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Step 1 Immuno

QuestionAnswer
Which leukocyte is impaired in Job's syndrome? neutrophils, abnl chemotaxis, hyper IgE
What type of leukocytosis does Addison's disease result in? eosinophilia; no sequestration of eosinophils in the lymph nodes
What is the definition of RBC count? ratio of RBC mass to plasma volume
When does absolute polycythemia occur? hypoxic stimulus for EPO release (so SaO2 is decr)
What is the best initial test for polycythemia vera? decr EPO
What are the characteristics of myelodysplastic syndromes? cytopenias and hypercellular marrow; <20% myeloblasts, if more it has progressed to AML
What is the pathogenesis of Adult T-cell leukemia? HTLV-1 activates TAX gene which (-) TP53 suppressor gene; (-)TdT markers
What is the tx of CLL? chlorambucil; nitrogen mustard alkylating agent
What do the medullary sinuses of lymph nodes contain? reticular cells and macrophages; communicated w/ efferent lymphatics
What are the clinical findings of Letterer-Siwe disease? diffuse eczematous rash, multiple organ invovlement, lytic lesions in the skull, pelvis, long bones
What are the clinical findings of Hand-Schuller-Christian disease? fever, localized rash on scalp, ear canals; lytic lesion in skull, diabetes insipidus, exopthalmos
What are some clinical findings in Waldesnstrom's macroglobulinemia that are not found in MM? IgM M spike (IgG in MM), generalized lymphadenopathy, NO lytic lesions
Describe the gross and microscopic findings of the spleen in portal HTN. perisplenitis creates thickened capsule; micro: Ca and Fe concretions present in collagen (Gamna-Gandy bodies)
What defensive protein produced by S. aureus impairs opsonization? protein A; found on cell wall, binds to Fc portion of IgG and prevents activation of complement
What bacterial factor is synthesized by some E.coli to allow bacteria to survive hematogenous spread and to establish meningeal infection? k-1 capsule Ag
What growth factor does C. diptheriae grown on? Cysteine-Tellurite agar
What bacteria demonstrate incr toxin synthesis due to an environmental trigger? Antrhax - war to 37 C w/ CO2 and protein; Tetanus - anareobic environments
Which RNA virus families are (-) sense? DBOPRAF= delta, bunya, ortho, paramyxo, reo, arena, filo
Techoic acid induces TNF and IL1 in gram (+) organisms; what is the similar structure in gram (-)? Lipid A found in outer membrane
What is found in the periplasmic space of gram (-) organisms? beta-lactamases
What is the chemical composition of spores? keratin-like coat, dipicolinic acid
What is giemsa stain used for? Borrelia, Plasmodium, trypanosomes, Chlamydia
What media is C. diptheriae grown on? Tellurite plate, Loffler's media
Why are Clostridium, Baceroides, and Actinomyces species obligate anaerobes? lack catalse and/or SOD and are susceptible to oxidative damage
Which Abx are ineffective against anaerobes? aminoglycosides (require O2 to enter bacterial cell)
What are the facultative intracellular bugs? Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisela, Legionella
What is function of Protein A of S. aureus? Binds Fc region of Ig and prevents opsonization
What destroys exotoxins? 60 C (except staphylococcal enterotoxin)
What is the heat stability of endotoxin? stable at 100 C for 1 hr
What do superantigens stimulate the release of? IFNgamma and IL2
What two toxins inactivate EF2 via ADP-ribosylation? C.diptheriae and Pseudomonas exotoxin A
What toxin does S. pyogenes produce? streptolysin O - hemolysin
What is the function of the toxin that causes whooping cough? incr cAMP by inhibiting the Gi subunit
Which toxins ADP-ribosylate to permanently incr cAMP? cholera, pertussis, E. coli
How does pertussis causes lymphocytosis? inhibit chemokine receptors
When do bacteria produce spores? stationary phase (nutrient depletion)
The ability to take up free DNA from the environment allows strains of strep pneumo to share what virulence factor? IgA protease
What is the term for a cell that has incorporated F+ plasmid into their bacterial chromosomal DNA? Hfr cell
What bacterial toxins are encoded in a lysogenic phage? Shiga-like toxin, botulinum, cholera, diptheria, erythrogenic toxin of s. pyogenes
What organism causes endocarditis after GU procedures? E. faecalis (grows in bile, 6.5% NaCl)
What causes MRSA? altered transpeptidases (PBPs)
What does diptheria look like on gram staining? gram (+) rods w/ metachromatic (blue and red) granules
What encodes diptheria toxin? beta-prophage
What is the anthrax toxin? edema factor (bacterial adenylate cyclase)
What is the only gram (+) bacteria with endotoxin? listeria
What are the toxic effects of long-term dapsone treatment? hemolysis, methemoglobinemia
Which organisms form pink colonies on MacConkey's agar? Klebsiella, E. coli, Enterobacter (FAST) and Citrobacter and Serratia (SLOW)
Which non-lactose fermenting organisms are oxidase (-)? Shigella, Salmonella, Proteus
What does Legionella grow on? charcoal yeast extract cultured w/ iron and cysteine
Psuedomonas aeruginosa non-lactose fermenting, oxidase (+), gram (-) rod
What bacteria invades perivascularly around arteries and veins and releases exotoxins forming black lesions? Psuedomonas (erythema gangrenosum)
How does Shigella propel itself through a cell? actin polymerization
What is Weil's disease? AKA icterohemorrhage leptospirosis - fever, hemorrhage, anemia, jaundice, azotemia, HA abdominal pain, photophobia with conjuctivitis
What two factors do Rickettsiae need that make them obligate intracellular organisms? CoA and NAD+
Describe the Weil-Felix Reaction. pt (with Rickettsial Ab) serum is mixed w/ Proteus Ag, antirickettsial Ab cross-react and agglutinate
What is different about the Chlamydial cell wall? lacks muramic acid
How does the Chlamydial reticulate bodies replicate in the cell? binary fission
In what disease do you have a positive Frei test? lymphogranuloma venereum (acute lymphadenitis)
What is diagnostic for Candida albicans infection? germ tube formation at 37C
What fungal infection shows mold w/ septate hyphae that branch at 45 angles? Aspergillus fumigatus
What fungal infections shows mold w/ nonseptate hyphae that branch at wide angles? mucomycosis
What fungal infection presents with cigar-shaped unequal budding yeast visible in pus? Sporotrichosis
What is the triad of congenital toxoplasmosis? chorioretinitis, hydrocephalus, and intracranial calcifications
How is cryptosporidosis dx? cysts on acid-fast stain in stool
How is giardiasis dx? pear-shaped trophozoite or cyst w/ 2 nuclei in stool
What is the treatment for African Sleeping Sickness? Suramin for bloodborne disease; Melarsoprol for CNS penetration
What is the treatment for Chaga's disease? Nifurtimox
How is Leishmaniasis dx? macrophages containing "amastigotes" (lacks flagella)
What is the tx of Leishmaniasis? sodium stibogluconate
What are some characteristics of Babesiosis? blood smear, no RBC pigment, appears as "Maltese cross"; fever and hemolytic anemia
What type of disease does onchocerca volvus cause? hyperpigmented skin and river blindness, allergic rxn to microfiliaria; tx w/ ivermectin
In what disease can you see worms crawling in the conjunctiva? loa loa; tx is diethylcarbamazine
What disease causes elephantitis? Wuchereria bancrofti
What disease contracted from food contaminated with eggs causes granulomas and visceral larva migrans? toxocara canis; tx is diethylcarbamazine
What disease can become encysted in the liver and cause anaphylaxis if echinococcal Ag are released from cysts? echinococcus granulosus
What is Paragonimus westermani? undercooked crab meat --> inflammation and infection of lung, hemoptysis
What is complementation referring to viral genetics? 1 or 2 viruses infecting cell has a mutation, nonmutated virus "complements the mutated one by making a functional protein
What are some live attenuated vaccines? smallpox, yellow fever, chickenpox, Sabin's polio virus, MMR
What is the only live attenuated vaccine that can be given to HIV (+) pt? MMR
What is the only DNA virus that is ss? Parvoviridae
Where do herpesviruses acquire their envelop from? nuclear membrane
All RNA viruses replicate in the cytoplasm except which ones? influenza and retroviruses
All DNA viruses replicate in the nuclear except which one? poxvirus
Which viruses are naked? Calici, Picorna, Reo, Parvo, Adeno, Papilloma, Polyoma
What are the DNA enveloped viruses? Herpes, Hepadna, Smallpox
What are the DNA nucleocapsid viruses? papilloma, adeno, parvo
What are the RNA enveloped viruses? influenza, parainfluenca, RSV, MMR, rabies, HTLV, HIV
What are the RNA nucleocapsid viruses? enteroviruses, rhinovirus, reo
Why can some babies born to HIV positive mothers be falsely positive initially? anti-gp120 crosses placenta
pt with dysuria, frequency, urgency, suprapubic pain and (+) leukocyte esterase test bacterial UTI
what does a biopsy of Kaposi's sarcoma reveal? lymphocytic inflammation
What are the bactericidal drugs? Vancomycin, FQs, Pens, Amingoglycosides, Cephs, Metronidazole ("Very finely proficient at cell murder")
What are the bacteriostatic dugs? Erythromycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracyclines, Chloramphenicol ( "ECSTaTiC")
What drug is resistant to beta-lactamases and inhibits cell wall synthesis (binds to PBP3)? aztreonam
How can you prevent "red man syndrome" that occurs with vanc administration? antihistamines, slow infusion rate
Created by: ash0403