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What is epidemiology?
Study on when and where disease occur and how transmitted.
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What are things to focus on when looking at epidemiological data?
time, number of cases, and population size
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Mobidity vs. mortality?
Morbidity is the diseased state, mortality is death.
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What is pathology?
The study of disease
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What is etiology?
The study of the cause of a disease
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What is pathogenesis?
The development of a disease
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What is an infection?
Colonization or invasion of the body by pathogens
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What is a disease?
State where body isn't functioning normally
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The human adult is estimated to have how many human cells? bacterial cells?
10^13; 10^14
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How are humans described as a "cylinder"?
Humans are a cylinder with a hole through the center with just about every surface colonized by bacteria
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Two examples of sparse areas
stomach and bladder
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The stomach was first thought of to be ___________ .
free of orgs
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The stomach is usually free of bacteria, but helicobacter pylori survives. How? What does it do?
Not normal flora. Stomach ulcers.
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Areas like the bladder can be transiently infected. But what exists to get rid of the intruders?
Normal Clearance Machanisms
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What is normal microbiota?
- Permanently colonize the host
- Don't produce disease
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What is transient microbiota?
- May be present for days, weeks, or months
- disappear
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What are locations for microbiota on and in the body?
- Nose and throat (upper respiratory system)
- Eyes (conjunctiva)
- Mouth
- Skin
- Large intestine
- Urinary and reporductive systems (lower urethra in both sexes and vagina in females)
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What is mircobial antagonism? Example?
- "Competition" between microbes
- Example = vagine
- Matains pH of 4
- Normal flora inhibits overgrowth of yeast
- if change of pH -> increase growth of yeasts (c. albicans)
- if normal flora is eliminated by: antibiotics, excessive douching, or deodorants -> vaginal infections
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What are the consequences of microbial antagonism?
- Normal flora protects host against colonization of potentially pathogenic m/o's
- Complete for nutrients
- Produce substances harmful to invading m/o
- Affect conditions -> pH, O2 availability
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What are probiotics?
Live microbes applied to or ingested into the body, intended to insert a beneficial effect
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In a population diseases are classified by ______?
Behavior within the host
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What is a communicable disease? Directly or indirectly? Examples?
- Disease that spread from one host to another.
- Both directly or indirectly.
- Chicken pox, measles, genital herpes, typhoid fever, tuberculosis
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What is a contagious disease? Examples?
- Spread.
- Chicken pox, measles
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What is a noncommunicable disease? Example?
- Not spread.
- Caused by m/o inhabiting in the body; may cause disease when introduced into the body.
- Clostridium tetani (tetanus) -> produce disease via abrasions or wounds
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What is incidence?
Fraction of a population that contracts a disease during a specific time.
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What is prevalence?
- Fraction of a population having a specific disease at a given time.
- Takes in to account both old and new cases.
- How serious and longa disease affects a population.
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What are the 4 frequencies of occurance pertaining to disease?
- Sporadic disease
- Endemic disease
- Epidemic disease
- Pandemic disease
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What is a sporadic disease?
Disease that occurs occasionally in a population.
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What is an endemic disease?
Disease constantly present in a population.
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What is an epidemic disease?
Disease acquired by many hosts in a given area in a short time
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What is a pandemic disease?
Worldwide epidemic
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What is herd immunity?
- Immunity in most of a population - does not provide reservoir for organism to hide/evolve/grow.
- Vaccination can provide her immunity.
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What is local infection? Example?
- Pathogens are limited to a small area of the body.
- Boils, abscesses
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What is a systemic infection? How does it spread?
- An infection throughout the body.
- Spread via the circulatory system.
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What is a focal infection?
- Systemic infection that began as a local infection.
- Teeth, tonsils, sinuses
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What is bacterium?
Bacteria in the blood.
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What is septicemia?
Growth of bacteria in the blood.
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What is toxemia?
Toxins in the blood.
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What is viremia?
Viruses in the blood.
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What is a primary infection?
Acute infection that causes the initial illness.
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What is a secondary infection? Example?
- Opportunistic infection after a primary (predisposing) infection.
- Sometimes more dangerous than a primary infection.
- ex. Skin and respiratory tract infecitons
- Pneumocystis pneumonia -> AIDS
- Streptococcal bronchopneuminia -> following influenza
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What is a subclinical (inapparent) disease?
- No noticable signs or symptoms.
- Can be carried by people who never develop the illness.
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What is a reservoir?
There must be a reservoir of infetion as a source of pathogens for an infectious disease to occur.
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What is transmissoion?
- The pathogen must be transmitted to a susceptible host by...
- direct contact
- indirect contact
- or by vectors
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What is invasion?
Microorganism enters the host and multiplies.
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What is pathogenesis?
- Microorganism injures the host.
- Directly or by toxins
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What happens to a vector during mechanical transmission?
Passive transport -> insects feet or other body parts.
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What happens to a vector during biological transmission?
Active process -> arthropod bites affected host, pathogen reproduce in vector, transmitted to another host.
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What are nosocomial (hospital-acquired) infecitons?
- Acquired as a result of a hospital stay.
- 5-15% all hospital patients acquire nosocomial infections.
- Infections result of human error and misunderstanding of sterile technique.
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Bacterial pathogenesis processes include:
- Maintained reservoir
- Transported into host
- Adhere to colonize and/or invade the host
- Multiply in host or host cells (nutrient?)
- Bacterial product secretion and damage
- Shedding and return to environment or reservoir
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Reservoir includes _____ , ______, and _____.
humans, animals, and the environment
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Animals are a major carrier of bacterial pathogens. True/False?
True
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What are virluence factors?
Any bacterial products that contribute to disease processes, and mutation of these genes result in decrease in infection potential
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Invasion includes attacking _______, ________, and ______ and can potentially spread throughout the body
basement membranes, cells, and tissue.
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How do microorganisms enter a host to cause disease?
- Adhere to host tissue
- Penetrate or evade host defenses
- Damage host tissues
- Some m/o do not cause disease by direct damaging host tissue
- accumulation of waste products
- toxins
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What are the 3 portals of entry?
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3 mucous membranes (portal of entry)
- Respiratory tract
entry: inhalation -> mouth or nose; drops, moisture, and dust particles - disease: common cold, pneumonia, TB, influenza, measles, small pox
- Gastrointestinal tract
entry: food, water, contaminated fingers; most mo's entering body destroyed by HCl and enzymes in stomach; bile and enzymes in small intestines - disease: hep A, typhoid fever, cholera, etc; pathogen eliminated in feces and can be transmitted to other hosts
- Genitourinary tract
entry: sexual contact - disease: STDs
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How do MO get into body through the parenteral route?
Cuts, lesions.
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MO have a preferred portal of entry. If they enter some other way, will you get symptoms?
No.
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How do MO "adhere" to the host cell?
Things called "adhesin" that cling onto receptors on the host cell.
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How do capsules help invading MO fight the host defense?
Prevents phagocytes from adhering to them.
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How does the cell wall of the invading MO helps fight the host defense? (2 types)
M protien: heat and acid resistant. mediates attachment of phagocytes.
Waxy lipid: resists digestion from phagocytes.
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What causes the "blackening" of an infected site?
Hyaluronidase
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How does invading MO penetrate host's cytoskeleton by rearranging the actin?
Invasins.
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Gram negative type IV secretion system secrete what?
Protein.
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Gram negative type III secretion system secrete what?
Yersnia.
What is Yersina?
Limits phagocytosis and immune signaling.
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Innate vs. adaptive immunity?
- Innate: any pathogen
- Adaptive: specific defense
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Our first line of defense consists?
- Skin
- Mucous
- Normal microbiota
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Our second line of defense consists?
- Natural killers
- inflammation
- fever
- antimicrobial
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What is our third line of defense?
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Where to B-cells mature? T-cells? Lymphocytes?
- Bone barrow
- Thymus
- Lymph nodes
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Peripheral lymphoid organs do what? (3 things)
- Trap antigens
- Initiate immune response
- Signal recirculation of lymphocytes
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What role does dendritic cells have in immunity?
Take material and present them to T-cells.
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What chemical is released by a damaged cell that causes vasodilation?
Histamine
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What are the 3 pathways of antimicrobial activation? How are they activated?
Alternative - does not involved ab. initiated by complement proteins and pathogens
Lectin - marcophage ingest, sti. liver to release lectins.
Classical - Ab binds to Ag
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The complement system produced by the liver destroys microbes in what three ways? Other than those three ways, what other functions do they have?How can MO evade this system?
- cytolysis
- imflammation
- phagocytosis
- recruit phags
- puncture cells causing lysis
- unite specific and non-specific to act as one
- Capsules
- Surface lipid-carbs prevent MAC formation
- enzymes digest C5.
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What is opsonization? Who carries this out?
Process of coating a MO so that phags can recognize and eat. Opsonins carries this out.
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What role do toll like receptors play in immunity?
Attach to MO and induce cytokines. (they say that this right here is a fucka that needs to be messed with)
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What do alpha, beta and gamma interferons do?
Alpha/beta inhibit viral replication
Gamma causes neutros and phags to phagosize bacteria
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How do natural killers destroy a MO?
- Release perforin
- creates pore
- fluid goes in
- lysis
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What's in the humoral component of the adaptive system?
Extracellular and B-cells everything else is cellular component.
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B-cells mature where and is part of the cellular or humoral response system?
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T-cells mature where and is part of the cellular or humoral response system?
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B-cells and T-cells recognize which: Intact and fragment antigens.
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What do antibodies bind to?
Epitope
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CD4 and CD8 goes with what mhc class? (think of making both equal 8)
MHC-II, MHC-I
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What is the variable region of the immunoglobulin?
The part of the antibody that binds to the antigen
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How do
vertebrates produce millions of antibody proteins, if they only have a few
hundred genes coding for those proteins?
DNA rearrangement & somatic mutation
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What is junctional diversity?
DNA sequence variations introduced by the improper joining of gene segments during the process of V(D)J recombination.
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What are the 5 immunological classes? (like sounds like GMA TV!)
G.M.A.D.E.
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What are the functions of each?
IgG
IgM
IgA
IgD
IgE
- IgG: enhance phags, neutro toxins, activate, complement system, protect newborns
- IgM: agglutinates microbes, first to respond
- IgA: protects mucAs
- IgD: innitiate immune response on B-cells
- IgE: allergy and parasites
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Which immunological class is the first to arrive? IgG IgM IgA IgD IgE?
IgM
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Which is most abundant in body?
IgG
IgM
IgA
IgD
IgE
IgA
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Which is most abundant in serum?
IgG
IgM
IgA
IgD
IgE
IgG
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What is the "clonal selection" of the B-cell?
mature B-cell shas it's own immunoglobulins on surface. Sees something, attaches to it and some B-cells proliferate to memory while most into anti-body producing plasma cells.
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How do MHC-I work with CD8 (cytotoxic T-cells) to destroy the virus?
MHC-I are on nucleated cells. If something invades it, MHC-I takes a piece and presents it outside. CD8 is the only one that sees this and if it does, it destroys it.
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Naturally acquired natural and passive immunity?
Natural: immunity from exposure or some transfer of antibodies from immune donor.
- Passive: antibodies without having to look for a
- "donor". like birth, or breast milk.
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artificially acquired vs artificially passive immunity?
Arti acquired: vaccine
Arti passive: transplant of precursor antibodies (bone marrow transplant)
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What is the Edward Jenner experiment?
Cowpox rubbed on skin. Ab formation and memory. Rubbed second time = rapid and intense immune response.
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Salk vaccine?
Inactivated polio vacc. from monkey's kidney. inactivated by formalin.
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Sabin Vaccine.
oral polio vaccine with weakened live virus.
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Difference between Attenuated whole-agent and Inactivated whole-agent vaccines and Toxoids?
Attenuated: Weakened, lifelong immunity, no booster
Inactivated: MO has been killed
Toxoids: aimed at toxins produced by pathogen. boosters every 10. like tetanus.
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What are subunit vaccines?
- Uses antigen fragments
- Safer
- can't reproduce in body
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What are recombinant vaccines?
Uses other microbes programmed for antigenic fraction.
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What are acellular vaccines?
Use fractions of a bacterial cell
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What are conjugated vaccines?
Used for children with low response to vaccines due to capsular polysaccharides.
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What are nucleic acid vaccines?
Newest type not used yet. Naked DNA
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What is the most safest and effective way to prevent disease in children?
Vaccine
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What is the ELISA test?
Unknown antigen is placed on an enzyme. Antibodies are then showered on it. The enzyme will use a signal(chromogen) if the right antibody forms with the antigen.
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What are monoclonal antibodies?
Antibodies that are produced in a lab from a single B-cell.
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What is the difference in procedure between direct and indirect ELISA?
Antibody put first.
Antigen put first.
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