistic or may acquire virulence, lactose fermenting gram neg, 3 adhesins and some exotoxins, causes UTIs and neonatal meningitis and enteritis syndromes, treatment with extended spectrum penicillins/carbapenems/cephalos. |
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Definition
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Term
| Identify the E. coli strain that has these key features - Heat-labile toxin AB toxin similar to cholera toxin, Heat stable toxin not AB toxin, Watery diarrhea (secretory)“Traveller’s Diarrhea”. |
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Definition
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Term
| Identify the E. coli strain that has these key features - Expresses Shiga toxin, AB toxin A subunit disrupts protein synthesis, Watery diarrhea turns to bloody diarrhea with mucus (inflammatory, invasive, dysentery), Hemolytic uremic syndrome may result from Stx-2, Severe disease with renal failure in very young and very old, Foodborne illness. |
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Definition
| Enterohemorrhagic e. coli |
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Term
| Identify the E. coli strain that has these key features - Type III secretion mechanism induces pedestal formation on target enterocyte forming microcolonies outside cell, destruction of microvilli causes malabsorption, Watery diarrhea, infants in developing countries. |
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Definition
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Term
| Identify the E. coli strain that has these key features - Closely related to Shigella, Plasmid with genes mediating invasive phenotype, Destruction of colonic epithelial cells, may cause ulceration, Diarrhea, dysentery in developing countries. |
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Definition
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Term
| Name this organism - aerobic gram neg rod, Lactose fermentation negative, Oxidase positive, Not normal flora, found in soil and water, endotoxins lipid A and LPS, Pyocyanin inhibits ciliary function, Exoenzymes S and T as well as elastases, One of the most important nosocomial pathogens UTI, pneumonia, skin, ear, and corneal infections. |
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Definition
| Pseudomonas (auerginosa most common) |
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Term
| Since antibiotic resistance is a major problem for Pseudomonas organisms what is done for treatment? |
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Definition
| Empiric “double coverage” with antimicrobial agents from two classes to avoid resistance, Antipseumomnal beta-lactam with aminoglycoside or ciprofloxacin; topical treatments are also used |
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Term
| What category of bacteria are colonizers of the upper respiratory tract and GI, usually part of mixed infection with other Gm+/-, rare in culture, necrotizing infections and abscesses, odontogenic sources, including - bacteroides fragilis group, and pigmented bacteria like fusobacterium, porphyromonas, prevotella, veillonela. |
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Definition
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Term
| What is critical in anaerobic infection treatment since there is a poor penetration of antibiotics into abscesses and devitalized tissue? |
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Definition
| Surgical debridement and removal of necrotic tissue; antibiotics are also used |
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Term
| What type of organisms are mostly odontogenic in source, fastidious gram neg rods, that cause culture negative endocarditis, with ceftriaxone as the treatment of choice? |
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Definition
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Term
| Pastruella multocida is most common from ______ _______ and usually requires debridement or drainage. |
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Definition
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Term
| This type of bacteria is a fastidious aerobic gram neg that has animal and insect reservoirs and can cause orroya fever, chonic skin manifestations, trench fever, or cat scratch disease. |
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Definition
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Term
| These type of organisms require salt water environments to be acquired which can cause skin infection or diarrhea. |
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Definition
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Term
| Name this organism - pleomorphic gram neg rod, obligate aerobe, found in water, trans via aerosol, intracellular pathogen, causing Pontiac fever or pneumonia (legionnaires). |
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Definition
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Term
| What is unique about legionella pathogenesis? |
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Definition
| It binds complement C3b on macros and enters the cell via endocytosis, where it multiplies in the endosome then causes cell lysis to spread |
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Term
| T or F: The T cell receptor-does not undergo class switching or somatic hypermutation. |
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Definition
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Term
| How does T-cell selection in the thymus work? |
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Definition
| T cells are educated in the thymus, where they undergo positive selection to select one type of either MHC-I (CD8) or MHC-II (CD4). They then undergo negative selection to remove self-reactive T cells. |
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Term
| After self selection what Ig’s do B cells express when they are mature? |
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Definition
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Term
| Where in the body does B cell selection occur depending on their affinity for presented antigen by dendritic cells? |
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Definition
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Term
| Mycobacterium tuberculosis prevents fusion with lysosomes, raises the pH, and interferes with IFNg signalling, thus preventing the host macrophage from killing TB, so what do the macrophages do as a result? |
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Definition
| They fuse with other infected macrophages forming a granuloma to contain the pathogen |
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Term
| How is the opsonization of gram + bacillus different from encapsulated bacillus? |
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Definition
| Gram + can bind C3b marking it for opsonization via macros, but encapsulated bacillus require 3-5 days for opsonization via floating antibodies. |
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Term
| What is the classical pathway and which antibody class is used? |
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Definition
| IgG is used to bind C1q for the antibody-antigen complex of the classical pathway |
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Term
| Differentiate between the four types of hypersensitivity reactions. |
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Definition
| Type 1 is IgE mediated thru mast cells, Type 2 is IgG mediated and associated with cell surface antigen (drugs can bind to cell surface, or Eryth Fetalis), Type 3 is IgG mediated through immune complexes, Type 4 is T-cell mediated causing immune reaction |
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