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What is infectivity?
Aility to enter the host and replicate
What is an example of infectivity?
coagulase (enzyme that creates a special sticky coating around staphg to protect it from the host's defenses.)
What is pathogenicity?
ability to produce disease in a healthy host
What is virulence?
disease-producing potential; potency of pathogen and speed of its replication
Virulence is measured in terms of what?
in terms of the number of microorganisms required to kill its host
What is toxigenicity?
the amount and tye of toxin produced as a byproduct of the disease.
What does the hemolysin byproduct do? and an example?
What does the leukocidin byproduct do? and an example?
- destroys WBCs
- Staph aureus
What is an endotoxin and an example?
byproduct of gram (-) bacteria that cause pyrogenic effects and the resulting disease.
- Sugar + fat molecule create disease states.
- ex = Cholera
Other than coagulase, what are two more examples of infectivity?
TB & cammo wax
What is an exotoxin?
Protein enzymes released from living microbes that cause body to swell.
What is an example of an exotoxin?
Staphylococcus (gram +) can grow and reproduce in salt. Toxins create the "sickness" we feel. No smell, no spoilage. Lots of vomiting.
What type of immunity is B-cell immunity?
Humoral (directed against pathogens in EXTRAcellular fluid)
What do B-cells target?
bacteria and viruses
What do T-cells do?
target infected cells and kill tumors!
What is cellular immunity?
- (aka cell-mediated)
- directed against pathogens WITHIN the cells (INTRAcellular)
What do b-cells secrete?
What do t-cells secrete?
Where are b-cells found?
in the spleen
Where are T-cells found?
blood & lymph nodes
Type of ab (immunoglobulin) that can fix complement.
Type of ab (immunoglobulin) that is found mainly in mucus, but also in histamine.
Type of ab (immunoglobulin) that is important in activation of B-cell.
Type of ab (immunoglobulin) that can crossthe placental barrier.
Type of ab (immunoglobulin) that is involved in allergies.
There are fixed macrophages in two of our important body organs. Name the macrophages and the corresponding organ of each.
- Kupffer cells = LIVVER
- Microglia = BRAIN
What is chemotaxis?
- It's how the specialized WBCs know how to get to injury and where exactly to lay down the protein to make a clot;
- Movement of a cell toward or away from a chemical substance.
Chemotaxis is part of what system?
The kinin system
How can we give people immunity?
In the form of an IV (IVG)
What kind of rxn is a type I hypersensitivity?
What kind of rxn is a type II hypersensitivity?
Specific Cytotoxic Rxn
What kind of rxn is a type III hypersensitivity?
Immune Complex - A rxn agains soluble antigens in serum.
What kind of rxn is a type IV hypersensitivity?
Explain what (and which) ab do in a type I hypersensitivity rxn.
IgE ab bind to mast cells & basophils which cause degranulation and a release of histamine
Explain what (and which) ab do in a type II hypersensitivity rxn.
IgG or IgM bind to an antigenic cell and the cell lyses.
What are two examples of a type II hypersensitivity?
- Goodpasture's Syndrome;
- Blood transfusion rxn (given wrong type of bld)
With a type II hypersensitivity rxn, which ab does the body produce and what do they do?
- immunoglobulin ab that can damage tissue cells
- the allergen gets attacked and cells are also destroyed
What is Goodpasture's Syndrome?
- A type II hypersensitivity rxn (cytotoxic) to Paraquat weed killer, chem in cigs, cocain, benzene, kerosene
- Defective ab are produced which attack RBCs
What is destroyed and what can it cause in those with Goodpasture's Syndrome?
Collagen, which clogs the kidneys an lungs and causes renal failure (glomerulonephritis) and widespread hemoptysis
What is an arthus?
a type III hypersensitivity rxn (immune complex) to a vaccine which causes edema, hemorrhaging and necrosis at the site
How are soluble antigens normally removed and what happens to them in a type III hypersensitivity rxn?
- normally removed by macrophages in the spleen and liver.
- they form in lg amts and overwhelm the body immunocomplexes, deposit in tissues and cause inflammation
Which type of cells or ab are involved in a type IV hypersensitivity rxn?
T-cells. NOT antibodies.
Why is the type IV hypersensitivity rxn delayed a day or two?
b/c the macrophages and T-cells need time to migrate to the rxn site
Where does the type IV hypersensitivity rxn show up?
on the skin
What is Stevens-Johnson Syndrome?
a Type IV SEVERE allergic hypersensitivity to MEDICATION
What happens to the skin in those with SJS?
- Degloving (secondary to cytotoxic T-cells)
- epidermal apoptosis
What are the 3 types of autoimmune disorders?
- Type II (Cytotoxic Rxns)
- Type III (Immune complex)
- Type IV (Cell-mediated)
What is Grave's Disease?
A Type II Autoimmune Disorder in which the body attacks the thyroid (overproduction of thyroid hormone; thyroid swells)
What is Myasthenia Gravis and what does it affect?
- A Type II Autoimmune Disorder in which ACh receptors are blocked by ab.
- Muscles that control the eyes, face, neck and limbs are commonly affected. ("tosis" of the eye)
What are two examples of a type II autoimmune disorder?
- Grave's Disease
- Myasthenia Gravis
What is Systemic LUPUS Erythematosus?
- a type III autoimmune DO
- autoantibodies react agains DNA, blood cells, neurons
- after apoptosis, immune complexes form under the skin, in kidneys and in joints.
- widespread inflammation
What are the symptoms (cluster) of lupus?
- oral ulcers
What is Rheumatoid Arthritis?
- a type III autoimmune DO
- IgM auto ab collect inside joints, cause swelling and heat and damage the joint
What are two examples of type III autoimmune DO and who do they affect?
- Lupus and arthritis;
- primarily women
What is Type I diabetes?
- A type IV autoimmune DO
- Insulin Dependent
- The body attacks its own BETA cells in the PANCREAS = destroys ability to produce insulin
What is MS?
- A type IV autoimmune DO
- caused by myelin-reactive T-cells activated by a trigger (infection?)
What are some signs/symptoms of MS?
- axonal loss & scarring
- brain atrophy
- impaired eye movements, blurry vision
- noncoordination in extremities & gait
- heat intolerance
- incontinence, retention, constipation
- cognitive impairment & confusion
What are two examples of type IV autoimmune DO?
- Type I DM
- Multiple Sclerosis
What is the temp range considered to be a sign/symptom of sepsis?
96 - 101.4
What is the heart rate that is considered to be a sign/symptom of sepsis?
sustained HR 90 or more bpm
What is the respiratory rate range that is considered to be a sign/symptom of sepsis?
sustained 20 or more per min
What is the range of WBC count considered to be a sign/symptom of sepsis?
- less than 4,000/mm3
- more than 12,000/mm3
- more than 10% immature neutrophils
When is BP a sign of sepsis?
Severe hypotension (90/40)
What are two signs of sepsis that do not involve numbers?
- bacteria and toxins are in the blood & growing OOC
- cytokines produce widespread systemic VASODILATION
At what level of UOP is considered a sign of sepsis?
No, or minimal UOP (10 cc/hr)
When testing for HIV, and the second HIV test (Blot or IFA) is negative, when do you retest?
in 6 mos to cover the window of poss seroconversion
The ______ test is used to confirm the _______ HIV test
_____ describes what sets the disease process in motion (initial contact); ______ explains how the disease process evolves (cellular & tissue events after contact).
A bacterial infection on top of the flu is an example of what?
A complication (secondary infection)
Excessive bleeding when injured is an example of what in regards to a person with hemophilia?
Decreasing risk factors BEFORE disease occurs.
Early detection of the POTENTIAL for dev of a disease.
Examples of primary, secondary, and tertiary prevention.
- Primary - immunizations
- Secondary - Pap smear to detect HPV
- Tertiary - coctail to treat HIV AFTER diagnosed
Clinical interventions to prevent further deterioration or reduce the complications of a disease once diagnosed.
What are SElye's 3 stages of GAS (General Adaptation Syndrome)?
- Alarm stage
- Resistance/Adaptation stage
- Exhaustion stage
What is the alarm stage of Selye's General Adaptation Syndrome (GAS)?
- the first stage;
- generalized stimulation of the sympathetic NS and the HPA axis
- results in release of catecholamines (NE & Epi)
- and cortisol
What is the second stage of Selye's General Adaptation Syndrome (GAS)?
- body selects most effective & economic channels of defense
During this stage of GAS, cortisol levels drop because they are no longer needed.
What is the Endocrine Response #1 to stress?
- Adrenal MEDULLA dumps epi, dopamine, and sm amts of NE after stimulation by sympathetic NS
- Liver releases glycogen to increase BGL
- Heart contraction and CO increase
- Increase in free fatty acids & serum cholesterol
- Inhibition of insulin from pancreas = increase in glucose
What is the Endocrine Response #2 to stress?
- ADH released from post. pit. = water retention
- CRF in hypoth. stim post pit to release ACTH = stim release of cortisol from adrenal CORTEX
- PRL & GH also released from Post pit
Main effect of cortisol (hydrocortisone).
to increase BGL & aa
Other than it's main affect, what else does cortisol do?
- suppreses B & T cell activity initially while increasing humoral immunity in time
- supports higher BP
What are the two patterns of reversible cell injury?
- Cellular swelling
- Fatty Change
How does cellular swelling occur and what is it?
- It is a pattern of reversible cell injury
- occurs with impairment of the Na+/K+ pump, usually as a result of hypoxic cell injury
Fatty changes are linked to __________. When they occur, small vacuoles of fat disperse throughout the _______.
- INTRAcellular accumulation of fat;
What does a fatty change in cells usually indicate?
a severe injury
How may fatty changes occur?
- normal cells are presented with an increased fat load, or
- injured cells are unable to metabolize the fat properly
How does hypoxia contribute to cellular swelling and membrane damage?
- It causes an inflammatory response - deprives cell of O2 and interrupts oxidative metabolism and generation of ATP.
- Reduced ATP causes acute cellular SWELLING
impairment of Na+/K+ pump causes intracellular K+ levels to decrease, and Na+ and H20 accumulate in the cell (swells!)
Some causes of hypoxia.
- Inadequate amt of O2 in air
- Respiratory disease
- Hypermetabolic states
Fatty change occurs mainly in which organ?
A protective nonspecific defense response to cell injury.
What is the purpose of inflammation?
- To remove the aggravating agent and
- to initiate the healing process
- Limit the injuriuos effect of pathological agent
Inflammation MOST OFTEN occurs when?
with infection. But also develops as a result of an injury to a cell
In inflammation, the adhesion of WBCs to endothelial lining.
The first responders in the vascular response to inflammatin (chemical mediators).
- histamine & seratonin;
- initial vasodilation & capillary permeability
How is redness produced in the inflammation process?
- dilation of arterioles and increased circulation;
- localized bluch from capillary distention
How is heat produced in the inflammation response?
- fluid leakage into interstitial spaced
- increased BF
How is pain produced in the inflammation process?
- pain receptors are stimulated by swollen tissue,
- local pH changes,
- and chemicals excreted during the inflammatory process
How is edema produced in the inflammation process?
- leakage of fluid into interstium;
- blockage of lymphatic dranage
How is loss of fxn produced in the inflammation process?
result of edema & pain
Local or systemic manifestation of inflammation? pyogenic microbes that present infection
Local or systemic manifestation of inflammation? hemorrhagic
Local or systemic manifestation of inflammation? abscesses
Local or systemic manifestation of inflammation? leukococytosis
Local or systemic manifestation of inflammation? increase in plasma proteins
Why do we feel pain with inflammation?
the tissue is swollen, full of exudate & presses on the nerves
What biochemical mediators initiate pain in the inflammation process?
prostaglandins. They also damage nerves.
Chronic inflammation is characterized by infliltration of ______ instead of ______.
- monocytes and lymphocytes;
What are the 3 phases of would healing?
What happens in the proliferative stage of wound healing?
- new tissue is built
- fibroblasts secrete collagen
- granulation starts forming (pink-red)
Which phase of wound healing includes hemostasis and vascular & cellular phases?