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Step 1 Immuno
| Question | Answer |
|---|---|
| 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
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