microstuff – Flashcards
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| What is sterilization? What is disinfection? |
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| Kills everything, does not kill endospores |
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| What is sanitization? What is degermation? |
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| Cleansing technique that mechanically removes micro-organisms – not sterile but decreases number of microbes, reducing the number of microbes on human skin |
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| What is the difference between a microbicide and a microbistatic agent? |
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| Kills microbes, temporarily prevents multiplication |
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| What is microbial death? |
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| The permanent loss of reproductive capability even in optimal conditions |
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| What factors affect the death rate? |
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| Number of microbes Nature of microbes in the population Temperature & pH of environment Concentration or dosage of agent Mode of action of the agent Presence of solvents, organic matter, or inhibitors |
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| Physical control of microbes is accomplished by which methods? |
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| Heat and radiation |
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| Which type of heat is the most effective and what method uses this type of heat? |
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| Moist heat under pressure, autoclave |
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| What is the thermal death point? |
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| Lowest temperature required to kill all microbes in 10 minutes |
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| What is pasteurization? |
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| Heat applied to liquids to kill potential agents of infection and spoilage. |
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| What is cold sterilization? |
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| Sterilizing using radiation instead of heat |
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| What is the difference between ionizing and non-ionizing radiation? |
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| Ionizing radiation penetrates much deeper, non-ionizing radiation is UV light and doesn't penetrate past the surface |
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| What method is used to sterilize the air in hospital isolation rooms? |
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| Filtration |
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| What are the four cellular targets of antimicrobials |
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| Cell walls, cell membranes, DNA or RNA synthesis, protein function |
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| What types of microbes are the least resistant? Most Resistant? |
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| Highest resistance --- Bacterial endospores Moderate resistance --- Pseudomonas sp., Mycobacterium, tuberculosis, Staphylococcus, aureus, Protozoan cysts. Least Resistance --- Most bacterial, vegetative cells, Fungal spores, Enveloped viruses, Yeast, Protozoan, trophozoites |
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| Which chemical agents are the closest to ideal agents? |
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| Glutaraldehye and hydrogen peroxide |
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| What class of chemical agents does chlorine and iodine belong to? |
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| Halogens |
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| What class of chemical agents does Lysol belong to? |
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| Phenolics |
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| What is the mechanism of action of alcohols? |
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| Dissolve membrane lipids, disrupt cell surface tension and denatures proteins |
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| What is a chemiclave? |
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| Automatic ethylene oxide sterilizer |
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| What is the mechanism of action of hydrogen peroxide? |
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| Germicidal effects are due to the direct and indirect actions of oxygen which forms free radicals that are highly toxic to microbes |
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| Detergents are useful for which level of antimicrobial effects? |
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| Low level disinfection only |
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| What types of heavy metals have been used for microbial control? |
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| Silver and Mercury |
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| What class of chemical agents does Cidex belong to? What is it used for? |
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| Aldehydes - glutaraldehyde; Sterilize equipment that cannot tolerate high heat |
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| What is chemotherapy? |
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| Any chemical used in the treatment, relief of prophylaxis |
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| What is prophylaxis? |
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| Any chemical used totreat or prevent disease - meds used to prevent disease |
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| What are antibiotics? |
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| Natural substances produced my micro-organisms that can inhibit or destroy other microbes |
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| What is your name? |
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| Ha Ha |
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| What is selective toxicity? |
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| Kills microbial cells without damaging host cells |
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| What are narrow and broad spectrum? |
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| Narrow= limited range of microbes affected by the drug broad = large range of microbes affected by the drug |
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| What are some of the characteristics of the ideal antimicrobial drug? |
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| # 31 Tabel 12.1 in Liz's Review |
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| What are the mechanisms of action of antimicrobials? |
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| Inhibition of cell wall, DNA/RNA function, protein synthesis and interfere with cell membrane structure or function |
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| Which classes of drugs affect the bacterial cell wall? |
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| Penicillins and cephalosporins |
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| Which classes of drugs affect DNA/RNA synthesis? |
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| Fluoroquinolones, Rifampin, antiviral drugs |
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| Which classes of drugs affect protein synthesis? |
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| tetracyclines, aminoglycosides, erythromycin |
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| Which classes of drugs affect cell membranes? |
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| Polymyxins, antifungals |
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| Antibiotics that affect cell wall? |
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| Penicillins, Cephalosporins, beta-lactam antibiotics |
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| Antibiotics that damage the cell membrane |
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| Polymyxins |
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| Antibiotics that act on DNA or RNA |
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| Fluoroquinolones, Rifampin |
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| Antibiotics that interfere with protein synthesis |
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| Aminoglycosides, Tetracycline antibiotics, Chloramphenicol, Macrolides |
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| Antibiotics that block metabolic pathways |
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| sulfonamides |
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| What is unique abut the structure of penicillins? How do microbes become resistant to penicillins? |
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| Beta lactam ring - develop enzymes to break the ring |
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| Penicillins are effective against what types of microbes? |
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| Gram positive cocci - streptococcus, staphylococcus, syphilis, some gram positive rods |
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| What is clavulanic acid? What drug is it found in? |
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| Chemical that inhibits beta - lactamase enzymes; augmentin |
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| What group of antibiotics account for the majority of all antibiotics administered? |
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| cephalosporins |
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| How many generations of cephalosporins are there and what is significant about these generations? |
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| 4 , first gen= gram pos organisms second, third, and fourth gen increases effectiveness against gram negatives |
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| What are 2 examples of aminoglycosides? |
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| Streptomycin and gentamicin |
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| What are the limiting factors of tetracyclines? |
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| GI disruption of normal flora and staining of teeth |
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| Which drugs are synthetic rather than natural antibiotics? |
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| Sulfanomides, fluoroquinolones, trimethoprim, dapsone |
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| Which drugs are used to treat fungal infections |
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| Amphoteracin B, nystatins, and azoles |
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| Which drugs are classified as macrolides? |
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| Erythromycin, clindamycin, vancomyin, rifampin, clarithomycin, azithromycin |
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| Which drugs are used form protozoan infections? |
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| Quinines, metronidazole |
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| what is the mechanism of action of drugs used for helminth infections? |
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| Interfer with their metabolism so they are weakened and able to be excreted from the body |
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| What is the capital of New Mexico? |
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| Will not be on the test ( I don't think ) |
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| What is the mechanism of action of antivirals? |
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| Inhibit viral penetration, multiplication or assembly |
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| How is drug resistance acquired? (4 ways) |
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| Drug inactivation decreased permeability/increased elimination change of metabolic pattern change in drug receptors |
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| What is natural selection and how does it effect drug resistance? |
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| The resistance microbes survive and replicate |
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| What are the 3 categories of adverse host-drug reactions? |
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| Direct toxicity to organs allergic responses changes to the normal flora/ superinfection |
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| Most important considerations in selecting a medication? |
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| The nature of the microbe, the susceptibility of the microbe, overall medical condition of the patient, toxicity of the drug |
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| What is the MIC? |
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| Minimum inhibitory concentration - smallest effective dose of a drug against a specific microbe |
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| What is the therapeutic index? |
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| the ratio of the toxic dose to the effective dose - the smaller the TI the more risk of toxicity to the patient |
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| What is the difference between a true pathogen and an opportunistic pathogen? |
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| True pathogen (adequate infectious dose) will cause in an otherwise healthy person, opportunistic only causes disease when the immune system is compromised |
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| What is the normal flora and where does it occur? |
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| Beneficial bacteria that are present on the skin, in the GI tract, upper respiratory tract and GU tracts |
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| Where are the Staphylococcus spp found? |
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| Skin, mouth, upper respiratory tract, GU |
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| Where are coliforms found? |
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| GI tract mostly and small amount on urinary tract |
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| What are the primary events in the infectious process? |
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| Portal of entry invasion of tissue portal of exit |
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| What does Beta 2 blockers do? |
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| Are you kidding me |
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| What is an infectious dose? |
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| The amount of pathogen required to cause disease in the host |
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| What are the mechanisms of adhesion of pathogens? |
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| Fimbriae, capsules, spikes, hooks, flagella |
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| What are exoenzymes? |
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| Enzymes secreted by the pathogens tat damage tissues and promote invasion |
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| What are endotoxins and exotoxins? |
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| Endotoxins are chemical secreted when the pathogenic cells lyses/dies; exotoxins are secreted by active/live pathogens |
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| What is the difference between localized, systemic and focal infections? |
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| Localized= infection stays in portal of entry Systemic= infection spreads to several area Focal= infection stays in portal of entry but releases toxins that effect other organs |
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| What is the difference between sign and a symptom |
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| Sign= objective finding noted by the observer symptoms= subjective findings reported by the patient |
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| What does the acronym STORCH stand for? |
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| These diseases that can infect the fetus from the mother Syphilis, Toxoplasmosis, others ( Hep B, HIV, chlamydia), Rubella, Cytomegalovirus, Herpes simplex virus |
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| What are some common portals of exit? Is the portal of exit the same as the portal of entry? |
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| The pathogen may leave the body by a different portal than used for the entry - respiratory and salivary, skin scales, fecal, urogenital tract, blood |
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| What is latency? What are sequelae? |
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| The pathogen remains in the body in a dormant state - it may still be shed and the person is a chronic carrier Sequelae - is Long- term permanent damage from the pathogen |
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| What is prevalence? What is incidence? |
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| The number of existing cases in certain population The number of new cases compared to the general healthy population |
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| What is the mortality rate? Morbidity rate? |
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| Total number of deaths in a population due to a certain disease/ Total number of cases afflicting members of the population |
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| What is endemic? Epidemic? Pandemic? |
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| The frequency of the disease is stable in a certain geographical area The frequency is increased in a certain area The disease has spread across continents |
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| What is a disease carrier? What is vector? What is a fomite? |
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| An asymptomatic person who carries the pathogen and is able to transmit it Something that is infected and transmits it between people ( tick, mosquito ) |
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| What is a nosocomial infection? What are the three most common sites of a nosocomial infection? |
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| Disease acquired during a hospital stay Respiratory tract, urinary tract, surgical incisions |
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| What are the 3 lines of host defenses? |
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| First line - physical, chemical and genetic barriers Second line - inflammatory response, Interferons, Phagocytosis Third line - acquired/specific immunity |
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| Which lines of the defense are inborn/ innate? |
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| only the first two lines of defense are inborn/innate third line is acquired |
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| What are some examples of physical barriers? |
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| Skin, rapid regeneration of mucous membranes, nasal hairs, ciliary defense in the respiratory tract, flushing by saliva, tears, sweat, vomiting, defacation, urination |
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| What are some examples of chemical barriers? |
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| Sebaceous secretions are antimicrobial, stomach acid (HCl), lysozyme in tears, lactic acid in sweat |
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| What are the genetic defenses? |
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| some pathogens can only infect certain species some make people immune to disease |
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| What 3 functions is the immune system responsible for? |
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| Surveillance of the body Recognition of foreign material Destruction of foreign material |
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| What are markers and why are they important? |
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| proteins and/or carbohydrates that enable the immune system to identify a foreign particle |
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| Which body compartments are involved in the immune function? |
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| Reticuloendothelial system (RE) extracellular fluid bloodstream lymphatic system |
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| RE system |
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| # 88 |
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| What 2 systems are included in the circulatory system? |
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| Blood stream and lymphatic system |
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| Which type of blood cells are the most responsible for immune functions? |
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| Leukocytes - wbc's |
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| Which cells are agranulocytes? granulocytes? |
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| Agranulocytes - Lymphocytes and monocytes granulocytes - Neutrophils, Eosinophils, basophils |
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| Which cells are the largest phagocytes and what is their origin? |
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| Macrophages- differentiated from monocytes |
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| What types of cells do lymphocytes differentiate into? |
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| B- cells and T- cells |
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| What role does the eosinophil play in the immune system? |
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| Destroy eucaryotic pathogens especially helminth worms and fungi |
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| What role do lymphocytes play in the immune system? |
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| The third line of defense- specific/acquired immunity |
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| Which cells are involved in humoral immunity |
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| B-cells |
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| Which cells are involved in cell mediated immunity |
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| T -cells |
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| What functions are macrophages responsible for? |
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| Phagocytic and killing functions processing foreign material and presenting them to lymphocytes secreting substances that activate other cells of the immune system (cytokines, interleukins) |
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| What is diapedesis? |
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| Ability to migrate out of the bloodstream into tissues |
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| What is chemotaxis? |
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| leukocytes migrate to the site of inflammation by following chemical stimuli |
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| What are the major functions of the lymphatic system? |
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| Provides an auxillary route for return of extracellular fluid to the circulatory system Acts as a drain off system for the inflammatoy response Renders surveillance, recognition, and protection against foreign material through the use of lymphocytes, phagocytes, and antibodies |
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| Where does the lymph come from? How is it circulated? |
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| From plasma by skeletal muscle contraction |
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| Where in the body is lymphoid tissue? |
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| Lymph nodes, thymus, spleen, GI tract (GALT), tonsils |
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| What are the functions of the inflammatory response? |
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| Mobilize and attract immune components to the site of injury Set in motion mechanisms to repair tissue damage and localize and clear away harmful substances Destroy microbes and block their further invasion |
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| What is the inflammatory response? |
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| A reaction to any traumatic event in the tissues |
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| What are the classic signs of inflammation |
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| Rubor-redness (erythema) Calor- warmth (heat) Tumor- swelling (edema) Dolor - pain |
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| What substance initiates fever? What are some examples of these? |
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| Pyrogens- exogenous (pathogens, blood, vaccines) or endogenous ( liberated by wbc's during phagocytosis- interleukin 1 and tumor necrosis factor) |
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| What are some benefits of a fever? |
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| Inhibits multiplication of pathogens, impedes nutrition of bacteria, increases host's metabolism and stimulates immune reactions |
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| Which cells are considered phagocytes? |
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| Neutrophils and macrophages ( which have a larger role in the immune system than the neutrophils) |
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| What are histiocytes? |
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| Specialized macrophages that remain in certain tissues. Examples: langerhans=skin; kupffers=liver; alveolar=lungs |
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| What are the functions of phagocytes? |
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| Survey tissues for microbes, remove damaged tissue, extract antigens from foreign material |
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| What is interferon? |
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| family of proteins produced by leukocytes and fibroblasts that inhibit the reproduction of viruses by degrading viral RNA or blocking the synthesis of viral proteins |
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| What are the different types of interferons? |
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| Alph, Beta, Gamma |
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| What is the complement system? How does it function? |
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| complex defense mechanism with multiple proteins involved that produces a cascade reaction |
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| What are the 3 stages of the complement cascade? |
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| Initiation amplification and cascade membrane attack |
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| What is the final result of the complement system? |
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| Formation of a membrane attack complex to make holes in the cell membrane of bacteria, cells and enveloped viruses. |
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| What is the difference between the 3 complement pathways? |
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| difference is the substance that initiated the cascade reaction |
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| What is an interferon? |
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| All classes are produced in response to viruses, RNA immune products and other antigens Bind to cell surfaces and induce changes in genetic expression Inhibit the expression of cancer genes and have tumor suppressor effects Alpha and Beta types stimulate phagocytes and gamma type is an immune regulator of macrophages, T and B-cells |
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| What is the line of host defense? What are the two features that most characterize this defense? |
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| Acquired specific immunity; specificity to the anitigen and memory |
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| What are the stages of acquired specific immunity? |
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| Development of the lymphocyte system Processing of Antigens and clonal Selection Activation of lymphocytes and clonal expansion antibody production cell- mediated immunity |
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| What are receptors? |
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| Protein or carbohydrate markers on the surface of cells |
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| What are the functions of receptors? |
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| they perceive and attach to foreign molecules, recognition of self molecules, to receive and transmit chemical messages, to aid in cellular development |
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| What is the clonal selection theory and what does it result in? |
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| It is preprogrammed lymphocyte specificity, existing in the genetic makeup before an antigen has ever entered the sytem Each genetically different type of lymphocyte expresses a single specificity- Undifferentiated lymphocytes undergo a continuous series of divisions and genetic changes that generate hundreds of millions of different cell types |
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| What is the specific B-cell receptor? |
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| Immunoglobulins- large glycoprotein molecules that serve as the specific receptors of B-cells and as antibodies |
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| How are immunoglobulins synthesized? |
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| A heavy chain is bound with a light chain then the 2 heavy chains are bound together forming a Y structure |
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| What are antigen binding sites? |
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| Highly variable in shape to fit very specific antigens - at the ends of the Y structure of the Ig |
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| What are MHC receptors? What do the 3 groups of receptors react with? |
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| Receptors found on all cells except RBC's 3 types are: Class I - markers that display unique characteristics of self molecules and regulation of immune reactions. Required for T lymphocytes Class II - receptors that recognize and react with foreign antigens. Located primarily on macrophages and B cells. Involved in presenting antigen to T cells Class III - secreted complement components, C2 and C4 |
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| How are lymphocytes differentiated initially? |
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| Maturation occurs differently for B and T cells: B cells in the bone marrow and T cells in the thymus |
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| What are the different classes of T-cell receptors called and why are they significant? |
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| CD receptors ( cluster and differentiation ) - Type of receptors dictates what is recognized by the T - cell |
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| What are the characteristics of an antigen? |
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| Provokes an immune reaction perceived as foreign by the immune system large enough to provoke an immune reaction |
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| What is an antigenic determinant? |
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| Small molecular group that is recognized by lymphocytes. It is the primary signal that the molecule is foreign. An antigen has many of these |
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| What is a hapten? |
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| Are small molecules that are usually not antigenic unless attached to a larger carrier |
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| What is an allergen? |
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| Antigen that provokes allergic reactions |
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| Are most antigen T-cell dependant or do they react directly with B-cells? |
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| Most are T-cell dependant-only a few can interact with B-cells directly |
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| How is an antigen processed and presented? |
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| Must be processed by phagocytes ( dendrites ) called antigen presenting cells ( APC ). An APC/dendrite alters the antigen and attaches it to its MHC receptor where it can be presented to the B and T-cells. |
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| What are Interleukins? How are they involved in antigen processing and presentation? |
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| These are peptides that carry signals between leukocytes |
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| What are the different types of Interleukins? |
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| Interleukin-1 is secreted by APC to activate T(sub)H cells; Interleukin-2 is produced by T(sub)H to activate B and other T cells |
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| What happens to the B-cell once it is activated? |
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| They enter the cell cycle in preparation for mitosis and clonal expansion. Divisions give rise to plasma cells that secrete antibodies and memory cells that can react to the same antigen later |
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| What 2 fragments make up the structure of the antibody? What do they attach to? |
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| Fab - antigen binding fragment binds the antigen and Fc - crystallizable fragment binds to various cells and molecules of the immune system |
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| What are functions of antibodies? |
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| unite with, immobilze, call attention to, or neutralize the antigen; specifically opsonization, neutralization, agglutination and complement fixation |
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| What is opsonization? |
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| Antigens become coated with specific antibodies so that they will be more readily recognized by phagocytes to dispose of them |
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| Neutralization? |
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| antibodies fill the surface receptors on a microorganism to prevent it from functioning normally |
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| What is agglutination? |
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| Cross-linking cells into larger clumps |
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| Complement fixation? |
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| The interaction of an antibody with the complement can result in the specific rupturing of cells and some viruses |
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| How many classes of immunoglobulins are there? Which class is more prevalent? |
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| Five, IgG |
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| Which class of Ig's is the first responder with an initial anitgen encounter? |
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| IgM |
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| Which class of Ig's is in many secretions of the body and is present in breast milk? |
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| IgA |
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| Which class of Ig's has the largest molecules? |
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| IgM |
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| Which class of Ig's are produced by memory B-cells in a second exposure? |
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| IgG |
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| Which class of Ig's interact with mast cells and basophils and is involved with allergic responses? |
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| IgE |
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| What is cell mediated immunity? What cells are involved with it? |
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| Rather than making antibodies to control foreign antigens, the T-cells act directly against antigens and foreign cells |
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| What are the 3?????????? types of T-cells? |
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| Helper, suppressor, cytotoxic and delayed hypersensitivity T-cells |
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| How are the different types of T-cells differentiated? |
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| The functions of T-cells vary in their CD receptors and sensitivity to cytokines |
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| Which receptor is common to all t-cells? Which t-cells have CD4? CD8? |
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| C2 is common to all T-cells; T-helper cells have only CD4 receptors; T-cytotoxic cells have only C8 receptors |
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| What is the most prevalent T-cell? What is significant abut it? |
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| T-helper cells ; the conductor of the immune response by assisting other T and B-cell. Reacts directly by receptor contact and indirectly by releasing cytokines such as interleukin-2 |
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| Are you getting tired yet? |
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| yes |
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| How does a patient with an HIV infection become immunocompromised? |
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| HIV depresses and destroys the T-helper cells |
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| What is the function of T-cytotoxic cells? |
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| Foreign receptors are presented to it and it mounts a direct attack against the target cell by secreting perforins that lyse cells by creating pores in the target cell membrane |
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| What is the funtion of T-suppressor cells? |
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| Inhibit the actions of other T-cells and B-cells and regulate the immune response by producing protein inhibitors that prevent lymphocytes and macrophages from reacting with antigens |
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| What is the function of T-delayed hypersensitivity cells? |
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| Responsible for allergies occurring several hours or days after contact such as the tuberculin reaction (TB test) |
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| What is natural immunity? |
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| Acquired as part of normal life experiences |
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| Artificial immunity? |
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| acquired through a medical procedure such as a vaccine |
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| What is active immunity? |
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| Results when a person is challenged with Ag (???)that stimulates production of AB |
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| Passive immunity? |
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| preformed AB are donated to an individual |
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| What type of immunity is the result of an infection and recovery? |
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| Natural active immunity |
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| What type of immunity is the result of pregnancy and lactation? |
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| Natural passive immunity |
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| What type of immunity is the result of a vaccination? |
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| Artificial active immunity |
